Isolation and loneliness at any time of year

The concept of social isolation is complex and overlaps with other associated ideas such as loneliness, social vulnerability, social inclusion and exclusion, social connectedness, and social capital.

Social isolation is commonly defined as a low quantity and quality of contact with others and includes the number of contacts, feeling of belonging, fulfilling relationships, engagement with others, and quality of network members.d

Data from the Canadian Community Health Survey, which was a large-scale study with a range of social isolation indicators, provide an overall sense of the magnitude of the problem. The study found that:

• 16% of seniors felt isolated from others often or some of the time.

• 6% of seniors reported spending little or no time with someone with whom they could complete enjoyable activities.

• 5% indicated having someone to listen to them none or little of the time.

• More than 8% reported having someone to receive advice about a crisis none or little of the time.

• 3.9% of seniors reported having someone who shows love and affection to them none or little of the time.

• 6% reported having someone to do something enjoyable with none or little of the time.

• 6% reported never or not often participating in activities with family and friends.

• 17.3% reported feeling excluded often or some of the time.

These findings suggest that a significant portion of seniors experience social isolation in a variety of different ways. Preliminary results from the Canadian Longitudinal Study on Aging (CLSA) support these findings

The research has identified 9 risk factors are embedded within several overarching social contexts, including ageism, discrimination, limited access to resources and services, and marginalization. These risks factors are:

1. Age and gender: being 80 or older; being a woman (since women, on average, live longer).

2. Ethnicity: being an immigrant (specifically, having a different cultural and linguistic background from the general Canadian population or community in which you live); being from an official language minority community.

3. Geography: living in a rural or remote area where service provision and distance between individuals and families is less proximate; living in a deprived neighbourhood; living in a community where there has been a loss of community or neighbourhood values; living in a low-density neighbourhood.

4. Health and disability: having health issues (mental and/or physical) including having multiple chronic health problems (e.g., vision, hearing, incontinence, speech/cognitive impairment); lifelong health problems or late-onset or age-related condition such as incontinence; mental illness (e.g., dementia, depression); stigma associated with mental illness, poor health or a disability; low access to health care; minimal walking time; poor perception of one’s own health.

5. Knowledge and awareness: challenges relating to technology (costs, literacy, comfort); lack of information on services; lack of awareness or access to community services and programs

6. Life transitions: loss of a spouse; loss of sense of community; disruption of social networks; lack of family and friend supports; loss or restriction of drivers’ license; entry into care; care giving and associated factors (intensity of care-giving, low levels of care satisfaction, inability to leave the care recipient alone); divorce; living in a nursing home.

7. Poverty and lack of access to resources: lack of affordable housing and care options; living with low income; lacking access to transportation (no license or public bus system); financial dependence; living in a deprived neighbourhood (also considered a geography factor – see above).

8. Sexual and gender identity: being lesbian, gay, bisexual or transgendered (LGBT); a history of discrimination; having a weak primary social network; lack of social recognition; discrimination in the health-care system; fear of coming out in older age.

9. Social relationships: low quality of relationships; having no children or contact with family; living alone (greater likelihood among women, gay men and lesbians); not being married or common-lawed; loss of friends and social network; experiencing ageism.

In general, there is sufficient evidence to identify several common characteristics of successful interventions – such as involving seniors in the planning, implementation and evaluation stages – as well as different types of interventions, from group activities to educational phone chats.

Training programs for front line workers delivering programs is essential, as well as adequate resources. More generally, socially-isolated seniors could benefit from increased efforts to raise awareness of the underlying causes of isolation and to fight ageism. These are not easy issues to resolve, and addressing social isolation will require not only the coordinated and concerted action of multiple stakeholders but also increased understanding of the importance of this issue among the Canadian public.