Southampton researchers have identified ways to boost older patients' recovery at home.
Social isolation not only affects people mentally, but also increases their risk of poor physical health. It often affects older people.
Southampton researchers, led by Dr Harnish Patel, have identified it as a major factor that could hinder recovery after leaving hospital. Their review has been published in Geriatrics.
The results could inform better hospital discharge practices to support these patients' recovery.
The health impact of loneliness
Previous research has found our health is associated with the quality and quantity of our social relationships.
People who are lonely are more at risk of disease. This is true for both physical and mental health conditions. They are more likely to develop cardiovascular disease, depression and anxiety.
They are also at a greater risk of dying, with a mortality risk 1.5 times higher than average. This is similar to the risk from light smoking, and more than the risk from hypertension and obesity.
Loneliness after leaving hospital
Older people are more likely to be socially isolated when they return home from hospital. They are therefore at particular risk of loneliness hindering their recovery.
The research team looked at the results of studies reporting poor discharge outcomes in older people between 2010 and 2022. They identified seven suitable reports, covering 1,131 patients.
They listed three key themes from the data - social isolation, lack of support, and depression and anxiety. Older patients with symptoms of depression had an increased likelihood of death.
They also found social isolation can mean that illness goes unnoticed. These older people may find it harder to seek help if their condition gets worse.
Informing better hospital discharge
The researchers suggest various ways to improve older patients’ discharge from hospital.
They recommend planning discharge with the patient and their caregivers earlier in their stay.
They also suggest better communication and more information on discharge.
This would mean patients and caregivers are clear how they can support recovery. It would also mean they know who to contact if the patient’s health gets worse.
The researchers also suggest comprehensive geriatric assessment during the inpatient stay could be beneficial for short and longer term care planning. This would not only cover physical health, but also identify those at risk of poor outcomes from mental health disorders and loneliness.
Dr Harnish Patel is a Consultant in Medicine for Older People at University Hospital Southampton. He is also Associate Professor of Geriatric Medicine at the University of Southampton.
He is a researcher within the NIHR Southampton Biomedical Research Centre (BRC). His research sits with the BRC’s Nutrition, Lifestyle and Metabolism theme.
“This review highlights the importance of considering social and psychological factors when older people leave hospital,” he said.
“We hope our findings will inform the development of a better, more holistic discharge process.
“This would promote patients’ recovery, helping to reduce the need for readmission. It would therefore both reduce pressure on NHS services and improve care for older patients.
However, further study in this area needs to be undertaken.”
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