Social Isolation and Loneliness in Older Adults Opportunities for the Health Care System (2020) / Chapter Skim
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8 Education and Training
8 Education and Training
Pages 147-170
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From page 147... ...
Members of the health care workforce (including professionals and direct care workers) are vital in the effort to prevent, identify, reduce, and eliminate the negative health impacts of social isolation and loneliness in older adults.
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From page 148... ...
social isolation and loneliness in older adults. All types of health professions and careers need to be involved, and the necessary changes can be catalyzed through various types of education, including direct care worker education, lifelong learning by health professionals and direct care workers, and public educational campaigns.
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The compelling evidence base for the health effects of social isolation and loneliness provide faculty and educational leaders with a strong rationale for including this content in educational programs. The following sections highlight several opportunities for influencing the education and training of the formal health care workforce.
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From page 150... ...
This updated format is particularly germane to addressing social isolation and loneliness in older adults because much of the support needed may come from other sectors, including sources within neighborhoods and communities. Because the interventions needed to address social isolation and loneliness draw on so many different professions and disciplines, including a variety of frontline workers such as direct care workers and community health workers, volunteers, and family caregivers (sometimes called informal caregivers)
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National Goals for Health and Well-Being The Healthy People national goals provide yet another opportunity for encouraging the inclusion of content related to social isolation and loneliness in health professions education as well as in programs aimed at practicing clinicians and other professionals who care for older adults. Since 1990 Healthy People goals have been developed for each decade, and social cohesion is one of the topics addressed in the section on social determinants of health for Healthy People 2020 (HHS, 2019b)
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From page 152... ...
CURRENT EDUCATION AND TRAINING OF THE HEALTH CARE WORKFORCE In 2016 an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine (the National Academies) developed a framework for educating health professionals to address the social determinants of health (NASEM, 2016a; see Figure 8-2)
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From page 153... ...
SOURCE: NASEM, 2016a. The 2019 National Academies consensus study report Integrating Social Care into the Delivery of Health Care discusses the role of education in developing a workforce that can understand and address social factors and recommends the incorporation of competency-based curricula on social care into health professions and continuing education programs (NASEM, 2019)
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From page 154... ...
Finally, this document indicates that nurses provide a link between hospitals and community environments and supports the importance of nurses' roles in assessing social and psychological needs as well as physical health needs and making referrals to community services as needed. Master's and Clinical Doctoral Essentials similarly focuses on comprehensive care based on a full biopsychosocial model that includes the social determinants of health (AACN, 2006, 2008)
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Social workers are trained to serve as a bridge to the broader community and are well positioned to make connections between health providers and the larger social service community (CSWE, 2015)
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As interventions directed at social isolation and loneliness in older adults gain traction, direct care workers will need to be properly trained, educated, and supported. Governing and shaping the direct care workforce are a variety of broad and inconsistent state and federal training requirements in addition to an under-resourced training and public education landscape.
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From page 157... ...
across different direct care occupations, states, and service delivery models.5 While these requirements need significant improvement, they provide opportunities to expand the skills of direct care workers on social isolation, loneliness, and older adults. For example, federal guidelines for home health aides require that the aides must be trained in the "physical, emotional, and developmental needs of and ways to work with the populations served by the Home Health Agency, including the need for respect for the patient, his or her privacy 5 Federal regulations today require that home health aides and nursing assistants receive at least 75 hours of training, including at least 16 hours of supervised practical or clinical training.
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. Other Members of the Health Care Workforce Aside from health care professionals and direct care workers, many other members of the health care workforce may be especially important to addressing social isolation and loneliness because they are natural connectors of the health care system with the local communities.
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For example, nonprofit organizations in the direct care sector have used public education campaigns to: • focus attention on the growing workforce shortage in home care at the national and state levels, • support specific policy goals, • reach workers with information about their rights and benefits, and • explore future solutions for the full elder care workforce (EWA, 2019; PHI, 2018b, 2019d)
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Of note, the Reframing Aging Project was steered by a group of leading organizations in the aging services field: AARP, the American Federation for Aging Research, the American Geriatrics Society, the American Society on Aging, the Gerontological Society of America, Grantmakers in Aging, the National Council on Aging, and the National Hispanic Council on Aging (FrameWorks Institute, 2019)
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From page 161... ...
. AARP Foundation Connect2Affect The AARP Foundation has partnered with the Gerontological Society of America, Give an Hour, n4a, and UnitedHealthcare to launch a campaign, Connect2Affect, to address social isolation and loneliness (AARP Foundation, 2019)
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From page 162... ...
This model encourages attention to the social determinants of health, and as social needs are identified, the social work care coordinator addresses them in both health care and community-based settings. Using this model, social isolation and loneliness could be identified before discharge and addressed throughout the care transition process and as the patient integrates back into the community.
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From page 163... ...
. Education and research on the causes and outcomes of social isolation and loneliness in older adults, screening tools, assessment strategies, and effective interventions need to be connected with clinical practice in ways that accelerate improvements in practice, change systems of care when needed, influence payment systems, increase health, and highlight successful teamwork among health professionals, direct care workers, and community members.
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. FINDINGS AND CONCLUSIONS • Educating health care professionals, direct care workers, and the general public on the health impacts of social isolation and loneliness is essential.
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• Addressing social isolation and loneliness is a community-wide concern and requires that health professionals, direct care workers, and members of the community work together to achieve solutions. NEXT STEPS AND RECOMMENDATIONS Broadly based workforce development needs to account for the entire range of the health care workforce within formal degree and postgraduate programs for health professionals and in training programs for direct care workers and community members.
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From page 166... ...
• Health care systems, associations representing all types of health care workers (e.g., American Medical Association, American Nurses Asso ciation, American Psychological Association, National Association of Social Workers, American Geriatrics Society, American Association for Geriatric Psychiatry, associations representing direct care workers) ; health-related organizations (e.g., American Heart Association)
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From page 167... ...
These types of campaigns could have several audiences and purposes. For example, given that direct care workers often have the most interaction with the most vulnerable populations of older adults, the direct care sector could create public education campaigns that build awareness and support among direct care employers and workers about the health impacts of social isolation and loneliness.
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From page 168... ...
They need to know how to make and follow up on referrals to community services that may be helpful or that may specifically be intended to address social isolation and loneliness. This includes learning to work with direct care workers (e.g., home health aides, personal care workers)
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Aside from developing educational opportunities specific to social isolation and loneliness, the committee recognizes that there are existing educational opportunities that could incorporate issues of social isolation and loneliness, such as those focused on the social determinants of health and those that address the inclusion of social care needs into clinical practice. Finally, as the evidence for interventions evolves, these educational and training opportunities need to expand to include new and updated evidence-based practices for preventing, assessing, and treating the negative health and medical impacts of social isolation and loneliness.
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