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Social Prescribing for Older Adults Program

What is social prescribing?

Social prescribing is a holistic approach to healthcare that bridges the gap between medical and social care services. Through this approach, healthcare professionals refer and connect patients to community-based programs, services and activities to improve their health and enhance their quality of life. Social prescribing promotes health equity by addressing social needs that affect health and well-being – like access to adequate housing, food, transportation, income and social support. This helps older adults with limited natural supports to thrive. If a healthcare professional notices that a patient has non-medical, health-related social needs, they can make a social prescription to a Link Worker.

What is Healthy Aging Alberta’s Social Prescribing for Older Adults Program?

Healthy Aging Alberta’s Social Prescribing for Older Adults Program is currently supporting 10 regional social prescribing demonstration projects in Edmonton, Calgary, Lethbridge, Jasper, Whitecourt, Innisfail, Sylvan Lake, Red Deer County, Vulcan, and Strathmore/Wheatland County. Healthy Aging Alberta distributes funding to community-based social prescribing networks in these communities, and they determine how to functionally incorporate social prescribing pathways into their community in a way that aligns with principles established by Healthy Aging Alberta. Each of these communities has at least one Link Worker that receives referrals from healthcare providers across primary care, home care, and hospital discharge.

“It has been a long time since I breathed clean air in my apartment and talking to other seniors in the Seniors Centre Without Walls program has made me feel that I am not alone.”
– Jummie, Edmonton 55+ Social Prescribing Program Participant

“I recently had a client call me to thank me for the referral to the social prescribing program and said that the Link Worker was an ‘absolute angel’. I highly recommend this program and will continue to refer my clients as needed.” – AHS Homecare Case Manager

Frequently Asked Questions

Any regulated healthcare professional can make a social prescription. This includes doctors, nurse practitioners, nurses, dieticians and pharmacists. If a healthcare professional notices that a patient has non-medical, health-related social needs, they can make a social prescription to a Link Worker.

If a healthcare professional determines that a patient has a non-medical need that is affecting their health and well-being, they can write a social prescription by completing a referral form. For information about referral forms in communities that Healthy Aging Alberta is supporting with social prescribing, please contact [email protected].

First, an intake worker in a community-based, seniors-serving organization receives the social prescription. Next, the intake worker connects the patient to a Link Worker who works with clients to identify their social needs. If a client has complex needs or requires long-term support, the Link Worker will refer them to a social worker.

There is a growing body of evidence that shows the impact of social prescribing. In 2017, the University of Westminster published an evidence summary that identified 28% fewer primary care consultations and 24% fewer emergency room visits for people receiving social prescribing support. Healthy Aging Alberta is building out an evaluation framework to continue to grow the evidence base for social prescribing in a Canadian context.

Link Workers are non-clinical professionals employed by community-based, seniors-serving organizations. They help clients to develop and achieve a personalized set of goals by accessing community resources. Link Workers do not replace the role of healthcare providers. Rather, they complement a client’s medical care by providing additional support. Link Workers also refer more complex issues to social workers who are a part of the social prescribing network in community.

No, Link Workers are not employed by the health system. By working within community-based, seniors-serving organizations, Link Workers serve as a single point of contact for accessing a range of community-based programs and services. Through their work, they become embedded into informal communities of practice. As a result, Link Workers often have more flexibility than if they were employed by the health system.

Link Workers and community-based social workers can provide outreach interventions that are required outside of the clinic. Together, they work in a team-based environment to navigate the variety of programs and services available in the community. The Link Worker can also collaborate with healthcare professionals to streamline service delivery for the client.

Link Workers connect clients to recreational and social programs, assist with accessing financial benefits and provide referrals to assisted transportation programs. They also connect clients to in-home support services, such as housekeeping and snow removal.

A social prescribing program can still grow without a dedicated Link Worker. Healthcare providers can still make referrals to community-based organizations that provide programs and services for seniors. However, the client may not benefit from the full wrap-around supports and assessments that the Link Worker role provides.

There are many other community programs that offer navigation, or “active signposting”. This is a light touch approach where staff provide information to signpost people to community programs and services. This approach often works best for people who are confident and skilled enough to find their own way to these programs and services after a brief intervention. Social prescribing offers a more engaged approach for people who may require additional knowledge and support to get involved in these programs and services.

About 80% of a person’s health depends on social determinants of health like adequate food, housing, income and relationships with others. A Link Worker will do an assessment of a client’s social determinant of health needs to determine which programs and services can best meet these needs. A social prescription to community-based programs and services that meet these non-medical needs can improve mental and physical health and well-being. This includes improvements in blood pressure, weight loss, reduced cholesterol, and sugar levels, as well as health-related behaviours such as increased physical activity, reductions in alcohol, drug consumption and intake of unhealthy foods.

Social prescribing is not the only approach to addressing the wider determinants of health for older adults. There are many other programs that help to address some of the broader issues impacting their health. However, we have to be pragmatic in facilitating the connection between health and community services. Many older adults go to their doctor or healthcare provider because it is a familiar route to seek help.

Social prescribing provides a way for healthcare providers to refer older adults to community-based services when they have more than just a medical need. If someone doesn’t have a family physician, another regulated healthcare professional could make a social prescription to a Link Worker. Alternatively, if someone doesn’t have a connection to a health professional, they can contact 211 and ask to be connected to an outreach worker in their community.

If you already have a social prescribing program for older adults in your community, you can advocate for increased funding for the Link Worker role to colleagues in the health sector and government. You can champion this approach of service delivery when talking to colleagues across the sector.

If you don’t have a social prescribing program for older adults in your community, you can connect with Healthy Aging Alberta for resources to use when speaking with potential funders.

Elijah BeaverSocial Prescribing – Healthy Aging Alberta