Why is this an issue for older people in our communities?
In 2020, due to COVID-19 and the health warnings for older people with advice to cocoon, there is a heightened risk of loneliness and isolation due to disruption to routines, inability to meet and socialise, closure of many typical gatherings, and regional disconnects with government restrictions in place.
In the current climate, data already reflects that older people are experiencing the impact of these forced isolations. A report from The Irish Longitudinal Study on Ageing (Tilda) and ALONE showed an increase in the prevalence of isolation and loneliness in the five month period from March to July 2020. Based on the ALONE COVID-19 helpline records, not only were 55% of calls received from the age group (over 70s) advised to cocoon, 75% of all callers were living alone. The pressures of forced isolation while also facing stress such as putting off medical treatment due to cocooning indicated far-ranging effects for older people.
All of us can feel the strain of isolation at different times in our lives, however research from organisations such as Respond Housing Association show that older people experience a higher level of isolation for a range of reasons. In fact, one study indicates that 50% of people aged over 60 are at risk of social isolation.
For older people, one of the flow-on effects of isolation is vulnerability to loneliness and even social exclusion. The same study indicated one third of this group (approximately 33%) will experience some degree of loneliness in their lives. This can take a serious toll in terms of health and quality of life, community engagement and cohesion, and possibly even welfare issues if an older person is in social housing. For example, even just having social commitments can keep a person more active and isolation could result in them becoming sedentary with associated health issues.
Taking steps to combat this is important for the wellbeing of both individuals and our older people in the short-term and long-term. As the fabric of our societies changes rapidly, we need to remember that human beings are wired for connection and isolation has profound negative impacts to all aspects of our health.
In this article, we will explore the causes of isolation and loneliness for older people in more detail as well as outline strategies for how we can help older adults can combat this.
What is causing loneliness and isolation?
While the logical thought might be that spending time with people automatically curbs isolation and mitigates loneliness risk, the reality is that it’s not quite this simple. There are nuanced contributing factors that can affect people in obvious and silent ways.
For older people, the HSE advises the following factors are common:
- Getting older or more frail
- No longer being the hub of the family
- Leaving the workplace
- The deaths of spouses and friends
- Disability or illness
There are additional factors that we can uniquely observe as being related to 21st century life as well as individualised social aspects:
- Changes in how people socialise – more technology use resulting in a disconnect
- Difficulty in making new friends as people get older tied to grief over losing old friends
- Feeling a lack of purpose in life and detachment from living
- Communication difficulties due to time and distance
- Moving to care homes away from own communities
- Loss of autonomy that debilitates socially, physically and mentally.
What can we do to help older adults experiencing isolation and loneliness?
The number one thing we can do for older people is to listen to them respectfully instead of patronising or disempowering them. Rather than letting isolation and loneliness get out of control or ignoring it, these are some steps that we can take to help. Ultimately, it’s essential that we commit to looking out for signs of isolation and loneliness in older people due to its negative health impacts. Speaking to PsychCentral, Doctor Dilip V. Jeste says, “Loneliness rivals smoking and obesity in its impact on shortening longevity.”
Recognise the signs
Every person is different so make sure not to assume that an older person is or isn’t ‘seeming’ like themselves. Knowing that isolation and loneliness could be affecting them at any time will help with understanding the dynamic factors at play. Regular check-ins make a difference as does normalising talking about how you are both doing in general so it’s a considerate, two-way conversation.
There are a range of strategies for this, such as:
- Creating an emotional temperature check and asking how they’re going out of 10
- Ask them about what they’ve been enjoying and what’s got their attention, such as if they’ve heard something interesting on the radio or are reading a good book, which can show what they’re engaged with
- Offering to make plans with them, gauging their interest, and maintaining commitments
- Bringing up any concerns you have in an objective way and letting them know that you are there for them without pressure
- Ask about how they are going physically including diet, sleep, and different exercises if they are not injured or physically restricted.
Reinforce their independence
Ensure that older people are able to be independent as much as possible in order for them to live life on their terms.
Assist them if necessary or work with them so they can maintain their lifestyle and personal needs such as being able to:
- Live in their own home with care with a good routine in place
- Exercise or physical therapy
- Access nourishing food as groceries or catering
- Have good sleep patterns
- Upkeep of personal hygiene including cleaning, washing clothes, and personal grooming
- Connect with others and have purposeful personal practices such as spirituality
- Enjoy preferred recreation such as organised groups, creativity, activities, entertainment, education or projects.
Assist with maintaining a routine and making sure they can get out of the house
After working for most of their lives or having children, many older people can suddenly find themselves without a routine. This is made worse if they can no longer drive or are unable to leave their home easily. Providing opportunities for older people to build and maintain a routine gives them independence, connects them with other people, and reinforces their own capabilities.
Some ideas for bringing routine back and fostering this are:
- Develop a regular structure to the day.
- Staying active in and around the home. Exercise is a mood enhancer. Getting out and about with our older people even for a short walk while taking the necessary precautions will help.
- Or going grocery shopping at the allocated times designated hours for older people in supermarkets and public places.
- Help encourage a healthy diet and to keep hydrated – Lots of fruit, vegetables and water – to help boost immune system and energy levels.
- Keeping our older people involved and up-to-date on community activities that may interest them and contact any groups that the older person was involved in to see what new ways they are organising things.
- Help develop new interests. Creative activities such as art or reading are particularly beneficial.
- There are many events available live online, including concerts or religious services.
- Calling for a chat or dropping in to play cards while maintaining social distancing
Make sure to stay connected in a range of ways
A major issue for older people can be a sense of disconnect due to a shift in lifestyle. An additional aspect is the rapid uptake in technology with research showing that older people are still the least likely age group to have a computer in their home.
Staying connected can involve:
- Setting a social date with the older person or helping them set a social date with others with social distancing measures in place.
- Supporting them to overcome fear around technology with conversations about what they would like to use and showing rather than forcing the use of devices.
- Having younger family members meaningfully reach out and maintain contact with older family members over the phone or writing letters.
- Looking for opportunities to encourage and support older people to interact with others. You can ask what they need and what is getting in the way of making connections then create solutions together. This could mean that you drive an older person where they need to go, show them how to use technology, or even make plans together that you’re both involved in that gathers a group of loved ones for regular catch-ups.
Knowing when to seek help
Overall, we are all different and paying attention to the range of factors can help if you are checking in on an older person such as a relative or friend. It might take some time to find the right way for an older person to share how they are feeling and it might even be a surprise that someone has become isolated or even chronically lonely. Knowing this is a risk for older people can help with looking out for signs to identify if anything is wrong and being prepared to intervene with support if necessary.
Remember that the HSE says, “People who are lonely often find it hard to reach out. There is a stigma surrounding loneliness. Older people tend not to ask for help because they have too much pride.”
Be there to support an older person so that they don’t feel they have to suffer silently, be stoic or minimise serious feelings. Even if it’s a short-term or long-term issue, it’s important not to bypass these and have older people in our communities struggle.