Among many obvious contributors to poor health in the elderly – such as lifestyle, past injuries, or limited access to medical care – there is one factor which may not be immediately obvious but has a significant impact on overall health: isolation. With old age comes an increased risk of isolation as the older adult becomes less mobile and his or her peers and older relatives pass away. It is clear how this likely has an emotional impact on the elder, but what might be less obvious is that this emotional effect influences the elder’s physical health. By addressing isolation and helping an older adult find more pathways to social interaction, the elder’s overall health can be improved and their cost of care may be reduced.
Benefits of Socialization
A February 2 article in The Guardian extols the virtues of nonprofit “befriending” programs for the elderly in the UK and notes the economic impact of such programs for the National Health System (NHS). In 2013, the nonprofit Age UK implemented a pilot program called “Newqay Pathfinder” in Newquay, Cornwall. They selected 106 elderly people at high risk of being admitted to a hospital, evaluated their personal needs, interests, and hobbies, and sent volunteers to spend time with them and help them become involved in community activities. Later evaluation revealed that once the pilot program went into effect, local hospital admissions reduced by 30%, acute admissions for long-term conditions dropped 40%, and adult social care costs decreased by 5%. Volunteers for the program and the elders they served also reported positive emotional effects, such as previously isolated elders joining exercise groups and gaining more confidence.
In the US and worldwide, many studies have shown a positive correlation between social interaction and physical health benefits. In Living Long & Well in the 21st Century: Strategic Directions for Research on Aging, the National Institute on Aging reports the findings of several studies related to social interaction and health. According to the NIA,
- Social relationships are consistently associated with biomarkers of health.
- Positive indicators of social well-being may be associated with lower levels of interleukin-6 in otherwise healthy people. Interleukin-6 is an inflammatory factor implicated in age-related disorders such as Alzheimer’s disease, osteoporosis, rheumatoid arthritis, cardiovascular disease, and some forms of cancer.
- Some grandparents feel that caring for their grandchildren makes them healthier and more active. They experience a strong emotional bond and often lead a more active lifestyle, eat healthier meals, and may even reduce or stop smoking.
- Social isolation constitutes a major risk factor for morbidity and mortality, especially in older adults.
- Loneliness may have a physical as well as an emotional impact. For example, people who are lonely frequently have elevated systolic blood pressure.
- Loneliness is a unique risk factor for symptoms of depression, and loneliness and depression have a synergistic adverse effect on well-being in middle-aged and older adults.
Risks of Isolation
Isolation in older adults can develop for a number of reasons. According to the AARP, causes may include:
- Caregiving for a loved one. People who are providing unpaid care for a friend or relative often work alone and have less time for friends and family because of their caregiving duties. By the time they are in need of care and support themselves, their social network may have significantly eroded.
- A cultural shift in how many close confidantes most people have. According to some research, people are now reporting having fewer “close contacts” than they did a few decades ago, and the number of people reporting that they have no close contacts has risen from 10 to 24.5 percent since 1985.
- Living alone. As the number of people over age 65 who live alone rises, so does the trend of isolation. In 2010, 40 percent of people in the US age 65 or older reported living in one-person households. That’s up from 25 percent in 2000.
- Sexual orientation. LGBT older adults are at greater risk for social isolation than their heterosexual counterparts. This trend is caused by several factors, including discrimination and victimization, loss of friends and partners to the AIDs epidemic, or not having children.
- Loss of mobility. Life expectancy exceeds safe driving expectancy by 6 years for men and 10 years for women. Many older adults do not have access to cheap public transportation, which may dramatically limit practical and social activities.
Additional risk factors for isolation may include depression, poor hearing or vision, or health issues such as incontinence.
How to Prevent Isolation
There are many ways families and senior service providers can help to reduce the risk of elder isolation. Here are a few strategies to try:
- Help improve mobility. Educate the elder about local public transportation or other options for getting around town. Encourage the use of adaptive aids, such as canes or walkers, and try to help the elder overcome negative feelings about “looking old” while using these aids.
- Encourage activities which provide a sense of purpose. Help the elder connect with charitable groups, social organizations, or other programs that are connected to his or her interests. Feeling that he or she is still able to contribute to society will boost the elder’s confidence, and participating in such programs will generally require social interaction. Members of the group will become a new social network for the elder.
- Encourage wellness activities. Elders may resist participating in activities because of a negative self-image. Regular light exercise, such as chair yoga or a fitness swimming class, will help maintain physical health in addition to improving the senior’s body image – plus it will provide an opportunity for social interaction.
- Address health issues such as hearing, vision, and incontinence. Elders may tune out from conversations or other social activities due to poor hearing or vision. Encouraging regular testing and addressing hearing or vision problems will help the elder to fully engage with others whenever social opportunities arise. Finding the right medication or supplies to address incontinence will enable the senior to leave his or her home to engage in social opportunities without fear of embarrassment.
- Pay particular attention to seniors who are at higher risk of suffering from isolation. As noted above, seniors who are providing care for a loved one, who are part of the LGBT community, or who are living alone are at significantly higher risk of suffering from isolation than their peers. Since these seniors are less likely to have family members who might notice their isolation, health care and senior service providers should be particularly alert when dealing with seniors in these populations and should watch out for signs of loneliness. While we generally are not in a position to take extraordinary actions to address loneliness and isolation, senior service providers can direct clients to resources for social activities or transportation. And we can always take a little extra time to ask at-risk clients how their day is going, show sympathy, give them confidence-boosting compliments, and point them in the direction of local organizations they may want to join to stay active in the community.
As the senior population grows, the negative health effects of isolation will likely become an even bigger problem. Addressing the causes of isolation with your senior loved one can increase his or her physical health as well as emotional well-being. By helping seniors find outlets for socialization, it is possible to extend longevity and independence while reducing overall medical expenses.