Combatting the Epidemic of Loneliness in Seniors
We live at a time when we can instantly communicate with distant friends and family members using a few mouse clicks or taps on a touchscreen. Despite advances in communications technology and the increasing connectedness it brings, research indicates that, as a society, we are lonelier than we have ever been.
A 2020 report published by Cigna shows that more than half (61 percent) of U.S. adults report feeling alone sometimes or always. This number paints an exceptionally bleak picture since it is based on data collected in mid-2019—before the COVID-19 pandemic and widespread public health measures that resulted in extraordinary levels of social isolation. Although, people from all walks of life can feel isolated and alone, perhaps no other age group feels the keen sting of loneliness more than the elderly.
Understanding Loneliness in Seniors
Aging brings many changes that can contribute to a more solitary life. One of the biggest issues for seniors is that their social circles begin to shrink as the years go by. On one hand, retiring grants older adults more free time for hobbies and relaxation, but it also puts an end to meaningful interactions with colleagues on a regular basis. Additionally, friends, significant others and family members may move away or pass away.
Carol Bradley Bursack, caregiving expert and author of Minding Our Elders: Caregivers Share Their Personal Stories, saw firsthand how deeply her grandparents and parents grieved these personal losses.
“I had to wonder how much fun it is to be the last one standing,” she recalls. “My mom, who once loved getting Christmas cards, found that the number of cards she received dwindled each year, and the ones she did get often contained sad news of death or disease.”
Even those who still live close by may be difficult to meet with in person due to changes in mobility. This is especially true once a senior stops driving for safety reasons. Age-related conditions, such as hearing loss and eye diseases, can also make it so difficult to communicate that it doesn’t seem worth the effort anymore.
Embarrassment can be a factor as well. Many older adults living with chronic medical conditions not only face logistical challenges when it comes to leaving the house, but they may also feel insecure about these “obvious” signs of aging. Incontinence is a common concern that can complicate an elder’s social life, while the use of durable medical equipment like mobility aids and oxygen therapy systems can affect their self-confidence.
It is trying enough for a senior to maintain healthy relationships despite these challenges. When one’s entire peer group is experiencing any combination of these factors, it can be difficult (if not impossible) to get together or keep in touch with friends on a regular basis. Sadly, many seniors experience a decline in the quantity and quality of their relationships as they age, whether it is self-imposed or due to forces outside of their control.
Families Struggle to Support “Forgotten Elderly”
Even when an older adult is being taken care of by family caregivers, T. Byram Karasu, M.D., distinguished professor emeritus at the Albert Einstein College of Medicine’s department of psychiatry and behavioral sciences, says that there is often little attention paid to deep, engaging communication between a senior and the rest of their family. The changes listed above certainly play a role, but caregivers are usually so worn out from juggling their day-to-day responsibilities that they have little time or energy left for singlehandedly meeting all a senior’s emotional and social needs.
Bobbie Smith, a professional caregiver for Home Instead Senior Care with more than six decades of elder care experience under her belt, echoes this sentiment but believes the structure of families is also an underlying issue. She says that a modern trend is the breakdown of extended family relationships like those between grandparents and grandchildren. This has caused many elderly people to feel as though they have been “pushed to the side” and forgotten about. Family units that have spread across the country find it particularly difficult to make time for visits and even regular communication by phone and mail.
The Effects of Loneliness on Elderly Individuals
A lack of fulfilling personal relationships doesn’t just affect one’s mental and emotional health. In fact, it can also take a toll on one’s physical health. A 2018 meta-analysis of 35 research articles that measured loneliness and mortality confirmed that feeling lonely is a risk factor for all-cause mortality for both men and women.
Another study conducted by researchers from the University of California, San Francisco (UCSF) found that adults 60 years old and older who reported feeling lonely were at higher risk for functional decline in addition to the increased risk of death. This decline manifested specifically in participants’ abilities to perform activities of daily living (ADLs)—the basic tasks (bathing, dressing, transferring, toileting, continence and eating) that are necessary for truly independent living. In other words, unchecked loneliness has the potential to jeopardize an elder’s ability to live independently and accelerate their need for assistance from a family caregiver or another source of long-term care.
Loneliness is thought to act on the body in a way that is similar to chronic stress. According to research funded by the National Institute on Aging (NIA), it raises levels of stress hormones like cortisol, which impairs immune responses and contributes to inflammation. Prolonged loneliness is hard on the body and can leave seniors vulnerable to mental health issues like anxiety and depression and chronic conditions like heart disease and obesity. Another investigation published in JAMA Psychiatry even found an association between feelings of social detachment and the development of brain biomarkers common in preclinical Alzheimer’s disease.
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Alleviating Elderly Loneliness: Solutions and Ideas
Smith feels there are many steps that can be taken to rectify this situation.
“It’s so easy to combat loneliness in the elderly, but we have to be willing to get up and make it happen,” she explains.
If your loved one is feeling socially isolated or lonely, use some of the tips below to help them feel more connected and supported.
Listen and Observe
“We often don’t listen enough to the people we love,” laments Tina Tessina, Ph.D., psychotherapist and author of The Ten Smartest Decisions a Woman Can Make After Forty.
According to Tessina, “Saying, ‘tell me more,’ is a gift you can give from your heart.” Encouraging someone you care about to express themselves can help you discover what they’re thinking and feeling and what interests and passions lie dormant, just waiting to be rekindled.
“You’ve got to really dig deep and find out what their interests were before and get them to try to awaken those forgotten activities,” Smith says.
Keep in mind that once-loved activities may no longer interest them or fit their abilities. Do your best to help them discover ways to adapt these hobbies or find new pastimes altogether.
Develop a Strategy for Minimizing Isolation
Once you know what your loved one enjoys doing, you can use this information to develop a personalized plan for eradicating loneliness.
For example, Smith was caring for an angry 91-year-old man who was reluctant to communicate when she discovered that he had a passion for singing and photography. One day while walking down the hall with him, she began to belt out a few bars of Bing Crosby’s Let Me Call You Sweetheart. The man responded by singing right along with her and grudgingly admitting, “You’re OK.”
Today, he sings for his community and is a member of a club for retired photographers that Smith helped him get in contact with. Sometimes our elders just need a creative push to step outside their comfort zone and seek out the meaningful interactions they yearn for.
In that same vein, healthy seniors can often find a renewed sense of purpose and connection by helping others who are less fortunate. They can deliver Meals On Wheels, join the Retired Senior Volunteer Program, or volunteer for hospice or other worthy organizations. Even older adults who are less vigorous can still be encouraged to volunteer. If they can see well enough, they may be able to read a book to a grandchild or a group of preschoolers. If elders live in a facility and can still walk well, they could accompany less mobile residents when they go to the dining room for meals, help decorate for holidays or events, or hand out snacks.
“If an elder feels he or she can contribute to the well-being of their family, friends or community, the burden of loneliness can feel lighter,” Bradley Bursack emphasizes.
Let Them Teach You
Smith encourages caregivers to connect with loved ones by allowing them to pass along some hard-earned knowledge.
“I learn something new every day because I am being taught by the best,” she admits.
The key is to let the senior’s passions and experiences guide the lesson plan. For example, if your mother loves to embroider, ask her to teach you how to do it. This not only has the potential to be a great bonding experience, but it can also help restore a bit of balance to the child-parent dynamic that may have been lost once caregiving began.
Bridge the Generation Gap
According to Smith, caregivers can play a vital role in fostering relationships between elders and their youngest relatives. Grandkids often perceive their grandparents as weird or boring, when they should consider their elders sources of valuable wisdom and fun. Try to devise ways of helping multiple generations of your family spend time together, whether in person, by phone or via mail.
“When family members or staff actively listen to older adults tell stories of their past, they may feel more like they still are part of an active life,” notes Bradley Bursack. “This type of validation can help blunt the sharp edge of loneliness.”
Karasu also points out that seniors have the potential to contribute a lot to their families if they are allowed to remain engaged. He says this is doubly important, considering research has shown that an unengaged elderly adult will experience cognitive decline at a much faster rate than a senior who is mentally stimulated by interactions with other people.
It’s the Thought That Counts
Another piece of advice from the pros is to urge other family members to reach out to an elderly loved one. It doesn’t have to be a grand, time-consuming gesture. Something as simple as sending a card, sharing a favorite meal, or calling for 30 minutes once a week can go a long way to making a senior feel loved and connected to the rest of the family.
Consider Senior Living
For some older adults, no amount of effort encourages them to come out of their shell. It may take a large change to get them to renew their interest in people and activities. While moving to a senior living community might seem like a viable solution for a lonely elder, it isn’t always that straightforward. The success of such a transition depends on the individual person and the fit of the facility. It also takes time and effort for a loved one to adapt to and grow comfortable with their new living arrangement and neighbors. In fact, it may appear to backfire at first.
“When seniors move to nursing homes or assisted living communities, it can be a totally disorienting experience,” Karasu points out.
Family members and staff should provide gentle encouragement to help new residents acclimate, meet new people and participate in activities and events. One of the best parts of senior living (aside from receiving necessary care) is that opportunities for socialization and fulfillment are available right outside a resident’s door. While some older adults may struggle at first, Bradley Bursack’s mother-in-law immediately benefitted from this change in environment.
“Even with my daily visits, she had become fearful, paranoid and introverted living alone in her condominium,” she recalls. “Once we moved her to an excellent nursing home, she bloomed. I believe that she finally felt safe. The staff encouraged her to play the piano once again—something she hadn’t done for years. She sat with a special group at meals. She had found her home and never looked back.”
Aging loved ones who aren’t quite ready for the move to senior living can also benefit from in-home care services, adult day care services, community senior centers and other local resources.
Taking Steps to Alleviate Loneliness in Older Adults
Just as the physical effects of aging must be dealt with, so, too, must the emotional aspects. The reality is that we can’t protect our loved ones from the pain of losing a spouse or a shrinking social circle. Some degree of loneliness becomes inevitable as people experience significant changes later in life.
However, we can look for ways to help older generations interact with others and feel truly useful. We can listen when they feel like talking and ask questions, showing our interest. We can show our love through touch and eye contact. If you know someone who is lonely, pick up the phone or stop by to visit. Send a note or a treat in the mail. Helping to mitigate the damaging effects of loneliness and isolation can ultimately contribute to better overall health and quality of life for our aging loved ones and ourselves. All it takes is that first step to get started.
Sources: 2018 Cigna U.S. Loneliness Index (https://www.cigna.com/assets/docs/newsroom/loneliness-survey-2018-full-report.pdf); Association of loneliness with all-cause mortality: A meta-analysis (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754055/); Loneliness in older persons: a predictor of functional decline and death (https://www.ncbi.nlm.nih.gov/pubmed/22710744); Social isolation, loneliness in older people pose health risks (https://www.nia.nih.gov/news/social-isolation-loneliness-older-people-pose-health-risks); Association of Higher Cortical Amyloid Burden With Loneliness in Cognitively Normal Older Adults (https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2575729)