The impact of social interaction or relationships becomes more important than numbers or mere superficial ties. Someone can be living with a partner and yet still feel isolated due to internal conflict or change in self image. Over extended periods, loneliness develops as well as persistent alterations in immune system function and stress response. A descrepancy often occurs between an individual's perceived versus actual supportative relationships. it is also important to make the distinction between maladaptive isolation and healing time alone. Adjustment periods to environmental change, role identification or life phase/situation may require concentrated thinking and limited social contact in so that negative thinking is not perpetuated
Studies from the literature show a definitive link between social isolation, disease progression and increased morbidity. This is particularly the case with the older adults population diagnosed with heart failure. Depression frequently accompanies comorbidities such as CHF, but is not readily identified in many situarions since disease trajectories are similar in both. Health care providers/teams should assess symptoms which may be seen in both diagnoses and treat based on evidence based protocol. Common symptoms associated with CHF include: fatigue, low energy levels, appetite change, peripheral edema, cognitive impairment and decreased motivation. Symptoms of depression include : sad affect, loss of interest/appetite, low energy , fatigue, sleep disturbance and cognitive impairmment. Overlapping signs and symptoms can make differentiation between clinical problems difficult to determine.