Isolation and loneliness

I belong to three senior groups that provide information and support for seniors, and the issue that keeps coming up over and over again is the issue of social isolation and loneliness for seniors.

The issue is not what we can do about it, or what causes it, but how do we identify those who are isolated and lonely. Many seniors live alone, because they have lost loved ones, but they live full and healthy lives, they are not lonely and not isolated. A recent study of a representative sample of Americans between the ages of 57 and 85 found that their average circle of friends was just under 4 people. However, one of the underlying factors determining the prevalence of people considered “isolated” is whether they live alone. According to a recent study by the National Council on Aging, an estimated 17% of all Americans over the age of 65 are isolated because they live alone, and face one or more barriers related to geographic location, language, or disability or income. One of the reasons may be that the older a person is, the more likely they are to have smaller networks, fewer primary network members, and more distant relationship ties.

Many researchers agree, however, that a solitary lifestyle alone is not an accurate indicator of isolation. A few studies have examined isolation in representative samples of older Americans, used a representative sample of older Americans to explore the relationship between loneliness and health. Isolation, defined as loneliness, was present among 16.9% of adults over 50 years old, 8.8% of which were considered chronically lonely. The prevalence of isolation has been explored internationally as well, with rates ranging from 2 to 20% among community-dwelling older adults (as opposed to those living in residential skilled settings).

Although a higher prevalence of isolation may occur at older ages, certain adaptations, such as increased interactions with neighbors and friends or use of technology, could serve as protective factors.

Our issue as organizations is that we do not have any good means to identify the 17% of seniors who self-identify as lonely. There is a lot of research that tells us what types of interventions work, but these interventions are used when people identify themselves as lonely. Because there is a stigma about mental health or asking for help for mental issues, in my generation and the older generations, there is a reluctance to identify as lonely as admitting it would be a sign of mental illness or being seen as weak.

Intervention types can be placed in the broad categories of one-on-one (professional or volunteer), group-focused (support groups, participation in group activities), or community-focused (village model, intergenerational intentional communities, modifying built environment).

One of the groups I am in used an intervention that incorporates technology by providing telephone support. Other interventions may be emailing with friends and family, facilitating communication or coordination of support with social network and group interventions virtual senior center, discussion group sessions held online, etc.

Most commonly targeted in terms of subjective isolation are loneliness and quality of relationships with social networks. Interventions targeting objective isolation often focus on the size of social networks (primary and secondary), frequency of interaction with contacts, and participation in socially engaging activities.