Reducing Loneliness and Social Isolation in Older Adults
There’s never been a time when the importance of human connections has been more evident. Children see their playmates in a small square on a screen; work colleagues turn happy hour into a brief and often poorly attended end-of-week chat; celebrations are marked by balloons that don’t pop. While across the globe people of all ages struggle to adapt to the demands COVID has placed on interactions, few feel the consequences as vividly as older adults. We can imagine how devastating feelings of isolation and loneliness are to those who live alone or who are separated from their loved ones in nursing homes and hospitals. The frequently neglected problem of isolation can be serious. One author concludes that the mortality risk of loneliness is comparable to smoking 15 cigarettes a day. The older adults suffering from loneliness were also less likely to engage in healthy behaviors; in fact, lonely older adults are 50 perfect more likely to die prematurely [www.cdc.gov]. Mental health is highly dependent on the nature of an individual’s personal relationships, and as these connections become less frequent and more distanced, quality of life is likely to suffer. That’s why learning all you can about how to identify and reduce loneliness and introduce measures to improve the quality of an older adult’s life is so very important.
4 TYPES OF INTERVENTION
Researchers have identified four types of intervention that can help seniors become more resilient and increase feelings of support and value:
Help improve social skills and increase quality of communication
Increase social support and other resources that improve quality of life
Increase social interactions
Increase positive thinking and trust
While you can’t change everything about your loved one’s situation, there are a number of things you can do to improve their quality of life and emotional well-being. The suggestions below expand on several of the interventions listed above, and provide specific ideas for how you might introduce a few more positive changes into your loved one’s daily activities.As you are probably well aware, it’s easy to become frustrated in your efforts to make a positive impact on an older adult’s life. Yet, you cannot underestimate the positive influence you can have on your loved ones. While communication may be difficult, and while it may often feel like an older adult is not listening to your suggestions or requests, your challenge is to be flexible, creative, and persistent. You can make much more of a difference than you imagine! Each situation is different, and each older adult has a unique set of hopes and fears. You are probably already doing many of the right things to ease their situation and brighten their experience during this stressful time.
6 STEPS TO HELP YOUR LOVED ONE DURING THE PANDEMIC & BEYOND
1. Observe carefully; don’t make assumptions
When we know someone very well it’s easy—and only natural—to make assumptions about what they enjoy, what they prefer, or even how they might be feeling at any particular point in time. But it’s important that assumptions are accurate, because they guide subsequent decisions and behavior. Therefore, it’s well worth the effort to ensure that your assumptions about your loved one align with current reality by practicing what we call Curious Discovery. Curious Discovery is the process of confirming your beliefs by closely and frequently observing your loved one and his or her behaviors and reactions. You might even ask questions that help confirm your understanding of their needs and concerns. Engaging in a dialogue about the things that you have taken for granted is the first step in creating an effective action plan and providing meaningful support.
2. Verbalize positive feelings; reaffirm positive regard
You may take it for granted that the older adult in your life knows how much they mean to you. But who doesn’t like to hear “I love you,” “I’m thinking about you,” or “You are important to me” repeated? It’s particularly important when a loved one is disagreeable or belligerent that you reassure them of your unconditional love. Whenever you are communicating with your loved one, whether remotely or in person, make it a habit that whenever you think a positive thought you verbalize what you are feeling. This needs to be the case whether you are on the phone, zooming, texting, or visiting. If your loved one is resistant and things get awkward or stressful, you may not feel that you are making any progress in addressing their anxiety or defiance. It’s particularly important in this case that you use language that clearly distinguishes the behavior from the person. Labels and parental phrases such as “you’re not trying,” or “you’re driving me crazy,” can be hurtful and create additional conflict. It’s important for them to hear, “I need you to listen so that I can help keep you safe,” not, “You are belligerent and absolutely impossible.”
3. Worry unobtrusively
This is a stressful time and almost everyone is worried and anxious. You are concerned about your loved one, perhaps frustrated that you’re not able to be with them and unsure just how to help them cope with isolation and loneliness. The kindest and most generous thing you can do is to keep these feelings of worry and uncertainty to yourself. Your loved one needs reassurance; they have their own anxieties and you don’t want to compound their fears or add to their stress by sharing yours. This doesn’t mean that you pretend everything is just fine; it means that you focus on the positive and try not to dwell on how difficult life seems to be during this particularly confusing time. There’s a psychological principle called emotional contagion which simply means that your emotions not only influence those around you, but make it likely that others will “catch” or share whatever mood you exhibit. It would be difficult, then, to cheer up an older adult if you are communicating anxiousness or apprehension. Perhaps you can call on a friend to talk with if you feel the need to discuss your situation and share your frustrations and decision-making dilemmas. Older adults need stability and consistency. You can provide that best by continuing to reassure them and staying calm even as a situation may be escalating. Honesty is essential—but in the context of “we are all working together, this won’t last forever.”
4. Develop routines; things to look forward to
Even when you’re unable to be physically present with your loved one you can help create a sense of stability and consistency in their life. Try to develop routines that they can depend on and look forward to, things that provide stability and comfort. For instance, try to make your calls at approximately the same time each day. Perhaps you can send a weekly note or photograph that they can look forward to opening. You can create some regular topics of conversation or “updates,” like new recipes you’ve tried or silly things grandchildren have said or done. Or perhaps you can generate a new question every week that the two of you—or your entire family—can then answer. Questions like “What was your best meal of the week,” or “What day did you enjoy most and what did you do?” work best. The point is that, with some thought and planning, you can create meaningful experiences and conversations that they will look forward to and enjoy. Even from afar, you can work with your loved one’s caretaker to establish daily routines and rituals. Let other family members know your plan—they may want to participate or have some new ideas you can try.
5. Don’t underestimate the value of technology
While nothing can replace the human touch, technology can play an important role in bringing loved ones together and helping older adults feel connected. Zoom and other face-time technologies provide opportunities to share experiences and personalize relationships. Families enjoy everything from virtual dinners to games to stories and other collaborative activities. Technology can also help to prevent loneliness by providing personalized stimulation and engagement. Virtual reality games can keep older adults mentally active and inspire reminiscence therapy. Robots and chatbot provide another avenue of engagement and support. Currently there are studies underway to evaluate the use of robotic pets in senior community settings. You may have heard that older adults fear or dislike technology, or you may have had experiences of your own where a loved one resisted learning how to use email or connect to Zoom. Keep in mind that it may not be the technology itself that your loved one wants to avoid but, rather, it could be a fear of something new and seemingly complicated. If you think that low self-efficacy may be part of the problem, be patient. Introduce things slowly and focus almost exclusively on the benefits—that you want them to be safe and keep in touch. You might even call “email” and “zoom” or “facetime” by a different name, one that sounds more personal and familiar.
6. Be patient
We know that social isolation is a risk factor for a number of undesirable outcomes in the aging process, not only depression but heart disease, obesity, hypertension, cognitive decline, and impaired immune response, among others (https://www.sprc.org). The difficult situation in which we find ourselves due to COVID-19 calls for patience, creativity and resourcefulness. Think in terms of making small steps toward an important goal—begin by doing whatever you can to provide your loved one with comfort, confidence, and companionship during this difficult time. There is no magic to addressing issues of mental health and emotional well-being. While stress and fatigue may threaten to pull individuals into depression and pessimism, you can be a constant and positive influence in your loved one’s life. If you practice Curious Discovery, you will be able to see the signs that they have become more optimistic and happier. This positive change will likely be due to your commitment to see the glass half full, your patience, and your willingness to think out of the box. This positive and proactive focus sustains both family members and the loved ones who need them.
