Isolation and Loneliness in Caregiving


“Does anyone else out there feel lonely and isolated since beginning to care for their parents?”

Perhaps it’s because caregivers are a selfless bunch. Burdening other people with their problems isn't usually in their nature. Maybe there are so many intimate and embarrassing aspects of looking after an elderly loved one that sharing with others seems crass or akin to a betrayal of a family member’s dignity. Or it could simply be that family caregivers feel too busy or stressed to connect with other people.

Whatever the reason, loneliness and caregiving often go hand in hand. To make matters worse, the isolation that many caregivers experience is subtle at first but steadily worsens. As your loved one’s needs demand more and more of your time, you begin to see less and less of friends and family. Until one day, you realize that your social life has deteriorated along with your care recipient’s health.

The problem is that, in addition to exacting an extreme emotional toll, loneliness can carry dangerous—even deadly—physical consequences.

How Loneliness Can Be Deadly

According to Dr. Douglas Nemecek, Cigna’s chief medical officer for behavioral health, “Loneliness has the same impact on mortality as smoking 15 cigarettes a day, making it even more dangerous than obesity.”

In recent decades, medical researchers delved into the effects of social relationships on not only the public’s mental health but also on their physical health and longevity. Whereas strong, positive social ties are associated with an increased likelihood of survival, a lack of these fundamental connections negatively influences health outcomes and increases mortality risk.

One such study conducted by University of Chicago psychologist, Dr. John Cacioppo, analyzed survey responses from over 2,100 adults age 55 and over to examine the connections between satisfying relationships and rates of physical and mental decline. He and his team concluded that lacking close personal connections raises an individual’s risk of premature death by 14 percent.

The increase in morbidity and mortality risk that accompanies loneliness can be attributed to an array of biological responses that occur when a person feels alone, such as elevated blood pressure, increased inflammatory response, interrupted sleep, higher morning levels of the stress hormone cortisol and intensified symptoms of depression.

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Why Being Alone Hurts

During a 2013 presentation at the TEDxDesMoines Conference, Dr. Cacioppo delved into the evolutionary factors behind the negative health effects of social isolation. Historically, humans have relied on the collective intelligence and strength of a group to defend themselves against predators and find food.

“We think of loneliness as a sad condition but, for a social species, being on the social perimeter is not only sad—it’s dangerous,” he says. “The pain and aversiveness of loneliness—of feeling isolated from those around you—is also part of a biological early warning machinery to alert you to threats and damage to your ‘social’ body, which you also need to survive and prosper.”

Just as low blood sugar triggers a hunger response and pain alerts us to potential tissue damage, loneliness also serves as an unconscious warning, compelling us to satisfy our “hunger” for human connection.

Why Seniors and Their Caregivers Lose Social Connections

Loneliness in the elderly is increasingly recognized as a serious yet fixable problem, but their family caregivers struggle to maintain social connections, too. Both caregivers and their loved ones are at risk for physical and emotional isolation for a variety of reasons.

For example, the stigma and challenging symptoms of dementia make it increasingly difficult for a person with cognitive impairment to connect with those around them. The dual-edged nature of this all-too-familiar scenario is that dementia caregivers also feel the sting of isolation as their loved ones continue to decline, resulting in significant memory loss and increasing difficulties with communication.

Caregivers’ social connections and outside relationships may weaken and fall by the wayside as their elder care responsibilities increase. Over time, a caregiver’s sole focus often becomes their aging loved one. All too often, pivotal care decisions must be made when a senior requires a higher level of care than a family caregiver can provide and must transition to a residential facility. Another shock occurs when one’s caregiving responsibilities end upon a loved one’s death. In both instances, once this routine of selfless devotion changes or ends, caregivers are faced with the reality that their social circle has shrunk or completely disappeared. Relationships with spouses, children and other family may be strained, and friends are commonly unresponsive.

Forging New and Stronger Relationships

Creating new connections with other people and rekindling neglected ones is a time-consuming (yet necessary) process for seniors and caregivers alike. While there’s no clear road map for developing and maintaining solid interpersonal bonds, Dr. Cacioppo and his team pinpointed the following three essential elements of healthy relationships.

  1. Intimate connectedness: A feeling caused by socializing with people you are confident will always support you and with whom you can be your true self.
  2. Relational connectedness: In-person interactions that are mutually beneficial to all parties involved.
  3. Collective connectedness: Feeling as though you are part of a larger group beyond individual existence.

Human beings all need a combination of these three elements to combat the ever-present threat of loneliness, but cultivating relationships while caregiving can be challenging. Experts recommend the following tips for maintaining relationships as well as your emotional and physical health.

  • Reach out and ask for what you need.
    Prioritize relational connectedness with family and close friends who would also benefit from maintaining a connection with you and your care recipient. Potential candidates might include siblings, extended family, grandchildren and old friends. Let them know that you could use some company with no strings attached. There are likely people out there who miss their relationships with you and are waiting for an invitation to reconnect. Reestablishing a close connection may provide you with a social bond and a larger care team to help you and your loved one.
  • Join a support group.
    It may seem counterintuitive, but sometimes the anonymous nature of a support group will allow you to form an intimate connectedness with others who are experiencing the same feelings and challenges. If you feel you’ve grown apart from family and friends because you can’t share your true feelings, a support group or a therapist may provide a safe place where you can vent, receive advice and learn better ways of coping with caregiver stress. Doing some emotional work in these judgement-free settings may allow you to get to a better place so you can reconnect with other friends.
  • Consider adopting a pet.
    Pets are a source of unconditional support and love. Many people are comforted by the loyalty and companionship they get from a pet. While pets have beneficial emotional and physical effects on their owners, it’s important to carefully evaluate whether a dog, cat or other animal will fit into your lifestyle now and the years to come.
  • Find a cause you care about.
    Tap into the collective connectedness concept by joining a group and meeting new people. Take inventory of your interests and look for volunteer opportunities or meetings. Volunteer at the polls, join a knitting circle or get involved in a charity with a mission you are passionate about. Although it might take some time to feel comfortable connecting with strangers in a group setting, the knowledge you’ve gained may be an invaluable source of support to others. Common interests and experiences help to establish an instant camaraderie.

Caregiving is undoubtedly a very demanding role. Finding time for yourself is difficult enough, not to mention finding the time and energy to go out and socialize with other people. Achieving a balance in life is hard when you feel like you’re always letting someone down, but it is crucial to recognize your limits, set boundaries and make your needs a priority.

Sources: Social Relationships and Mortality Risk: A Meta-analytic Review (; AAAS 2014: Loneliness is a major health risk for older adults (

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