Have you seen the face of Senior Isolation?
Last month I reflected that my Grandma has avoided isolation, and this has helped her enjoy good health to for over 95 years. This month, I explore the complicated relationship between isolation and health, and give examples of people whom I have seen experiencing isolating conditions and, sadly, are vulnerable to poor health.
There are many different health and social factors that can increase the risk of social isolation. According to the Government of Canada’s Report on the Social Isolation of Seniors, seniors at risk of isolation include, but are not limited to those “living alone; being age 80 or older; having compromised health status, including having multiple chronic health problems; having no children or contact with family; lacking access to transportation; living with low income; and changing family structures.” I have also seen that social isolation can increase with loss of balance, depression and anxiety, and caregiver burn-out.
Social isolation can increase certain health risks, or can make certain health conditions worse. The Report on Social Isolation discusses how influence from social connections can encourage health-positive behaviours, like physical activity, choosing foods rich in important nutrients, and avoiding or quitting smoking; meaningful connections also create purpose, which improve motivation for those health-positive behaviours. On the other hand, seniors without a social network are more likely to drink, smoke, eat a poor-quality diet, and don’t move enough. When seniors don’t care for their health, they may increase their risk for stroke and heart attack; they may also lose muscle, so they not only risk falls and lose independence, but they also have a higher risk of death if they become critically ill.(1,2) Socially isolated individuals also have a higher risk of depression, which decreases the chances they will properly care for themselves, and increases their risk of death by suicide.
Isolation can look different for each person, as the information above suggests. Because each person has different strengths and vulnerabilities, as well as different life circumstances, each person may be affected by different isolation risks, and can follow a different path in health decline. Here are a couple of examples I have seen in the past year.
Walter*, diagnosed with Parkinson’s disease, and Margaret*, his caregiver spouse, are vulnerable to isolation. Walter, especially, has lost many of his social contacts because he spends a lot of time at home – outings take a lot of work. Walter used to meet with a group of gentlemen for coffee each week, but he can no longer attend; his peers also don’t visit Walter, because many of them are dealing with their own health struggles. Walter noticed he had decreased meaning in his life and was mourning this. I also reflected that he wasn’t getting appropriate support to maintain muscle function and prevent the worsening of his Parkinson’s symptoms.
At the same time Margaret has also lost social connections, because she is busy caring for Walter. Even when she can get away she is afraid to leave Walter for long, for fear that he might fall and get hurt while she is away. When I heard her story, Margaret was losing weight without trying; she felt she was managing her caregiver demands, but I commented that she might be struggling with self-care, and putting her own health at risk. Importantly, if Margaret’s health continued to decline she would not do a good job of caring for either herself or Walter anymore.
Depression has caused Clara* to become isolated, even though she has lived in a retirement home for over four years. Like Walter, Clara has been diagnosed with Parkinson’s. More Importantly, because of depression, Clara often has chosen to stay in her apartment, rather than interact with the community in the retirement home. Clara has been missing out on the encouragement to move, and on building meaningful connections that create purpose, which can help to fight depression. Depression has made it hard for Clara to accept help, because she fears being a burden: she has preferred to stay in her apartment when a volunteer comes to take Clara grocery shopping. When I recently saw her, Clara had lost a lot of muscle tone and was startlingly frail – a sign of advanced health decline.
Walter, Margaret, and Clara have different circumstances and journeys, but all are affected by isolation. Sadly, because they don’t have enough supportive and meaningful connections, all are at risk for or are experiencing loss of health.
When it comes to isolation, a solution might seem very far away – solutions must be as personal as the causes and consequences of isolation. If you are experiencing this frustration – maybe you noticed isolation when you saw family at Christmas, for example – I want you to know that the first step in finding a solution is to recognize isolation – if you don’t see it, you can’t do anything about it. If you’re ready to move forward but don’t know where to begin or feel overwhelmed by the task, let’s have a conversation. Call or e-mail to book – I am ready to hear your story. It would be my privilege to hear your experiences, concerns and questions, and explore possible solutions.
You Don’t Have to Journey Alone!
*names are changed for privacy
Gariballa and Alessa. 2013. Sarcopenia: Prevalence and prognostic significance in hospitalized patients. Clinical Nutrition 32:772.
Vetrano et al. 2014. Association of sarcopenia with short- and long-term mortality in older adults admitted to acute care wards: results from a CRIME study. Journals of Gerentology. Series A, Biological Sciences and Medical Sciences 69:1154.