Explaining Loneliness/Social Isolation
As human beings, we are all hard-wired to be social; even the most introverted among us recognize the value of human contact and will seek out companionship. Our ability to form and maintain close connections with others enables us to survive and thrive. As we grow older, we often find ourselves more alone than when we were younger. Whether it is due to the unexpected passing of a spouse or partner, leaving the workforce to retire, being separated from family members by long distances, or lacking transportation, older adults can find themselves at a significantly increased risk of experiencing loneliness and social isolation.
It is important to note that while loneliness and social isolation are often associated together, they are two different things that may not be experienced at the same time. Loneliness is the feeling of being alone, regardless of the amount of social contact. You can be surrounded by people and still feel alone or you can be completely alone but never feel lonely. Social isolation is a physical separation from people and a lack of social connections, which can lead to loneliness. According to a report from the Administration for Community Living’s Administration on Aging, in 2017, about 28 percent of older adults in the United States lived alone in the United States, but many never reported feeling lonely or socially isolated. At the same time, some people can be surrounded by others, yet can still feel lonely.
How can social isolation and loneliness affect your health?
In a report led by the South Carolina Institute of Medicine and Public Health and the South Carolina Department on Aging, it was stated that social isolation and loneliness can have a significant impact, not just on someone’s mental health, but their physical health as well. According to a statement released by the U.S. Surgeon General in 2020, widespread isolation can have the same health impact as smoking 15 cigarettes a day.
There is research to support the claim that social isolation and loneliness are linked to a higher risk of developing many physical and mental health conditions. The CDC reported that social isolation was associated with a 50% increase risk of dementia and other serious conditions. Some conditions include higher blood pressure, heart disease, weakened immune systems, depression, anxiety, cognitive decline, and even death.
Studies conducted by the CDC suggest that when we experience chronic feelings of loneliness, we can often become depressed, which causes us to neglect doing things we would do to take care of ourselves, such as exercising or cooking heart-healthier meals. The National Academies of Sciences, Engineering, and Medicine (NASEM) collected evidence in 2018 that supports the idea that adults 50 and older are socially isolated in ways that put their health at risk. Loneliness among heart cancer patients was associated with nearly four times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits. After feeling lonely and depressed for extended periods, it can lead to the formation of cancer cells in the body, the build-up of plaque in the arteries, and inflammation in the brain, which can lead to Alzheimer’s disease (Lubben, 2018).
What can cause an older adult to become socially isolated and lonely?
As mentioned, people tend to find themselves alone often as they age. It can be a challenge to feel connected to family members when they are living their own lives far off in a different state. It is also important to consider geological differences when looking at social isolation. Urban areas may have walkable destinations and access points for public transportation. This makes living in rural areas with no transportation an even more problematic concern for seniors. If an older adult finds that they can no longer drive, it can become easy to end up stuck at home, feeling isolated. It is also not uncommon for older adults living in these areas to have limited access to reliable broadband internet, reducing their opportunities for virtual interactions.
For individuals living with a disability, it can be even more likely they will experience social isolation. People with visual impairments or hearing loss can have more trouble communicating with others. Recognizing the geographical challenges that different groups face (Sonnega, 2021) is important. For disabled people living in rural areas, their impaired physical abilities can cause them to be home-bound. According to 2021 data from the Health and Retirement Study, social isolation was twice as prevalent for individuals with a disability compared to individuals without a disability (21.5% of individuals with any disability, between the ages of 50 and 65, experience social isolation and 10.9% of individuals without a disability, between ages of 50 and 65, experience social isolation).
Alzheimer's and Related Dementia
The June 2023 report released by the South Carolina Institute of Medicine & Public Health (IMPH) states that social isolation is associated with an approximately 50% increased risk of developing dementia. According to the Alzheimer’s Association, older adults with dementia may develop poor self-esteem as communication becomes more challenging. They may notice they lose their train of thought or cannot remember a persons name, leading to feelings of embarrassment. These factors, combined with a dementia diagnosis, can worsen social isolation.
In a long-term study (2011-2020) conducted at the Johns Hopkins University School of Medicine, data from the National Health and Aging Trends Study reviewed to show the association between social isolation and dementia.
- Of the 5,000+ adults, 23.3% were socially isolated and showed no signs of dementia at the start.
- At the end of the study in 2020, 21% of the participants had developed dementia.
- The risk of developing dementia was 27% higher among socially isolated adults (SCIMPH, 2023)
Family Caregivers
It is important to note that older adults are not the only ones impacted by social isolation and loneliness. Statistics reveal that between 40 and 70% of family caregivers experience clinical symptoms of depression, which can often be caused by feelings of isolation and loneliness associated with the caregiver experience. Caregivers who work full-time and are ages 45 years or younger show the greatest emotional and physical health deficit in contrast to non-caregivers. As a caregiver it can become increasingly difficult to find personal balance when you are so focused on providing for your loved one. They might find themselves cutting their work days short and spending all their weekends committed to their caregiving role. They may no longer feel they can afford to socialize and potentially feel guilty if they’re enjoying themselves while their loved one suffers.
There are ways that caregivers can deal with these feelings of isolation and loneliness. It is critical to build time into your caregiving routine to focus on yourself. Periods of respite care can allow caregivers to focus on their personal needs without worrying about their care recipient. If you are a caregiver struggling to find support from your friends or spouse, you can reach out to local support groups and online forums to find people who understand the situation you might be going through.
- If you are a family caregiver in South Carolina who is looking for support, you can visit the South Carolina Respite Coalition website to look for available resources and opportunities:
Traditionally Marginalized Groups
Some underrepresented subgroups of the elderly population are at the highest risk for social isolation and loneliness. These groups include people with lower socioeconomic backgrounds, individuals with disabilities, first-generation immigrants, and LGBTQ+ members. The LGBTQ+ community has faced decades of discrimination, leaving them at greater risk for physical and mental illness and social isolation. These findings are supported further by the fact that members of the LGBTQ+ community are two times more likely to live alone and four times less likely to have children than non-LGBTQ+ peers (IMPH, 2023).
When looking at racial minority groups, Hispanic people have consistently been associated with an increased prevalence of health conditions such as cancer, cardiovascular disease, and diabetes. Many of these individuals often have to deal with multiple health issues, which could understandably affect someone's ability or desire to get out and socialize. It is not uncommon for older immigrants to be more at risk for social isolation due to language barriers and a lack of social connections in a new country.
Lastly, individuals of low socioeconomic status can face major obstacles that cause them to become isolated. Those with lower incomes can’t always afford the cost of treatment for their health conditions, which can impair their quality of life. It is also not uncommon for a person’s income to keep people from participating in social engagements because they cannot afford to go out and spend money.
How can we help reduce the chances of social isolation/loneliness? Resources?
Luckily there are entities and resources that are used to help take action against social isolation and loneliness. In October 2022, IMPH and the South Carolina Department on Aging (SCDOA) launched the Social Isolation in Older Adults task force. Together they have funded services to help older adults live safely and independently at home and have identified recommendations to address social isolation. This list of services includes group dining, home-delivered meals, transportation to group dining sites or essential trips, personal care, homemaker, home chore, home modification, legal assistance, and assessments.
One recommendation from the IMPH and SCDOA involves reaching out to an older adult in your family or community on a regular basis. While it may not seem like much, many older adults have no one checking in on them, so taking the time to reach out can make a big difference. Another recommendation is to help older adults utilize social media to stay up-to-date with family and friends. Senior Planet and Older Adults Technology Services (OATS) have been working with AARP to teach technology skills to older adults for over a decade. Additional funding may be needed to bring reliable broadband internet access to older adults living in more rural areas.
Finally, another valuable tool is the SCDOA’s website GetCareSC.com. This website is a resource that allows seniors, caregivers, and adults with disabilities to search for service providers in their area. It also provides a comprehensive, up-to-date listing of available organizations and faith-based communities that excel at building personal trusting relationships and leading social activities. They also offer other members of the community to become more engaged. Volunteering is an excellent way to help the community and foster social inclusion among the senior population.
Sources
[Gallup-Healthways. (2011). Gallup-Healthways Well-Being Survey: In U.S., Caregivers’ Emotional Health Often Suffers.]
Banu, Reshma; Liladrie, Sirena; and Noka, Behije, "The Role of Faith Communities in Improving Supports to Reduce Loneliness and Social Isolation in Immigrants 65+" (2019). The Role of Faith Communities in Improving Supports to Reduce Loneliness and Social Isolation in Immigrants 65+. 1. https://source.sheridancollege.ca/centres_elder_building_connected_communities_reports_faith/1
Sonnega, A, Smith, J. “Health and Retirement Study: A Longitudinal Data Resource for Psychologists.” Encyclopedia of Geropsychology (2021). Pg. 20-24. 978-981-287-083-4. https://hrs.isr.umich.edu/publications/biblio/9899
National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. doi: 10.17226/25663. https://nap.nationalacademies.org/read/25663/chapter/3
Lubben, J. E., E. Tracy, S. E. Crewe, E. Sabbath, M. Gironda, C. Johnson, J. Kong, M. Munson, and S. Brown. 2018. Eradicate social isolation. In R. Fong, J. Lubben, and R. P. Barth (eds.), Grand challenges for social work and society. New York and Washington, DC: Oxford University Press.
- AARP Joins With Non-Profits to Teach Tech to Older Adults
- FCA: Caregiver Statistics: Health, Technology, and Caregiving Resources
- Practical Tips for Dealing with Isolation as a Caregiver