She was a shut-in admitted to the telemetry unit. This was the latest of several readmissions that year, and we suspected that she could not afford the co-pays for her medication.
When I inquired if she needed medication assistance, she admitted to not taking the drugs as prescribed. So, I offered to get a pharmacist to come talk with her about how to take her medication or help her find a financial assistance program.
Come to find out, she knew how to take the drugs, and her Medicare plan fully covered the prescription costs and provided home delivery.
As I asked further questions to determine the issue, she finally looked at me and said, “I cannot take them on an empty stomach.” Her problem was not noncompliance with medical advice; she simply did not have enough food at home.
I knew where she went to church and, fortunately, that church had a food assistance program. The problem was no one at the church knew she was struggling to obtain sufficient food.
Alignment Healthcare, a tech-enabled Medicare Advantage company, released the results of it 2022 Social Threats to Aging Well in America on Aug. 29, 2022.
The study of 2,601 U.S. adults 65 and older revealed that economic instability, loneliness, food insecurity, transportation, mental health and technology are the biggest impacts on the health care of senior citizens.
According to the study, 1 in 5 seniors cited cost as a top barrier to health care and 1 in 6 carries significant medical debt. As health care costs continue to surge, the figures will increase.
The rising cost of food creates another challenge, with the study finding that 15% of senior adults are concerned with their ability to buy groceries in the future. Others have problems preparing food or being able to travel to the store or to doctors’ appointments
Health care, food and transportation are all interconnected. A problem in one area impacts the other two.
In addition, isolationism has become a hallmark of old age in America. According to Alignment’s study, 1 out of 5 of seniors wrestle with loneliness. The rising rate of loneliness is a direct contributor to depression and other mental health conditions among the elderly.
In 2020, the U.S. witnessed over 46,000 suicides, 9,137 were people 65 and older, according to the National Council on Aging. Seniors represent 12% of the total U.S. population and 18% of total suicides.
Older adults experience more grief than younger adults as they have lost more loved ones. They wrestle with more chronic diseases and a loss of self-sufficiency. Loneliness and isolation only exacerbate these factors.
The nation needs to do more in providing mental health services to the elderly, but that will require a focus on transportation and technology, as 20% lack appropriate means to access services.
Most senior adults that I meet are open to assistance. They appreciate help with shopping, meals and doctor visits. The problem is that we live in an increasingly disconnected society.
As a result, seniors often do not reach out as they do not want to be a burden, while kindhearted individuals and community groups do not offer assistance because they often do not know the names of the senior adults in their neighborhoods let alone what they may need.
One of my favorite early ministry experiences was at a small rural church. Twice a week, I would take the church van to pick up several elderly ladies and take them grocery shopping in town. Then, I would carry their groceries inside and help put them away.
These trips were more than buying food. They were a chance to check in on each lady and make sure she did not have additional needs. During these trips, I could check up on these ladies, ensure they had adequate food, and listen to their stories.
The point is that we made a conscious effort to ensure these ladies were still connected with the church even when they could not regularly attend worship. This connectedness allowed us to see the unmet needs and find ways to address them, while also combatting isolation.
We have a limited capacity to manage health care cost at a community level, but we can impact food insecurity, transportation, isolation and mental illness through initiatives like this shuttle service.
One of the emerging problems of our technology-driven society is a lack of connectedness. We have access to dozens of social media platforms, but we often don’t know the people living in our neighborhood very well.
Our communities of faith need to do better. The key to addressing negative social determinants of health is not always to open a new clinic or spend millions of dollars on additional health care services. It starts by caring enough to meet the basic needs of those around us.
Author’s note: In compliance with patient privacy rules, the case study of the woman being readmitted to the hospital multiple times does not reflect a specific patient. Rather, it is a composite reflection of conversations the author has had countless times with multiple patients over the last 15 years.
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Senior Staff Chaplain and Clinical Ethicist at the Baptist Health Medical Center in Little Rock, Arkansas.
