Social Isolation of Seniors Part 2

Social isolation is: “less social contact than someone wishes, causing loneliness or other emotional distress” In “normal” ageing, a senior’s social circle may grow smaller due to:

•         Illness or disability

•         Loss of spouse or friends – more than 6% of Canadians over the age of 65 reported not having any friends

•         Caregiver responsibilities

•         Poverty

•         Lack of personal hygiene

However, senior isolation is serious. 

1.     Senior isolation increases the risk of mortality. According to a 2012 study in the Proceedings of the National Academy of Sciences, both social isolation and loneliness are associated with a higher risk of mortality in adults aged 52 and older.

2.     Feelings of loneliness can negatively affect both physical and mental health. Regardless of the facts of a person’s isolation, seniors who feel lonely and isolated are more likely to report also having poor physical and/or mental health, as reported in a 2009 study using data from the National Social Life.

3.     Perceived loneliness contributes to cognitive decline and risk of dementia. We evolved to be a social species it’s hard-wired into our brains, and when we don’t meet that need, it can have physical and neurological effects.

4.     Social isolation makes seniors more vulnerable to elder abuse.  Many studies show a connection between social isolation and higher rates of elder abuse, reports the National Center on Elder Abuse. Whether this is because isolated adults are more likely to fall victim to abuse, or a result of abusers attempting to isolate the elders from others to minimise the risk of discovery, researchers aren’t certain.

5.     LGBT seniors are much more likely to be socially isolated. LGBT seniors are twice as likely to live alone, according to SAGE (Services & Advocacy for GLBT Elders); they are more likely to be single and they are less likely to have children and they are more likely to be estranged from their biological families.

6.     Social isolation in seniors is linked to long-term illness. In the PNAS study mentioned above, illnesses and conditions such as chronic lung disease, arthritis, impaired mobility, and depression were associated with social isolation.

7.     Loneliness in seniors is a major risk factor for depression. Numerous studies over the past decade have shown that feeling loneliness is associated with more depressive symptoms in both middle-aged and older adults

8.     Loneliness causes high blood pressure. A 2010 study in Psychology and Aging indicated a direct relationship between loneliness in older adults and increases in systolic blood pressure over a 4-year period. These increases were independent of race, ethnicity, gender, and other possible contributing factors.

9.     Socially isolated seniors are more pessimistic about the future. According to the National Council on Aging, socially isolated seniors are more likely to predict their quality of life will get worse over the next 5-10 years, are more concerned about needing help from community programs as they get older, and are more likely to express concerns about ageing in place.

10. Physical and geographic isolation often leads to social isolation. “One in six seniors living alone in the United States faces physical, cultural, and/or geographical barriers that isolate them from their peers and communities,” reports the National Council on Aging. “This isolation can prevent them from receiving benefits and services that can improve their economic security and their ability to live healthy, independent lives.”

11. Isolated seniors are more likely to need long-term care. Loneliness and social isolation are major predictors of seniors utilizing home care, as well as entering nursing homes, according to a 2004 report from the Children’s, Women’s and Seniors Health Branch, British Columbia Ministry of Health.

12. Loss of a spouse is a major risk factor for loneliness and isolation. Losing a spouse, an event which becomes more common as people enter older age, has been shown by numerous studies to increase seniors’ vulnerability to emotional and social isolation, says the same report from the British Columbia Ministry of Health. Besides the loneliness brought on by bereavement, the loss of a partner may also mean the loss of social interactions that were facilitated by being part of a couple.

13. Transportation challenges can lead to social isolation. According to the AARP, “life expectancy exceeds safe driving expectancy after age 70 by about six years for men and 10 years for women.” Yet, 41% of seniors do not feel that the transportation support in their community is adequate, says the NCOA.

14. Caregivers of the elderly are also at risk for social isolation. Being a family caregiver is an enormous responsibility, whether you are caring for a parent, spouse, or another relative. When that person has Alzheimer’s disease, dementia, or a physical impairment, the caregiver may feel even less able to set aside his or her caregiving duties to attend to social relationships they previously enjoyed. This can trigger loneliness and depression.

15. Loneliness can be contagious. Studies have found that loneliness has a tendency to spread from person to person, due to negative social interactions and other factors. In other words, when one person is lonely, that loneliness is more likely to spread to friends or contacts of the lonely individual. Making things even worse, people have a tendency to further isolate people who are lonely.

16. Lonely people are more likely to engage in unhealthy behaviour. A 2011 study using data from the English Longitudinal Study of Ageing (ELSA) found that people who are socially isolated or lonely are also more likely to report risky health behaviours such as poor diet, lack of physical activity, and smoking.

17. Volunteering can reduce social isolation and loneliness in seniors. We all know that volunteering is a rewarding activity, and seniors have a unique skill set and oodles of life experience to contribute to their communities. It can also boost longevity and contribute to mental health and wellbeing, and it ensures that seniors have a source of social connection.

18. Feeling isolated? Take a class. A review of studies looking at various types of interventions on senior loneliness found that the most effective programs for combating isolation had an educational or training component: for instance, classes on health-related topics, computer training, or exercise classes.

19. Technology can help senior isolation – but not always. Even though modern technology provides us with more opportunities than ever for keeping in touch, sometimes the result is that we feel lonelier than ever. The key to finding technological interventions that really do help, says Health Quality Ontario, is matching those interventions to the specific needs of individual seniors.

20. Physical activity reduces senior isolation. Group exercise programs, it turns out, are a wonderfully effective way to reduce isolation and loneliness in seniors and of course, they have the added benefit of being great for physical and mental health. In one study, discussed by Health Quality Ontario, seniors reported greater well-being regardless of whether the activity was aerobic or lower impact, like stretching.

 

Senior isolation is neither inevitable nor irreversible. Getting the facts can help us prevent loneliness in our senior loved ones as they face the life changes of ageing.

Social Isolation of Seniors Part 1

Being socially active and connected is at the core of having a good retirement and ageing well. Being connected is an important social determinant of health and social connectedness is beneficial to your health. Feelings of loneliness and isolation can lead to serious consequences for senior health. 

Understanding the causes and risk factors for senior isolation can help us prevent it. Nobody relishes the prospect of ageing without a spouse or family member at their side, without friends to help them laugh at the ridiculous parts and support them through the difficult times. Yet that is just what many North American seniors face. The quality and number of connections you have with others are important to your health. These connections include

•         family

•         friends

•         neighbours

•         acquaintances

•         Also, known as social support, social capital, and social engagement

As the baby boomer generation crosses the over-65 threshold, it grows; but many of our ageing loved ones are still feeling alone in the crowd.

A key determinate of health and one that we can control the choices we make/ An example of this is where one lives. One’s neighbourhood may provide an opportunity for social interaction with others through the availability of organisations (e.g. community centres, clubs, etc.…) and community-based programs. Similarly, living in a neighbourhood where neighbours know each other builds a sense of trust and community: Having a high sense of community is associated with improved mental and immunological health

According to the U.S. Census Bureau 11 million, or 28% of people aged 65 and older, lived alone in 2010. As people get older, their likelihood of living alone only increases. Additionally, more and older adults do not have children, reports the AARP, and that means fewer family members to provide company and care as those adults become seniors

While living alone does not inevitably lead to social isolation, it is certainly a predisposing factor. Yet another important consideration is how often seniors engage in social activities.

Statistics Canada reports that 80% of Canadian seniors participate in one or more social activities on a frequent basis (at least monthly) – but that leaves fully one-fifth of seniors not participating in weekly or even monthly activities.

Social contacts tend to decrease as we age for a variety of reasons, including retirement, the death of friends and family, or lack of mobility. Regardless of the causes of senior isolation, the consequences can be alarming and even harmful. Even perceived social isolation – the feeling that you are lonely – is a struggle for many older people.

Fortunately, the past couple of decades has seen increasing research into the risks, causes, and prevention of loneliness in seniors.

Fact: Loneliness and social isolation impacts the health of seniors more than 6% of Canadians over the age of 65 reported not having any friends

It is in our best interest to combat these changes because social participation and social support are both strongly connected to good health and wellness over the life course. The interaction of poverty, a function of one’s income, with social participation displays conceptually how income may act as a social determinant of health. Although social connectedness plays a significant role in health, seniors are more likely than any other age group to feel lonely or isolated

For seniors, social exclusion is found in several forms:

• Exclusion from society due to laws or societal discrimination (e.g. mandatory retirement)
• Failure of society to provide for the needs of seniors
• (e.g. affordable housing)
• Denial of opportunities to contribute and participate actively in society (e.g. not being represented on a community planning committee)
• Economic exclusion (e.g. unequal or lack of access to resources)

Year books

Yearbooks bring back memories, a member of my FaceBook community, who I thought I only knew through a third friend, posted a picture of himself from his time at Simon Fraser University. We had been at the university at the same time. As soon as I saw his picture, I recognised it from the 1966-67 yearbook. I then realised that I knew him because of the activities we both had been involved in at the university. 

A few weeks later I had a Message from a person that I went to Elementary School with who had seen me at our high school reunion and although we did not have a chance to talk, reminded me via FaceBook of some of the good times we had when we were very much younger.

On another occasion I went to lunch with a few people I had worked with as a beginning teacher, some I had not seen in about 10 years. One of the people in attendance was the person who hired me, and who I had not seen since 1975. Neither one of us recognised the other. I had changed as he had. He looked good for 90 and as we talked, he spoke fondly of his time at the school and in the district. He was enjoying retirement and was looking forward to his next trip. He also brought his yearbooks from his time at the school, and everyone at the table was enjoying looking back. I found my picture and showed it to him and he laughed and said, I would never have recognised you.

I wonder how many use posts and groups on FaceBook or their yearbooks and from high school or university to bring back or sharpen our memories. I know that from time to time I do, and I enjoy the experience of remembering. 

Advice for talking to your Doctor

In BC the amount of time we have to see a doctor is limited to about 8 minutes per visit, so we have to make good use of our time. Many doctors, will only deal with one issue at a time, and the time they have is limited.

Make Good Use of Your Time 

Be honest

It is tempting to say what you think the doctor wants to hear, for example, that you smoke less or eat a more balanced diet than you really do. While this is natural, it’s not in your best interest. Your doctor can suggest the best treatment only if you say what is really going on. For instance, you might say: “I have been trying to quit smoking, as you recommended, but I am not making much headway.”

Decide what questions are most important

Pick three or four questions or concerns that you most want to talk about with the doctor. You can tell him or her what they are at the beginning of the appointment, and then discuss each in turn. If you have time, you can then go on to other questions.

Stick to the point

Although your doctor might like to talk with you at length, each patient is given a limited amount of time. To make the best use of your time, stick to the point. For instance, give the doctor a brief description of the symptom, when it started, how often it happens, and if it is getting worse or better. Share your point of view about the visit.

Tell the doctor if you feel rushed, worried, or uncomfortable

If necessary, you can offer to return for a second visit to discuss your concerns. Try to voice your feelings in a positive way. For example, you could say something like: “I know you have many patients to see, but I’m really worried about this. I’d feel much better if we could talk about it a little more.”

Remember, the doctor may not be able to answer all your questions

Even the best doctor may be unable to answer some questions. Most doctors will tell you when they don’t have answers. They also may help you find the information you need or refer you to a specialist. If a doctor regularly brushes off your questions or symptoms as simply a part of ageing, think about looking for another doctor.

As you talk to your doctor, make sure you remember and understand what she/he is telling you. Here are some tips to help in this area:

Helping You Remember No matter what your age, it’s easy to forget a lot of what your doctor says. Even if you are comfortable talking with your doctor, you may not always understand what he or she says. So, as your doctor gives you information, it’s a good idea to check that you are following along. Ask about anything that does not seem clear. For instance, you might say: “I want to make sure I understand. Could you explain that a little more?” or “I did not understand that word. What does it mean?” Another way to check is to repeat what you think the doctor means in your own words and ask, “Is this correct?”

Here are some other ideas to help make sure you have all the information you need.

Take notes

Take along a notepad and pen and write down the main points, or ask the doctor to write them down for you. If you can’t write while the doctor is talking to you, make notes in the waiting room after the visit. Or, bring an audio recorder along and (with the doctor’s permission) record what is said. A Recording is especially helpful if you want to share the details of the visit with others.

Get written or recorded materials

Ask if your doctor has any brochures, DVDs, or other materials about your health conditions or treatments. For example, if your doctor says that your blood pressure is high, he or she may give you brochures explaining what causes high blood pressure and what you can do about it. Ask the doctor to recommend other sources, such as websites, disease management centres, nonprofit organisations, and government agencies that may have written or recorded information you can use.

Talk to other members of the healthcare team

Sometimes, the doctor may want you to talk with other health professionals who can help you understand and carry out the decisions about how to manage your condition. Nurses, physician assistants, pharmacists, and occupational or physical therapists may be able to take more time with you than the doctor.

Call or email the doctor

If you are uncertain about the doctor’s instructions after you get home, call the office. A nurse or other staff member can check with the doctor and call you back. You could ask whether the doctor or another health professional you have talked to, has an email address or online health portal you can use to send questions