We live in an age where we can communicate with distant friends and family members with a few clicks of a mouse or taps on a smart phone screen. 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. A 2018 survey conducted by Cigna showed that nearly half (46 percent) of 20,000 U.S. adults report that they feel alone sometimes or always. Perhaps no other age group feels the keen sting of loneliness more than the elderly.

Understanding Loneliness in Seniors

Aging brings many changes that can 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. On one hand, retiring grants older adults more free time for hobbies and relaxation, but it also puts an end to meaningful interactions with colleagues on a regular basis. Friends, significant others and family members may move away or pass away. Even those who still live close by may be difficult to meet with in person due to changes in mobility. This is especially true once a senior stops driving for safety reasons. Age-related conditions, such as hearing loss and eye diseases, can also 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 living with chronic medical conditions not only face logistical challenges when it comes to leaving the house, but they may also feel insecure about these “obvious” signs of aging. Incontinence is a common concern that can complicate an elder’s social life, while the use of durable medical equipment like mobility aids and oxygen therapy systems can affect their self-confidence.

It is trying enough for a senior to maintain healthy relationships despite these challenges. 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 with friends on a regular basis. Sadly, many seniors experience a decline in the quantity and quality of their relationships as they age, whether it is self-imposed or due to forces outside of their control.

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Families Struggle to Support “Forgotten Seniors”

Even when an older adult is being taken care of by family caregivers, T. Byram Karasu, MD, distinguished professor emeritus at the Albert Einstein College of Medicine’s department of psychiatry and behavioral sciences, says that there is often little attention paid to deep, engaging communication between a senior and the rest of their family. The changes listed above certainly play a role, but caregivers are usually so worn out from juggling their day-to-day responsibilities that they have little time or energy left for singlehandedly meeting all 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 structure of families is also an underlying issue. 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. Family units that have spread across the country find it particularly difficult to make time for visits and even regular communication by phone and mail.

The Effects of Loneliness on the Elderly

Feeling that one lacks fulfilling personal relationships doesn’t just affect one’s mental and emotional health. In fact, it can also take a toll on one’s physical health. A 2018 meta-analysis of 35 research articles that measured loneliness and mortality confirmed that feeling lonely is a risk factor for all-cause mortality for both men and women.

Another study conducted by researchers from the University of California, San Francisco (UCSF) found that adults 60 years old and older who reported feeling lonely were at higher risk for functional decline in addition to the increased risk of death. This decline manifested specifically in participants’ abilities to perform activities of daily living (ADLs)—the five basic tasks (bathing, dressing, transferring, toileting and eating) that are necessary for truly independent living. In other words, unchecked loneliness has the potential to jeopardize an elder’s ability to live independently and to accelerate their 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. According to research funded by the National Institute on Aging (NIA), it raises the levels of stress hormones like cortisol, which impairs immune responses and contributes to inflammation. Prolonged loneliness is hard on the body and can leave seniors vulnerable to mental health issues like anxiety and depression and chronic conditions like heart disease and obesity. Another study published in JAMA Psychiatry even found an association between feelings of social detachment and the development of brain biomarkers common in preclinical Alzheimer’s disease.

Ways to Alleviate Loneliness in the Elderly

Smith feels that there are many steps that can be taken to rectify this situation. “It’s so easy to combat loneliness in the elderly, but we have to be willing to get up and make it happen,” she explains. If your loved one is feeling socially isolated or lonely, use some of the tips below to help them feel more connected and supported.

  • 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 someone you care about to express themselves can help you discover what they’re thinking and feeling and what interests and passions lie 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 to 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 for minimizing isolation.
    Once you know what your loved one enjoys doing, you can use this information to develop a personalized plan for eradicating loneliness. For example, Smith was caring for an angry 91-year-old man who was reluctant to communicate when 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 Bing Crosby’s 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 a member of a club for retired photographers that Smith helped him contact. Sometimes our elders just need a creative push to step outside their comfort zone and seek out the meaningful interactions they yearn for.
  • Let them teach you.
    Smith encourages caregivers to connect with loved ones by allowing them to pass along some hard-earned knowledge. “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 relationships between elders and their youngest relatives. Grandkids often perceive their grandparents as either weird or boring, when they should consider their elders sources of valuable wisdom and fun. Try to devise ways of helping multiple generations of your family spend time together, whether in person, by phone or via mail.
    Dr. 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 once 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 renew their interest in people and activities. While moving to a senior living community 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 or assisted living communities, 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 door.

Sources: 2018 Cigna U.S. Loneliness Index (https://www.cigna.com/assets/docs/newsroom/loneliness-survey-2018-full-report.pdf); Association of loneliness with all-cause mortality: A meta-analysis (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754055/); Loneliness in older persons: a predictor of functional decline and death (https://www.ncbi.nlm.nih.gov/pubmed/22710744); Social isolation, loneliness in older people pose health risks (https://www.nia.nih.gov/news/social-isolation-loneliness-older-people-pose-health-risks); Association of Higher Cortical Amyloid Burden With Loneliness in Cognitively Normal Older Adults (https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2575729)