Social prescribing for older adults: An evolutionary concept analysis

BACKGROUND: Social prescribing has emerged as an innovative model for addressing social determinants of health among older adults by linking healthcare services with community-based resources. Despite growing international adoption, conceptual ambiguity has limited consistent implementation and evaluation in nursing practice, particularly as the model has evolved across diverse policy and health system contexts. PURPOSE: This study aimed to clarify the concept of social prescribing in older adults using Rodgers' evolutionary concept analysis, with attention to antecedents, attributes, consequences, and implications for nursing. METHODS: A systematic search was conducted in CINAHL, PubMed, AgeLine, and PsycINFO for publications between 2018 and 2025. Eligible peer-reviewed studies addressed social prescribing or related healthcare-initiated community referral interventions targeting adults aged 60 years and older. Data extraction was guided by Rodgers' framework and focused on surrogate terms, related concepts, antecedents, attributes, and consequences. Fifteen studies met inclusion criteria. FINDINGS: Analysis revealed common surrogate terms such as community prescribing, social referral, and link worker facilitation. Related concepts included care coordination, case management, and social support interventions. Key antecedents encompassed social isolation, multimorbidity, life transitions, healthcare recognition of social needs, and enabling policy frameworks. Core attributes included person-centered care planning, non-medical community focus, link worker facilitation, systematic referral pathways, and healthcare-community integration. Across contexts, the concept demonstrated increasing formalization through structured screening and coordinated referral mechanisms. Reported consequences included reduced isolation, improved wellbeing, enhanced social networks, and stronger healthcare-community collaboration, alongside potential strain on under-resourced community services. CONCLUSIONS: Social prescribing is best understood as a dynamic, person-centered, healthcare-initiated process connecting older adults to non-medical resources through structured referral pathways. While shaped by national policy environments, its essential attributes remain transferable across systems when adapted to local infrastructure. Clarifying its defining characteristics strengthens nursing's role in assessment, coordination, and evaluation, supporting effective interventions that promote aging in place.