Healthy aging: Preventing Isolation

Loneliness and isolation can have serious consequences for seniors' physical and mental health, these factors has been associated with people developing more chronic illnesses and facing a higher risk of death. Social connection is key for senior well-being.

Joan O'Rourke, 80, of Pompano Beach, Florida, is the anti-isolation poster child. An avid boater, the former elementary school teacher sailed into the state 20 years ago not knowing a soul. So she made connections. She joined sailing clubs (one voyage took her to Cuba) and became active in local church groups. O'Rourke saw that for some members, Sunday service was their only chance to be social. "During the week, people are lonely too," she says, which spurred her to start a beach volleyball group. On holidays, she hosts dinners for five or six other seniors who would otherwise spend Thanksgiving or Christmas alone.

Loneliness and isolation can have serious consequences for seniors' physical and mental health. Here's how to tell if a family member, neighbor or friend is experiencing isolation, and some ways to help them reconnect.

Health and Safety Gaps

Among victims of the 1994 Northridge earthquake in California and the fatal 1995 Chicago heat wave, "one of the major determinants was isolated elders," says James Lubben, a distinguished professor of social work and director of the University Institute on Aging at Boston College. Natural disasters and climate extremes expose vulnerability, he says: "People look like they're coping pretty well, but they don't have any reserve capacity to help them out when the slings and arrows of life come on."

It often takes a medical crisis to reveal a senior's isolation, says Carrie Johnson, assistant director of the Hartford Center of Excellence in Geriatric Social Work at the Boston College School of Social Work. Today's outpatient care "really relies heavily on informal supports, be they family, friends or neighbors," she says. As a hospital discharge planner tries to set up a patient's continued care at home, it can become apparent that he or she is isolated – with no one to pick up prescriptions, change dressings or provide transportation to doctor's appointments.

Seniors who fall are at high risk for landing back in the hospital, Johnson notes. With daily rehabilitation exercises ordered, older adults may be too frail or lack enough balance to do them safely on their own. In general, she says, "When you look at the health risks related to isolation, it's going to be around seeking appropriate preventive health care." Avoiding falls, taking medication correctly, exercise and healthy eating are more likely when people have social connections.

Risks and Consequences

Isolation has been associated with people developing more chronic illnesses and facing a higher risk of death. Hypertension, less physical activity, worse mobility and increased depression have been tied to loneliness and isolation. Not too surprisingly, mental abilities can suffer as a person's world shrinks. Cognitive decline and dementia may become more likely with isolation.

Certain factors increase the risk of becoming isolated, according to AARP Foundation. Living alone, losing a close family member or friend, retiring, becoming a parent's caregiver, having language barriers or low income, and living in a rural, inaccessible or unsafe location make people more vulnerable.

Spotting Isolation

Signs of isolation can be subtle. "People become really adept at hiding it," Johnson says. "In our culture, we're not really willing to share that we're isolated or that we're lacking in support."

Neighbors are often the first to flag isolation, Johnson says. "They are that set of extra eyes on the person that see no one comes or goes. He or she doesn't get their walk shoveled during the winter; that type of thing." Or mail carriers may call the local senior center and say, "I think this person needs help."

First responders are also in a position to detect isolation. "They get called more frequently to some of these houses," Johnson says. "They'll begin to see this pattern develop of going to Mrs. Smith's house every month, or she's had three falls in the past six weeks."

The Lubben Social Network Scale (developed by James Lubben) looks at two key areas: family and friendships. Questions include: "How many relatives do you see and hear from at least once a month?" "How many relatives do you feel close to such that you could call on them for help?" and "How many friends do you feel at ease with that you can talk about private matters?" If you have fewer than two people on which to rely on individual items, "you're probably skating on thin ice," Lubben says. "You want to have a diversified portfolio, if you will, of family and friends in your network."

Where to Turn

If you're concerned that a neighbor – or distant family member – is at risk for isolation, contacting the town's senior center is a good starting point. Many senior centers have social workers to put it all together by determining people's needs and plugging into the right resources. States offer a variety of services for seniors. "In Massachusetts, we have aging service access points," Johnson says. Following an assessment, people are connected to Meals on Wheels, homemaker services (which vary by state but may encompass chores like cleaning, laundry and maintenance), grocery-shopping and other programs. They might need personal care assistants to help with bathing. All these providers add to a person's support system, Johnson says, "both social and kind of eyes on the ground."

Visit the National Council on Aging to find resources on senior centers, fall prevention and healthy aging.

Bridging the Digital Divide

Technology is one way seniors can stay connected – they just need to find their comfort zone. Bring Your Own Device community workshops help older adults get the most from mobile devices such as smartphones and tablets, "to navigate the information that's really going to help them live their best lives day to day," says Kamili Wilson, vice president for isolation strategy at AARP Foundation, which is involved in BYOD through its Mentor Up program.

In programs like BYOD, youthful volunteers like Anthony Levy reach across generations to teach tech skills to older adults. Volunteers use a patient, respectful teaching approach, says Levy, a 21-year-old student at University of Colorado–Boulder and founder of tBridges. Young mentors encourage seniors to familiarize themselves with devices, rather than pulling them away to "show" them.

"We know that technology is increasingly becoming a part of everyday life, and if you're not familiar with it, you will be at a disadvantage," Wilson says. Learning to navigate health information online is one advantage. In addition, basic social media training, especially on Facebook, helps older adults stay connected to family members and peers.

When O'Rourke's son gave her an iPhone to mark her 80th birthday, she attended a workshop in Coconut Creek, Florida, to learn how to use it. O'Rourke also took this opportunity to learn about the GPS in her car.

Social Connection for Prevention

Invest in building your network early, rather than waiting for crisis mode, Lubben advises. You may want to rethink your retirement plans. "A lot of people make the silly mistake of moving away from everybody," he says. "They want to move to a warm climate, and they move into an isolated situation. Then, as they get frail, they have to come back to whatever they had in terms of social ties."

To stimulate your mind and stay connected, put down that crossword puzzle or Sudoku and start talking to friends and neighbors instead. "Social conversation is one of the most challenging cognitive activities there is," Lubben says. "You have to pay attention; you have to be responsive; you have to think about your answer."

Volunteering, joining clubs and taking classes have long helped seniors stay connected. O'Rourke plays bridge, helps a group of women with their taxes and does morning sessions of water aerobics. But you don't have to become super-social to prevent isolation. It's not about turning into a social butterfly, handshaking politician or belle of the ball, Lubben says – just building yourself a foundation of support.

US News | By Lisa Esposito

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