1 in 5 older adults don’t have someone they can depend on in time of need. It’s driving up ER visits and food insecurity

“I love all that,” the 79-year-old who lives alone in South Florida tells Fortune. “And then, all of a sudden, that stops because of your age.” 

As she got older, Solos had trouble with her back and a car accident reduced her mobility. She wanted to keep her job but could no longer work in the same capacity. 

“The job offers are not out there for the older person, unless it’s just sitting behind a desk or doing something very quietly,” Solos says. Without work interactions, and with her daughter relocating further away, Solos became increasingly isolated and lonely.  

“There’s no medication for loneliness,” she says. 

A new report fromPapa exclusively obtained by Fortune, which offers companion care for older adults, highlights the pervasive loneliness experienced by a majority of people over 65. Loneliness and social isolation have serious health implications, like an increased risk for dementia, anxiety, depression, and heart disease, but it also leaves seniors with limited options for help in emergency situations. 

No one to help in an emergency

Papa surveyed over 28,000 Medicare Advantage members between January and June of this year and found three in five people are either lonely or extremely lonely, based on UCLA’s 3-point loneliness scale. The report also found one in five people don’t have anyone they can lean on in case of emergency, and 40% of respondents find it somewhat difficult or very difficult to find social support. 

“The question for us was, who are these people?” Kelsey McNamara, the senior director of research at Papa, tells Fortune. “What are their challenges? What do they need to thrive?”

Solos, who uses Papa’s companion support, wanted someone who would ensure her home had the proper safety precautions to prevent falls, and help her find accessible hobbies. Solos also wanted someone to talk to. 

“I told [my companion] how lonely I was,” she says. “That is the worst thing that happens as you get older.” Now, she and her companion play games and go on walks together—he has made her feel important again.

McNamara says the results of the survey underscore the pervasiveness of poor social health, which includes the interdependent relationships between social isolation, transportation access, financial security, and health outcomes.

“If you don’t have that one person to help you, and you also don’t have transportation, you don’t have that person to get you to doctor’s appointments, get you access to food, and actually get you into your community and to visit other people and to be social,” McNamara says. 

Loneliness puts people at risk for poor mental and physical health. Isolation, which can lead to loneliness, also puts people in immediate danger when they don’t have a trusted emergency contact. The report echoes this danger and found loneliness increases the risk for emergency room visits by two-fold, and severe loneliness does so by three-fold. 

“If you don’t have that outlet, you tend to seek crisis-driven care,” McNamara says, and not having someone to lean on can increase people’s chances of forgetting medications and appointments, not adhering to adoctor’s recommendations, or having an accident in the home alone. “Things escalate to a point where you have to go to the emergency department.”

The survey points to the need to prioritize screenings at medical checkups directed at identifying social health needs like food, transportation, and healthcare access, along with social connectedness. Health care providers should be asking older adults if they have someone who is easily accessible in times of need, according to Papa. 

“We need interventions to address social health at all levels,” McNamara says. “Just like we treat any other health condition. We need screening. We need prevention, and we need different types of treatments.”