As I picked up the heavy pile of paper patient notes from my pigeon hole, I spotted a memo clipped to the front of the patient’s notes.
The brief note read: ‘Please call this patient back, she asked to speak to you regarding her condition.’ I immediately recognised the patient’s name, and I wondered what she might want to talk about.
When I phoned her, it quickly became apparent that she did not require any medical input. She just wanted to talk. With genuine concern she asked, ‘How are you doing doc? How have you been over the pandemic?’
I paused for a moment as the questions took me by surprise. The sincerity was evident in her voice. She – like so many people – has found the pandemic hard.
She has learning difficulties and several health difficulties to manage. And on top of that, she is lonely. I spent some time listening to her, but then we talked about patient support groups she could access.
I wanted to give her lots of time, but also knew there were other patients and pressing jobs waiting that I needed to turn my attention to.
Loneliness and health
We are not meant to be alone. We all need connection, community and companionship. We may appreciate some time on our own, but that is of course different.
Loneliness is associated with worse health outcomes – it’s associated with negative physical and mental health, such as an increased risk of coronary heart disease and stroke, and a risk factor for depression in later life.
One meta-analytic review concluded that ‘the influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality’ (Holt-Lunstad et al, 2010).
If we seek to address other risk factors such as obesity and smoking, should we do more to address loneliness in our patient populations?
Loneliness and disability
Despite the huge variation in individual disabilities and the unique situation of each person, loneliness is something that can be a significant problem for many.
Research by Sense found that over half of people with a disability report feeling lonely. This rises to 77% when considering young people with a disability.
Loneliness and carers
Carers play such an important role in our society. However, 81% of carers have felt lonely or socially isolated as a result of their caring role.
These issues can be compounded by financial difficulties, lack of time to meet with others, and feeling unable to talk openly about their caring responsibilities.
What can we do about this?
One of our many privileges as doctors is that our patients often share their vulnerable thoughts and worries with us – though with vast workloads and never-ending clinical demands, it can feel overwhelming to tackle the issue of loneliness on top of everything else.
Loneliness may be described explicitly by a patient, or we may infer it from the patient’s history. It can feel like a non-medical issue.
However, when there is growing evidence about the impact of loneliness on health outcomes, should we be taking a more active role in diagnosing loneliness and referring our patients?
It only takes five minutes to quickly find out what local services can help your lonely patients.
Some commissioners have social prescribers or care coordinators, primary care colleagues may know of some local services, and there may be befriending charities near you.
There are so many great resources out there to signpost patients to.
Melody Redman is deputy chair of the BMA board of science and a clinical genetics registrar in Yorkshire