BACKGROUND: At VACHS, we identified oncology patients at risk for loneliness subsequent to COVID-19 social distancing recommendations. Cancer patients are older, more physically frail and immune compromised, making them high-risk for complications related to covid-19 infection. Given this risk, social isolation might extend significantly beyond the initial period of lockdown for oncology patients. To protect this vulnerable population, we shifted from face-to-face visits to telemedicine. A workgroup formed to develop an intervention to support Veterans at-risk for prolonged isolation. Social isolation is a well-established risk factor for poor health and mortality (Caccioppo & Hawkley, 2003). For individuals with cancer, social isolation has been linked to poorer survival (Reynolds & Kaplan, 1990; Hislop, Waxler, Coldman, Elwood, and Kan, 1987). Research in woman with ovarian cancer suggests that limited social support is associated with higher angiogenic cytokine levels (Costanzo et al., 2005). Thus, bolstering social support for individuals with cancer is important for both psychological wellbeing as well as possibly for cancer outcomes.
METHODS: A Friendly Phone Call Program (FPCP) was developed in collaboration by the Cancer Coordinator, Health Psychologist, Recreation Therapist and Social Worker to support Veterans who live alone, are elderly, or are physically frail throughout the COVID- 19 pandemic. Oncology providers were educated to identify socially isolated Veterans at-risk for distress during their phone appointments. The FPCP was notified of referrals by alert in CPRS. Charts were reviewed and triaged to the appropriate team member (i.e., psychology, recreation therapy, or social work). Follow-up phone calls were made utilizing a script to introduce FPCP and educate patients on available psychosocial services. In concert with FPCP, recreation therapy groups were offered by phone.
RESULTS: From 4/1/20 to 6/30/20, oncology providers identified 45 patients with psychosocial needs related to social isolation. 23 received outreach from Recreation Therapy, 9 by mental health, 8 by Social Work and 3 get weekly check-in calls from the Cancer Coordinator. 2 patients have since passed away.
CONCLUSIONS: VACHS developed a collaborative, multidisciplinary intervention that identifies patients at risk for psychosocial distress related to loneliness and provides ongoing, individualized, emotional support using existing staff and technology that is replicable in any VA setting.
