Connection & Purpose
Social isolation sits alongside smoking, inactivity and high blood pressure on the list of things that shorten healthy life and raise the risk of dementia. Having people to see, somewhere to be and something that needs doing is not a soft benefit; it shows up in how long people stay independent. The places in the world where people live longest are organized around it.
What this means for healthspan
Connection and purpose describe the people, places and activities that give daily life shape: family and friends, community groups, work or volunteering, faith or cultural ties, and the sense that what you do matters. Researchers separate social isolation, which is having few contacts, from loneliness, which is the feeling that your social needs are not being met. You can have one without the other.
Large studies link both isolation and loneliness with poorer health and a higher risk of dementia. Most of this evidence is observational, so it shows an association and cannot prove cause. People who are unwell may withdraw, and withdrawal may add to illness, so the effect runs both ways. Even so, connection is something many people can change, and it affects how well a health plan fits a real life.
What we assess, and why
We ask about who you see, what you do in a typical week, whether you feel lonely, what gives your days meaning, and whether anything makes it hard to take part, such as hearing loss, mobility, transport, mood or caring for someone else. We may use short validated questionnaires where helpful.
The aim is to understand your situation so that a plan is realistic. A plan to walk daily or join a class means little if you have no way to get there, or no one to go with.
What we may assess
Social engagement, loneliness, relationship support, meaningful activity, caregiving responsibilities and barriers to participation.
What is used is chosen for you, according to your individual risk, clinical appropriateness, the evidence and what you decide with your physician.
Why it matters
Understanding a person’s social environment and priorities helps shape a health plan that supports connection, belonging and a fulfilling life.
Examples of assessments and investigations
These are examples of what may be considered. Which of them are used for you depends on your history, your risk and what you decide with your physician.
Social history and daily routine
A conversation about household, family, friends, work and community involvement. It may be part of any visit.
Loneliness screening questions
A few validated questions about how often you feel left out or lacking company. Considered when you or your family raise concerns or when other assessments suggest withdrawal.
Social isolation measures
Questions about how often you have contact with others and how many people you can rely on. May be used to see change over time.
Meaningful activity and purpose
A discussion of roles, hobbies, goals and values, so that recommendations match what matters to you.
Caregiver strain assessment
A short tool for people who care for a partner, parent or friend. Considered when caregiving is affecting sleep, health or time for yourself.
Barriers to participation
A review of hearing, vision, mobility, continence, transport, digital access, cost and confidence. Where a barrier is found, it may lead to referral or practical changes.
Mood screening
Validated questions about low mood and anxiety, since these often overlap with loneliness. Considered when the history suggests it.
Community linkage
Help finding local groups, programs and services. This is sometimes called social prescribing and can be offered where it suits you.
What the evidence supports, and where it is uncertain
What the evidence supports
- Social isolation and loneliness are consistently associated with poorer physical and mental health and with higher risk of early death in large population studies.
- The 2024 Lancet Commission on dementia prevention lists social isolation in later life among 14 factors that may be modifiable, and estimates that addressing all 14 might prevent or delay up to about 45% of dementia cases across a population.
- The WHO Commission on Social Connection has called social connection a priority for public health and describes loneliness and isolation as under-recognized.
- Some programs, especially group activities, skill building and approaches with several purposeful components, have been reported to reduce loneliness in older adults.
Limits and uncertainties
- Most evidence on loneliness and health is observational. It cannot show that loneliness itself causes illness, or that fixing it will reverse a health risk for an individual.
- Population estimates, such as the share of dementia that might be prevented, are modelled. They do not predict any one person's risk.
- Reviews of loneliness programs for older adults vary widely in quality, and many of the underlying studies are small or at risk of bias. What works for one person may not work for another.
- Loneliness questionnaires cannot tell us why someone feels lonely. A screening result is a prompt for conversation, not a diagnosis.
- Being alone is not the same as being lonely. Some people are content with few contacts, and we do not assume that more social activity is better for everyone.
From findings to a plan, and what follows
How findings can inform a plan
Findings are used to shape a plan around what you value, not to set a social target. This may include practical steps such as treating hearing loss, addressing low mood or sleep, arranging transport, or connecting you with local groups, volunteer roles or community programs. Where caregiving is a strain, the plan may include respite and support options. Any goals are chosen with you and kept achievable.
Follow-up, monitoring and coordination
We may revisit connection and purpose at later visits, particularly after a life change such as retirement, bereavement, a move, an illness or a new caregiving role. If you feel persistently low, hopeless or unsafe, we will assess this promptly and, where appropriate, coordinate with your family doctor, mental health services or community supports. If you are in crisis, call 9-1-1 or 9-8-8.
What happens here
The approach is the same in every area: establish where you are, change something on a cadence, then measure again to find out whether it worked. Connection & Purpose does not have a program of its own. It is assessed as part of every membership and worked on with your physician, and with the dietitian, kinesiologist or counsellor where that is what it needs.
Caregiver Strain Index (CSI)
13 questions about how caregiving is affecting you, not the person you care for. It runs in your browser and takes about 5 minutes. Your answers are not sent to us; if you're signed in, your result is saved to your account.
Reliable places to read more
These are independent organizations. Monarch Health does not control their content and has no arrangement with them.
211 British Columbia (United Way BC)
211 British Columbia: free, confidential help finding community services(opens in a new tab)
Province of British Columbia
Seniors in British Columbia: health, safety, home and community care(opens in a new tab)
Canadian Institute for Social Prescribing
What is social prescribing?(opens in a new tab)
National Seniors Council, Government of Canada
Preventing social isolation and loneliness in Canada(opens in a new tab)
World Health Organization
Commission on Social Connection(opens in a new tab)
Where to go next
The other areas we work on