Social isolation is a serious concern for older people. INsite looks at what is being done about it.
Tony lives alone in the house he has lived in for the last 35 years. His wife died two years ago and since then his quality of life has started to take a downward spiral. His eyesight has worsened and as a result he is no longer able to drive. His memory is starting to lapse and he no longer trusts himself in social situations. He has stopped attending his historians’ group and now only attends church once a month, but he leaves before the cup of tea at the end. Although he was always more introverted than his wife, he misses the social interaction that she encouraged. He misses his wife. His misses his children who are scattered around the globe. He is desperately lonely.
From the outside looking in, there is nothing really wrong with Tony. Although his cognitive skills are starting to slip, he is still relatively astute. His physical health is, for the most part, very good. Neighbours smile when they see him, respecting that he is an older man who likes to keep to himself. They admire that he is managing to live independently by himself. While some guess that he might be a little lonely, none of them glean the extent to which his loneliness is contributing to his demise.
Alarming facts and figures
In New Zealand today, almost 50,000 older people are severely and chronically lonely, like Tony. This equals about eight per cent of people 65 years of age and over.
The idea of such a vast number of older people suffering from severe loneliness is distressing, especially when one considers the impact loneliness can have on a person’s health.
There has been much research on this subject over the years. A 2006 University of Auckland study found that an older person who is chronically lonely and depressed is almost twice as likely to enter residential care. Research from the United States also shows that people who feel very lonely are likely to die sooner. A United Kingdom study found that having weak social connections carries a similar health risk to being an alcoholic or smoking 15 cigarettes a day.
It is proven that loneliness is a risk factor for physical and mental health problems, including heart disease, dementia, and depression.
Loneliness affects health by raising blood pressure, increasing the release of stress hormones; lowering immunity, especially to viral infections; reducing sleep quality and creating daytime fatigue; and reducing the body’s ability to fight infection and respond to inflammation. As with other risk factors, the effects develop over time.
We have all probably experienced loneliness in some form over the course of our lives, whether it was triggered by the first week of our OE in an unfamiliar city, or following a separation from a partner, or being bullied at school. However, older people are more at risk of loneliness because they are also more likely to experience losses such as bereavement; family moving away; retirement; decreased sight, hearing and mobility; and reduced ability to manage alone.
What’s being done about it?
The Government’s Positive Ageing Strategy has an emphasis on keeping older New Zealanders living independently in their own homes for longer – a worthy objective, but one of the unfortunate repercussions is that ageing in place puts our growing ageing population is at risk of loneliness.
However, coinciding nicely with last year’s International Day of Older Persons, Senior Citizens Minister Jo Goodhew recently launched the Older New Zealanders: Healthy, Independent, Connected, and Respected document. The document outlines the services and support available to older people, and summarises the Government’s cross-agency approach to the Positive Ageing Strategy. It also highlights the need for a continued focus on older vulnerable New Zealanders, including those who may be socially isolated.
Advocacy groups also play an important role in bringing awareness to the plight of loneliness among older adults. Age Concern, for example, has been instrumental in helping to alleviate elderly social isolation. Its campaign, No New Zealander Should Ever Die of Loneliness has been effective in drawing attention to this issue.
One Age Concern initiative which has proven to be particularly effective is the Accredited Visiting Service (AVS), an intervention designed to improve the health and independence of the loneliest older people. AVS has been operating for over 20 years and throughout New Zealand there are currently 23 services – at least one in each District Health Board area. Each AVS client is matched with a police-checked and trained visitor who provides regular caring contact through one-to-one visits. The clients and visitors share conversation, activities and outings as desired. Clients are supported to make or renew other social contacts in their communities. Visitors are also able to identify and act upon the early signs of illness or increasing frailty.
Part of Age Concern’s campaign is also focused on encouraging older people to actively increase their social interaction with others, as well as letting people in the community know of how serious chronic loneliness can be and ways they can help.
Other initiatives like Senior Chef cooking classes and Total Mobility service which provides cheap transport in urban areas are also aimed to get older people out and about more in their communities. Meals on Wheels and other home and community support services that encourage some brief social interaction throughout the day all play their part in alleviating loneliness for older people.
The Selwyn Foundation offers a network of 39 community drop-in centres for older people across the upper North Island, as well as in Christchurch, offering a morning programme of social games, gentle exercises and occasional outings at a nominal fee. Respite for carers is offered at some venues, and in one location, the service is taken out to state-owned pensioner flat complexes, enabling the less mobile to socialise with their neighbours. The centres in South Auckland also have access to the services of a community liaison nurse employed by Selwyn, who assists with health concerns that guests, their carers, or the centre coordinators may have and who can engage with healthcare agencies on their behalf.
However, the problem is far from solved. We need to continue our awareness of how damaging the effects of social isolation can be for older people, and continue to find ways to lift the shrouds of loneliness from their shoulders.