When the heart muscle increasingly struggles to do its work pumping blood to the body, the condition is called heart failure. Heart failure affects more than 6 million people in the United States, and it can have a negative effect on quality of life. Because heart failure can influence mobility and energy levels, one of those side effects can be social isolation.
Research now suggests that social isolation, in turn, can worsen health outcomes for heart failure patients, leading to more hospitalizations and increased risk for death.
The takeaway for patients and healthcare providers is that part of the treatment for heart failure should emphasize staying social. Indeed, with one in four people with heart failure reporting that they feel moderately or very socially isolated, ensuring social contact may be a crucial part of recovery and rehabilitation.
Reasons for social isolation
Many factors can contribute to the social isolation of someone with heart failure, and those factors often interact.
Age is one, says Dale Mueller, MD, a cardiothoracic and vascular surgeon with Memorial Hospital in Jacksonville, Florida. With age, a host of related factors can pile up, among them dementia, limited physical mobility, an inability to drive, a decreasing circle of family and friends or a lack of access to transportation, he says.
Making time for social engagement can be tough for heart failure patients because the condition often requires frequent doctor visits, which can squeeze leisure time. At the same time, some medications for heart failure are designed to reduce fluid volume, which can increase urinary frequency that prevents long-distance travel, says Dr. Mueller.
And there’s another condition that can interfere with a desire to see other people: depression, which often accompanies heart failure.
Not everyone with heart failure will fall into the older age group. The condition can strike at younger ages, too, because of heart problems present from birth or that develop in women during pregnancy, for example. But younger people with heart failure are less likely to experience as much social isolation, says Mueller, because they tend to still be able to get around easily.
What to do about social isolation and heart failure
If mobility keeps someone with heart failure from getting out to socialize, then healthcare providers, friends and family need to step in.
“Several groups would probably have to be involved to improve social isolation issues,” says Mueller. He offers the following suggestions for what each group can do.
Patients: If you have heart failure, you need to adhere to your medications, diet and exercise programs, says Mueller. Research shows that when a patient with heart failure sets up a “self-care” plan, following it can help ward off poor outcomes and can promote sticking to a medication schedule. Maintaining yourself in the best health possible can be important to a good quality of life and for helping to lower one’s risk for depression.
Another way to help stave off the blues that can come from isolation is to live in an adult community. It’s a move that can “diminish or eliminate” factors that interfere with socializing, according to Mueller. Patients also shouldn’t be squeamish about encouraging family and friends to visit or to go on excursions, he adds.
And finally, Mueller says, patients should “embrace safe travel.” That might involve taking trips that get you out of the house and into new environments that are safe for you and don’t overly tax your stamina, with built in rest breaks and appropriate supports such as a walker or supplemental oxygen, depending on your condition.
Healthcare providers: Mueller notes that clinicians should be following guidelines for care. Going a step further, he says, providers can encourage patients to engage in social activities. A few ways to keep in touch with mobility-impaired patients with heart failure are telehealth or home visits, says Mueller. Ask your healthcare provider whether those are solutions that might work for you.
Providers who have concerns about a patient’s social isolation can always use a brief screening tool to assess the situation, so if you or a loved one with heart failure has concerns, ask your doctor about a screening.
Clinicians can also be on the lookout for depression by screening every patient with heart failure for symptoms. Addressing symptoms of depression can help with many aspects of care in heart failure, including renewing interest in activities and helping patients adhere to their medication schedules.
Family and friends: Help your loved one get out and about, says Mueller, by offering assistance for travel and for participating in social situations. Schedule visits and excursions frequently.
Being conscious about staying in contact with a person with heart failure can have an impact beyond preventing poor heart failure-related outcomes. Social isolation is also linked to increased risk for other kinds of heart disease and stroke, both problems that tend to arise in patients with heart failure.
