September 2018 Special Feature
Combating the Epidemic of Loneliness in Seniors
Written by Anne-Marie Botek
We live in an age where we can communicate with friends and family members across the country and around the globe with a few clicks of a mouse or taps on a smart phone screen. However, 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. Perhaps no other age group feels the keen sting of loneliness more than the elderly.
Why Are Older Adults so Lonely?
Age brings many difficult changes that 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. Friends, significant others and family members move away or pass away. Even those who still live close by may be inaccessible due to limited mobility, especially once a senior can no longer drive safely. Age-related changes in one’s physical condition, such as hearing loss and low vision, can 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 who suffer from incontinence, are on oxygen therapy or need to use a mobility aid to get around not only face logistical obstacles when it comes to leaving the house, but they must also overcome feeling self-conscious about these “obvious” signs of aging.
It is trying enough for a senior to maintain healthy relationships despite these challenges, but 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 on a regular basis. Sadly, many seniors experience a decline in the number and quality of their relationships as they age, whether it is self-imposed or due to outside forces.
Even when a senior is being taken care of by family caregivers, T. Byram Karasu, MD, from the department of psychiatry and behavioral sciences at the Albert Einstein College of Medicine, says that there is often little attention paid to deep, engaging communication between a senior and the rest of the family. The changes listed above are factors, but caregivers are usually so worn out from juggling their day-to-day responsibilities that they have little time or energy left for truly meeting 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 issue actually runs deeper throughout the structure of families. 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. This is especially true for family units that have spread across the country and have difficulty making time for visits and even regular communication by phone and mail.
The Consequences of Senior Loneliness
In addition to the damaging mental effects of feeling that one lacks fulfilling personal relationships, feeling lonely can also take a toll on one’s physical health. A University of California, San Francisco (UCSF) study found that participants 60 years old and older who reported feeling lonely saw a 45 percent increase in their risk of death. Isolated survey respondents also had a 59 percent greater risk of mental and physical decline than their more social counterparts. This decline manifested specifically in participants’ abilities to perform activities of daily living (ADLs), the six basic tasks that are necessary for truly independent living. In other words, loneliness has the potential to accelerate a senior’s 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. It raises the levels of stress hormones like cortisol in the body, which impairs immune responses and contributes to inflammation, mental illness and conditions like heart disease and diabetes. Another study published in the Journal of the American Medical Association Psychiatry even found that loneliness may be associated with the development of brain biomarkers associated with preclinical Alzheimer’s disease.
Lastly, psychologists from the University of Chicago analyzed data from an ongoing multi-generational cardiovascular study that began in 1948 and discovered another remarkable characteristic of loneliness: It is contagious. Older adults who feel lonesome are more prone to behave in ways that may cause other people to not want to be around them. Researchers found that solitary seniors have a tendency to further isolate themselves by pushing people away and not making efforts to engage with others. Furthermore, the few people that lonely seniors interact with are likely to become lonely themselves and follow the same path to the outskirts of their social networks. This has serious implications on the health and social lives of family members who are caring for lonely seniors.
Ways to Alleviate Loneliness in the Elderly
Smith feels optimistic that there are many things that can be done to rectify this situation. “It’s so easy to combat loneliness in the elderly, but caregivers have to be willing to get up and make it happen,” she says. Here are a few ways you can help alleviate loneliness in your elderly loved one:
- Listen and observe. “We often don’t listen enough to the people we love,” laments Tina Tessina, PhD, 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 them to express themselves can help you discover what interests and passions lay 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 and 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 to defeat seclusion. Once you know what your loved one enjoys doing, you can use this information to develop a personalized loneliness eradication plan. For example, while Smith was caring for an angry 91-year-old man who was reluctant to communicate, 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 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 part of a club of retired photographers that Smith helped him contact. Sometimes our elders just need a creative push to step outside their comfort zone.
- Let them teach you. Smith encourages caregivers to connect with their loved ones by allowing them to pass some hard-earned knowledge on to you. “I learn something new every day because I am being taught by the best,” Smith 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 a relationship between a senior and their youngest relatives. Grandkids often see their grandparents as either crazy or boring, when they should consider their elders sources of valuable wisdom and fun. Try to come up with ways to help the oldest and the youngest generations of your family spend time together, whether in person, by phone or via mail.
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 a couple times 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 seniors, no amount of effort encourages them to come out of their shell. It may take a large change to get them to reignite their interest in people and activities. While placement in a senior living community or a long-term care facility 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, assisted living communities, etc., it can be a totally disorienting experience,” Dr. 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 bedroom door.
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