Apr 17, 2016

Loneliness And Social Isolation Linked To Early Mortality

Whilst some people prefer to live alone, most people don’t want to feel lonely.

The mere thought that on any given day, night, week or month there are hundreds of thousands of elderly people without social connections, someone to talk to, or simply living in the community feeling they have no sense of purpose.

The evidence clearly indicates it is Australia’s elderly population that are more likely to live on their own than any other segment of the population.

The connection between loneliness and social isolation is not a simple one.

In short, whilst social isolation may lead to feelings of loneliness for some people, for others being socially isolated and having very few social connections may not have any impact on them at all. Conversely, a person with a number of social interactions and connections can still experience loneliness.

Statistics – Social Isolation and Loneliness

According to the Australian Bureau of Statistics (2013), the number of elderly people living alone continued to rise along with increasing age, from 29.7 per cent for those 75 to 85 years old, to 35.2 per cent after the age of 85+ years old. Elderly women in particular were more likely than elderly men to find themselves living alone.

In 2012, the latest Productivity Commission Report on Government Services, reported 16.2 per cent of people aged 65+ years never left their home, or did not leave home as regularly as they ideally wanted to. This increased to almost half (46.8 per cent) for older Australians with a profound or severe disability.

Older Australian’s now account for over 3.5 million of Australian’s population and with life expectancy increasing, the issue of social isolation and loneliness will continue to become a growing and more significant issue for Australia’s ageing population if effective strategies are not initiated sooner.

Research & Evidence – The Impact

A number of studies have shown connections between loneliness, psychological distress and poor wellbeing. Elderly people in particular are impacted by both loneliness and social isolation, impacting their overall mood and outlook on life. In instances where early detection and support is not in place there is the potential for symptoms to escalate and lead to more severe mental health conditions, such as depression and anxiety disorders.

It’s been reported in both public and private hospitals that older people are presented to emergency departments, not necessarily due to medical problems but for social interactions or simply not coping. A study reported ‘lonely’ people are 60 per cent more likely to access emergency services than those considered ‘non-lonely’ and twice as likely to enter residential aged care facilities.

It’s important that researchers and doctors not only look into life extending treatments, or the quantity of life for the elderly, but equally or if not more important is to give the elderly person every opportunity to enjoy quality of life. Supporting the notion of ‘quality of life’ is in the presence of where elderly people feel they contribute to the community and have a reason for existence. In the absence of either, they can feel a loss of social attachment or loss of identity; psychological distress can all contribute to affecting the general welfare of the elderly. Depression and anxiety disorders are also among the mental health problems brought by social isolation. These can further lead to feelings of worthlessness, pessimism and resentment. The worst case, however, can go as far as premature death.

According to a study by The University of Chicago findings showed major health risks were associated with loneliness revealing that elderly people who are affected by ‘extreme loneliness’ are up to 14 per cent more likely to die of premature death.

The English Longitudinal Study of Ageing reported that elderly people who are socially isolated are more likely to die earlier, however in this instance irrespective of feelings of loneliness. Higher mortality rates were also present regardless of demographic and health characteristics.

Video: What does it feel like to be old and alone? By Channel 4 News

Risk Factors for Social Isolation

One such challenge is understanding and combating social isolation and loneliness among older people. Whilst there are numerous risk factors for social isolation, some of the most common factors are listed below:

Living alone

Lack of communication with family or friends; specifically, feelings of isolation can be intensified by lack or absence of attention from people whom the elderly person is close with. Change from the usual environment to an unfamiliar neighbourhood can trigger instability and insecurity on the part of the aged. The same is true when family members move out for purposes of work or other personal commitments.

Loss of loved one

Sudden or expected death of spouse, a family member, or a close relative may cause immediate feelings of loss and abandonment; and for those unable to cope with these feelings, it may lead to social withdrawal.

Low income or socio-economic status

Frustrations felt by the elderly are often attributed to low income. Financial constraints prevent seniors from availing services in which they can indulge undermining their sense of self-worth and freedom, which may attribute to feelings of helplessness and ‘uselessness’.

Lesbian, Gay, bisexual, transgender, intersex

Diversity in gender identities causes discrimination and alienation, victimisation due to sexual orientation. Some 8.3% of the elders identifying as such, reported being abused or neglected by a caretaker because of homophobia and 8.9% experienced blackmail or financial exploitation.

Lifelong health problems including disabilities

Long-term illnesses and physical impairments prevent the elderly from being physically and socially active.

Lack of access to affordable transportation services

Difficulty in accessing transportation services, especially for older adults living in remote areas, has the effect of literal physical isolation, thus social disengagement is more probable.

Limited knowledge on technology-accessed communications

The elderly largely have limited ability or familiarity to access modern methods of social interaction like emails and the use of social media platforms, which are effective means in avoiding or lessening loneliness. Though interestingly many social media platforms publish in their user acquisitions reports the fast growing segment of the over 65+ onboarding on platforms like facebook and twitter to try and stay connected with their grand children or remote families.

Lack of awareness on community services related to senior population; lack of accessible and affordable care providers suitable for the needs of the elderly.

Video: Older people talk about how frailty can lead to loneliness and isolation by AgeUK

Combating Social Isolation and Loneliness

There are numerous suggested ways to involve our elderly people and help them combat the epidemic that is social isolation but there are others which are found to be more effective, some are listed below.

Creating quality, rather than numerous, social bonds

Building a few meaningful relationships are proven more effective than many interpersonal connections and interactions. Maintaining links with familiar people will also support feelings of inclusion and social involvement aiding in assisting the preservation of the elderly in preserving their sense of self and identity.

In particular, a study by the Journal of Clinical Nursing on dementia and loneliness reported the importance of relationships and the value of interacting with familiar people, following a series of interviews of people living with the condition.

However, despite this, the same study reported family carers of people with dementia often associated their loneliness with social isolation and arranged for them to attend day activity groups, surrounded by unfamiliar people and noise.

Whilst this can’t always be helped and if it means giving the family carer some respite to continue on in their full time role, there does need to be a balance to support both the individual and the family carer also. It is something to consider.

Initiating appropriate engagement for older adults

Interventions aimed at reducing cases of social isolation in the elderly can come in many forms. This can help establish and strengthen relationships despite geographical locations. Some interventions include:

-introduction of social media platforms to the aged (as this can help the aged feel more engaged socially)

-basic training for technology-accessed communications, like the simple operations on telephone and computers

In some instances, individuals who feel socially isolated don’t admit to being lonely or detached even if they are – it can be shameful and more often don’t want unnecessary pity from others.

An important factor that was found to distinguishing between older people who did and did not identify as feeling lonely, was that the ‘non-lonely’ group were much more likely to view social engagement as an opportunity to meet the needs of and demonstrate commitment to others, rather than simply meeting their own needs. Which meant to be seen as giving support to others as well as receiving it. Which comes back to having a sense of purpose and meaningful existence.

Whilst there are a number of strategies and supports to assist those at risk of social isolation and loneliness, however the need for diverse and individualised strategies to support older people are required as we all have different needs.

If you know someone who is experiencing loneliness or social isolation, there are a number of options to seek support.

For more help and/or assistance regarding social isolation and how to combat it, contact Community Visitors Scheme by phoning My Aged Care on 1800 200 422 or visiting My Aged Care www.myagedcare.gov.au

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