Aging in Place – the role of loneliness and social isolation

Loneliness and Social Isolation – the third leg in the triad

If you’re reading this post, odds are that aging in place for yourself or your loved ones is already your goal.  We’ve looked at major factors that should be considered when deciding if aging in place is a realistic objective, such as home safety (http://seniorsupportandtransition.com/home-modifications-safely-aging-in-place/) and physical strength and balance (Aging in place: the impact of balance and strength).  The third leg in the triad is the role of loneliness and social isolation when aging in place.

Some loneliness statistics

Loneliness not only can make someone feel sad, but can also actively contribute to the odds of mental and physical disease.  According to a recent article on the Huffington Post (http://www.huffingtonpost.com/entry/the-growing-health-threat-for-older-adults-you-should-be-aware-of_us_58599dc5e4b0d9a59456456e?ncid=tweetlnkushpmg00000043), which in turn quotes an AARP website created just to track this issue (https://connect2affect.org/), “Research shows a 26 percent increased risk of death due to subjective feeling of loneliness.”  When you couple this with their other statistics, namely:

  • 6 million adults 65 and older have a disability that prevents them from leaving their homes without help
  • 51 percent of people 75 and older live alone

One can see how this one factor may affect not just quality of life but also longevity for our seniors.

Most of us consider aging in place as preferable to other options – assisted living, continuing care retirement communities, nursing homes etc – because our seniors are likely to already have connections and relationships in their communities, which they fear losing if they leave: e.g. social, religious, philanthropic, hobbies.  Not to mention the thought of having to rebuild those connections in a new environment can be daunting, if not downright overwhelming.   So if our seniors, or we ourselves, plan to stay at home, we must be sure that there are social outlets and opportunities easily available.  We must also monitor the situation because in a blink of an eye, things can change.  Someone who is independent and mobile and able to transport themselves to church or lunch or the gym may wake up one day and realize they don’t know how to get from point A to point B anymore.

Great Aunt M and other family members

My great aunt worked, lived and thrived in the Parkchester area of the Bronx for three quarters of a century, with extensive work, church, family and social networks.  Yet suddenly, within the space of six months, most likely as a result of two trigger incidents in her life, she was well down the road to social isolation and then dementia.

Great Aunt M and Grandmother K Parkchester 1976

First, my grandmother, her loving but bossy sister, moved back in with her and essentially took over her life.  Shortly thereafter, my great aunt started to lose her hearing and for whatever reason, she refused to wear a hearing aid.  When she lost control of her day and lost her hearing, she just checked out.  She went on to live another decade, but was unable to stay in her apartment once her cognitive impairment became overwhelming; wandering around the Bronx at night in her nightgown became problematic.

In a similar vein, as my own mother aged, living with 2 dogs but otherwise alone in our family home, she too started to shut down.  Although uncomplaining and “not wanting to be a burden,” she became less and less social as her old friends passed on.  The house fell into disrepair and paperwork got lost or tossed.  Without anyone to talk to on a daily basis, she totally lost track of time and started to forget to eat.  Think about it – eating alone for years on end can be depressing for even the most rugged individualist.  She actually fainted on me during a visit; she couldn’t remember when she last had eaten.  And when she did remember to eat, it was usually Nutella or peanut butter from a jar.  Her Meals on Wheels sat unrefrigerated and spoiling, piled up on the counter.

Consider this: not everyone is cut out for aging in place at home, especially if this means their social interactions will be limited.  Mom’s cousin Frank is a perfect example.   If he were to live “at home” with his adult children, they would have to retrofit their home to accommodate his walker.  They would also need nursing staff to help them cope with his early Alzheimer’s.  But most of all, Frank is an extrovert.  He loves company at mealtimes, meeting new people and talking about anything and everything.  He really enjoys the social stimulation and activities of his assisted living situation.  For him, living in this kind of community is vastly preferable to the much more socially constrained environment of aging in place.

Staying engaged, staying connected

Thus even if your seniors have a safe home, and are keeping up their physical strength and balance, you need to stay on top of things and make sure they are able to get to whatever social outlets keep them engaged and bring them joy.  Like the other two legs of the triad, this too is a perpetual activity which requires monitoring.  Just because the home is safe today, or because Mom did her exercises today, doesn’t mean the same will be true tomorrow.  Things can change very quickly; one fall, subtly increasing cognitive deficits, the death of a spouse or other loved one, hearing or vision loss – any of these can turn an active social senior into a recluse virtually overnight.

Can your senior/you still drive?  Is there simple, safe, affordable public transportation to the places they want to go?  We are extremely fortunate in our town, the Next Station to Heaven, that we have an extremely active and supportive senior organization Staying Put (http://www.stayingputnc.org/), which has lots of social activities and transportation to and fro for members.  The Lapham Community and Senior Center (http://laphamcenter.org/) provides myriad fun and low-cost art, language and exercise classes geared to seniors.  The non-profit Getabout (http://www.getaboutnc.org/) transports seniors at low- or no-cost to medical and other appointments.

Find out what organizations serve the communities where your seniors – or you yourself – live, that can help them to stay connected, whether it’s visiting them at home or enabling them to attend events or go to the gym, church, the library.  Aging in place is no fun if you’re alone all the time.