John (a pseudonym) aged 72, lives alone in his own home.
He has been prescribed a number of medications to manage three different long-term health conditions but it is apparent to his general practitioner that he is not taking the medications as prescribed.
John was referred to a healthcare service that provides support in this type of situation, with the outcome that daily in-home visits were set up to ensure John took his medications correctly.
While this seems like the logical solution to ensure that John gets the right medications at the right time, John’s quality of life measurement, taken before the intervention and then six months later, showed a surprising decline. In fact, he had slid into a severe depression.
Inadvertently, the well-intentioned healthcare support had cut him out of his kete hauora – his basket of wellbeing and health.
On reflection, the manager of the healthcare support service recalled that John had been “the hub of the wheel within his neighbourhood … he knew everything about everybody, because of [the social] interactions [that occurred] when [family, neighbours and friends] came in to help him with his medication and other tasks around his house”. She recognized the daily in-home visits had in fact been detrimental for John’s overall well-being because “[our service] had ripped it [John’s kete hauora] out … and taken away his whole purpose… without even realising that we’d done it”.
John’s story is just one of the many stories collected and analysed by a social connection research project, #WellConnectedNZ, a two year research project between researchers from the Canterbury District Health Board, University of Otago, and University of Canterbury, funded by the Health Research Council, the Healthier Lives National Science Challenge and the Ministry of Health.
The focus of the #WellConnectedNZ project is to explore social connection and its intersection with health and wellbeing for people living with long-term health conditions in Christchurch.
We heard John’s story during a community consultation through the project and have heard many similar reflections from healthcare professionals and service providers.
What does research mean for healthcare providers?
Is there a message to healthcare providers in John’s story?
What can healthcare providers do to support individuals’ existing social connections whilst still providing suitable ‘care and support’?
The #WellConnectedNZ research team is working together with health service providers, health systems, and community groups to encourage recognition of the vital importance of social connection for individual and community health and to cultivate an ethos of support for the weave of the kete that provides holistic wellbeing and health via meaningful social connection.
What we have heard from many healthcare providers is a desire to cultivate a mindset of working together with patients toward what they want to achieve and how they would prefer to go about this, because, as articulated by a healthcare provider, “wellness is in the whānau as a whole, not in individuals”.
While individuals and whānau may not be experts in the medical sense, they are the experts in knowing their own lives and what they want or need to flourish.
An individual and their whānau might seek something different than what health professionals think is most important. They may have a more holistic view of social connections, and “their priority might not be your priority” because a focus on the medical condition itself ignores the social, emotional and spiritual aspects of an individual and their whānau.
It seems that approaching an interaction with a patient through the traditional problem/solution model results in things being done to and for people.
Instead, could health professionals think more creatively about developing healthcare plans with patients in order to partner with the individual and whānau and work alongside them to support their preferred activities to formulate a pathway moving forward?
One way to do this is by reframing the ways in which we invite information from patients—by really listening to what they say and by taking the time and care to understand their own life context, their wishes and preferences, and how their social connections sustain them and help them flourish.
In John’s case, perhaps it would have been helpful to ask about and understand his perspective on how he feels connected in his community, and then take this into account when developing a plan for his healthcare together in partnership with John. By our asking holistic questions and taking the time to truly listen, we can help stories like John’s have a different ending, resulting in increased social connection and individual wellbeing instead of isolation and poor mental health outcomes.