“Loneliness is different than isolation and solitude.  Loneliness is a subjective feeling where the connections we need are greater than the connections we have.  In the gap, we experience loneliness.  It’s distinct from the objective state of isolation, which is determined by the number of people around you.” - Vivek Murthy, two time (and current) Surgeon General.

We have heard a lot about loneliness and social isolation, particularly during the pandemic with enforced social distancing and near imprisonment of older adults in nursing homes.  In this context, we bring in two experts on these topics, Carla Perissinotto and Ashwin Kotwal, to explain:

• How loneliness and social isolation overlap and are distinct
• How common these measures of social well being are in geriatrics and palliative care
• Why we should care as clinicians
• How we can ask about them
• How we should respond to care for patients who are lonely or isolated

Some key references from among the many we discuss on the podcast:

• Loneliness in older adults predicts functional decline and death (JAMA IM 2012)
• The epidemiology of loneliness and social isolation during the last years of life (JAGS 2021) 
• Use of high risk medications among lonely older adults (JAMA IM 2021) 
• Integrating social care into healthcare: GeriPal podcast with Kirsten Bibbens-Domingo 
• Coalition to end social isolation and loneliness 

-@AlexSmithMD