Chronic Loneliness in the Elderly: How to Help Yourself or Someone Else

What Is Loneliness?

Have you ever felt lonely in a crowded shopping mall? Or, alternatively, have you ever felt perfectly content reading a book by yourself? Either way, you'll identify with one of the key points in understanding loneliness: It's very subjective.

That's why mental health professionals often distinguish between social isolation and loneliness. Social isolation in elderly individuals is what happens when they don't have much contact with other people. Isolation can affect a person by making him or her more likely to experience loneliness. But some isolated people aren't lonely.

In other words, social isolation doesn't necessarily lead to loneliness. But it can still be harmful. In addition to a higher risk of loneliness, the effects of social isolation are sometimes manifested in increased rates of depression and sensory deprivation.

Everyone's different when it comes to the amount of social contact they need. For example, extroverts are people who generally feel energized by being around others. In contrast, introverts are people who tend to feel more content being alone. As Susan Cain writes in her book Quiet: The Power of Introverts in a World That Can't Stop Talking, "Solitude matters, and for some people, it's the air they breathe." But it's important to know that introverts can feel lonely too. Although they often need time alone in order to recharge, most introverts do want to feel connected to other people.

Because everyone is different, we can't really quantify loneliness in terms of the number of friends a person has or the amount of time he or she spends alone. It's all about how a person feels.

So how is loneliness measured by mental health professionals? Researchers at UCLA devised a short loneliness test that asks people to rate their feelings on a number of factors related to personal connections, such as how often they feel:

• Excluded
• Totally alone
• Unable to talk to anyone
• Challenged in making friends
• Unable to put up with being alone
• Unable to get others to understand them
• Anxious for others to contact them
• Unable to connect with those around them
• Unhappy when doing things by themselves

The UCLA Loneliness Scale is now frequently used in studies of loneliness. For instance, the AARP study referenced above uses the scale.

Mental health professionals sometimes distinguish between social loneliness (i.e., missing a wide social network) and emotional loneliness (i.e., missing an intimate partner). The loss of an intimate partner is a significant trigger for loneliness: 47 percent of older adults who have lost a partner in the last five years identify as lonely, according to the AARP study.

The Loneliness Epidemic in the Elderly: Why It Exists

AARP's study findings provide a lot of insight into the nature of loneliness in older adults. Check out some of the survey results:

• About 35 percent of adults over the age of 45 are lonely—roughly 47.8 million people. Interestingly, loneliness seems to decrease with age. Those in the oldest age group (i.e., over age 70) are the least lonely; 24 percent of them say they are lonely.
• Overall, 29 percent of married older adults are lonely, compared to 51 percent of those who are single. But it's important to note that the quality of a relationship impacts whether a person experiences loneliness: 26 percent of older adults in happy relationships are lonely, compared to 48 percent who are not happy in their relationships.
• Income can also play a role. About half of older people with an annual income of less than $25,000 are lonely.
• Seniors who are caregivers are more likely to be lonely. This fact is a little surprising, since many caregivers are rarely alone. But looking after other people may leave caregivers with less time to develop their own interests and social connections.

Why are so many older adults feeling lonely? Here are three factors that come into play:

• Lack of social connections

  Loneliness—as a concept—wasn't written about until the 1700s, and psychologists didn't study it in depth until closer to the middle of the 20th century. Psychologists say that in recent history, the number of meaningful social connections made by people has decreased. And as we've lost those connections, we've increased our risk of being lonely.

  For example, because people are, in general, busier and we move from place to place more than we used to, we are less likely to know our neighbors. And the AARP study found that 61 percent of older adults who have never talked to their neighbors are lonely. As well, it seems as if fewer people are reaching out to those around them. In fact, the number of Americans—of any age—who say they have no close friends has tripled since 1985.

  Many of AARP's stats point to the fact that it's the quality, not the quantity, of our social interactions that counts. For example, although one might think that being retired would contribute to feeling lonely, retired people are actually less likely to be lonely than people who are still working: According to the AARP study, 29 percent of retired people are lonely, versus 36 percent of those who are still working. People may simply have more time to cultivate close personal connections after retirement.

  Here's another fascinating insight: Loneliness seems to be contagious. So if you're surrounded by lonely people, your own chances of feeling isolated are increased. Loneliness can also hinder your ability to read social cues. As a result, lonely people might not notice when others are trying to reach out to them.

• Living alone

  For much of human history, most people remained close to their families from birth to death. However, more seniors live alone today than ever before, for all kinds of reasons. For example, adult children often move far away from their parents for employment opportunities, and many retired seniors move to places with warmer climates. Take a look at how living alone has changed over time and how it can change with age:

  (All of the following stats were drawn from the Administration for Community Living's 2017 Profile of Older Americans, unless otherwise noted.)

  • About 28 percent of older adults live alone today, compared to 6 percent in 1900.
  • A gender difference exists, largely because the average lifespan for women is longer. That's why 34 percent of older women live on their own, compared to 20 percent of older men.
  • By age 75, about 45 percent of women live alone.

• Declining health

  Does poor health cause people to be lonelier, or are lonely people more likely to have poor health? The link between health and loneliness is complex. For example, lonely people visit the doctor more often. But one reason for this might be that they want the social contact they get by attending appointments. Similarly, lonely people are more likely to be depressed. But depression can also cause people to isolate themselves, and isolation can lead to loneliness.

  One thing is clear: Mobility issues and health problems impact opportunities for social connection. If you're sick or immobile, you're less likely to have meaningful contact with other people, and that can contribute to loneliness.

When Loneliness Is a Problem: Warning Signs

When you feel lonely, you don't need to take a test to know for sure. If you feel lonely, you are lonely. But remember: Loneliness is not a natural part of growing older. Although many seniors experience it, many others are able to establish and maintain feelings of social connection.

But it can be difficult to tell if someone close to you is affected by loneliness. After all, many seniors don't like to admit they need help. They may be afraid of seeming "old." So it's possible that someone close to you could be suffering without letting you know that they're lonely. Symptoms of loneliness can also be confused with normal signs of growing older.

Some of the signs of loneliness are:

• Sudden neglect of hygiene and personal care
• Lack of motivation
• Mysterious aches and pains
• A noticeable increase in negative thinking and pessimism
• A drop in energy levels
• Declining interest in social activities
• A change in reaching out to you—either less frequently or more frequently
• An increase in activities that might be ways of coping with loneliness, such as shopping
• An increase in hot baths or showers, which can act as substitutes for the warmth of human contact

If a senior experiences any type personal loss, including the loss of a pet, be aware of any changes in his or her behavior. Recently moving or losing the ability to drive can also trigger loneliness. So if a friend or loved one has experienced an event that could reduce his or her social connections, reach out.

Also, be alert to feelings of increased loneliness if you've experienced a loss or a change in your own life. Addressing these feelings early on will help you in the long run since loneliness can get worse over time if not dealt with.

Health and Psychological Effects of Loneliness

Loneliness can affect your health. In fact, the impact on our bodies has been compared to the effect of smoking 15 cigarettes a day. Being lonely has also been linked to a 26-percent increase in the odds of premature death. Some of the health problems that loneliness can exacerbate include:

• High blood pressure
• Heart disease
• Depression
• Diabetes

The wide range of health problems that can result from feeling alone actually makes sense from an evolutionary standpoint: In prehistoric times, we were more vulnerable to harm if we were by ourselves in the wild. So our bodies have learned to send out alarm signals. As a result, people who describe themselves as lonely have higher levels of cortisol, the "stress hormone." And lonely people often have weaker immune systems.

Loneliness has also been linked to a 40-percent increase in a senior's risk of developing dementia.

So it's normal to feel worried when reading about the health effects of elderly loneliness. Statistics can make it seem as if health problems such as dementia are inevitable if you live alone. But when it comes to your own risk, the numbers don't tell the whole story. Even if you don't have a lot of social contact, you may be one of the many seniors who do just fine.

Keep in mind that social isolation doesn't cause dementia in and of itself. Seniors who experience the early symptoms of dementia might withdraw socially as a result of those symptoms, increasing their loneliness. And lonely seniors may be more likely to do other things that can increase their risk of dementia, such as drinking alcohol in excess.

Here's one of the most important points to remember: Loneliness doesn't have to be permanent. Talk to your doctor if you feel lonely. Your healthcare team will help you create a plan.

Solutions for Seniors Who Feel Lonely

One key to overcoming loneliness is to think about ways you can start feeling more connected to others. Consider what type of social contact makes you happy and fulfilled. After all, it's the quality of your time with other people that's most important.

For some ideas on how not to be lonely, check out these tips:

• Increase your social interactions.

  Becoming more social might sound difficult at first. But if you're retired, you may have more free time than you used to. And many opportunities are available that can improve your social well-being.

  For example, if you live near a seniors' center, check out what it offers. And think about the activities you enjoy (or have enjoyed in the past). Look for events in your community that are related to those activities. Whether you like doing crafts, exploring spiritual issues, or playing games, your hobbies and interests can help you meet like-minded people.

  For seniors who are single and interested in finding a romantic partner, online dating can offer a more simplified way of meeting new people. There are even dating sites for people dealing with chronic health conditions and disabilities, while speed dating for seniors can facilitate more comfortable and less daunting interactions. Nevertheless, seniors need to safeguard their physical, emotional, and financial well-being before diving into the dating world, as they may be more susceptible to scams and swindlers.

  Of course, you also want to have social contact that is friendly and meaningful. As a senior, you may have lots of life experience to draw upon, but making new friends can still be challenging at any age. Here are some books that might help:

  • The Relationship Cure: A Five-Step Guide for Building Better Connections with Family, Friends, and Lovers by John Gottman: A guide for being more engaged in all kinds of relationships, written by a best-selling marriage expert
  • Stop Being Lonely: Three Simple Steps to Developing Close Friendships and Deep Relationships by Kira Asatryan: Proven, practical tips for developing closeness with others
  • The Grief Club: The Secret to Getting Through All Kinds of Change by Melody Beattie: A heartfelt guide for connecting with others in tough times

• Consider volunteering.

  If you're able to, doing volunteer work is a great way to increase your social connections. A study published in The Journals of Gerontology: Series B found that just two hours a week of volunteering significantly reduced symptoms of loneliness in widowed seniors. Some older adults enjoy volunteering by helping other seniors who have less independence than they do.

• Use technology to connect.

  This may seem like a strange tip. After all, using technology has been linked to loneliness in teenagers. But for many seniors, technology use can actually help with loneliness when used wisely.

  Technology can help by providing a great way to stay in touch or even meet new people. For example, you can text or email friends or relatives. (If you don't have a mobile phone yet, find out what the best cell phones are for seniors.) AARP offers workshops for older adults on using mobile devices.

  If you prefer to see someone's face when talking with him or her, consider having a Skype or FaceTime conversation. This might be easier on a tablet or computer than on a phone.

  Consider online dating. You might be surprised to discover that online dating has gained significant popularity among seniors like yourself who want to connect with new people and establish deep and meaningful connections. Embracing this digital trend enables you to expand your social network and engage with others. Given its numerous advantages, it's no wonder that an increasing number of seniors are now embracing online dating platforms and applications.

• Exercise and have fun.

  Exercise can improve both loneliness and depression, which in turn can improve the quality of your social interactions. Plus, many forms of physical activity have the added bonus of giving you opportunities to meet new people. So check out some ideas for getting exercise as a senior.

• Consider owning a pet or getting pet therapy.

  Having an animal companion can be a great way to feel less lonely. In fact, pet owners are 36 percent less likely to report feelings of loneliness.

  Of course, living with a pet isn't a practical option for all seniors. Here's what you can do if pet ownership isn't possible:

  • If you're not sure whether owning a pet will work for you, look into fostering. When you foster an animal, you look after it until the pet finds a permanent home. Fostering can help you decide whether your lifestyle, health, and living conditions can handle a pet.
  • Look into pet visiting services for seniors in your area. Pet visits allow you to experience the therapeutic benefits of animals without the responsibility of pet ownership.
  • Don't overlook the possibility of a robotic pet. Robotic pets like the Joy for All Golden Pup and the Joy for All Silver Cat have been shown to reduce loneliness in the elderly.

• Stay on top of any hearing issues.

  Hearing problems can lead to increased loneliness. In fact, a University of British Columbia study found that a 10-decibel decrease in hearing ability led to a 53 percent higher risk of social isolation. Sometimes, seniors are reluctant to talk about hearing problems with their doctors or other caregivers. But don't hesitate to bring up concerns about your hearing. In a quiet doctor's office, a physician might not notice that you're having issues unless you tell him or her. Plus, many doctors overlook the possible connections between hearing loss and loneliness and depression unless they're reminded about them.

• Address your transportation needs.

  Not having reliable transportation contributes to loneliness, since many seniors experience big changes in their activity levels once they stop driving. Your local Area Agency on Aging can help you (or someone close to you) investigate alternative transportation options.

• Reach out for support.

  If you're feeling depressed or overwhelmed by loneliness, help is available. For example, the Institute on Aging offers a toll-free 24-hour Friendship Line you can call for support. The organization's volunteers also do outgoing calls to check in on adults who have requested someone to monitor their well-being. The Friendship Line can be reached at 800-971-0016.

Helping With Senior Loneliness: Solutions for Supporting a Friend or Loved One

Watching someone close to you struggle with loneliness can be painful and frustrating. This is particularly true if you live far away or have to stay busy with other responsibilities. But by taking the time to help prevent someone's loneliness or address his or her lonely feelings, serious health issues can be avoided down the road.

However, figuring out how to get rid of loneliness in a friend or loved one isn't always easy. You have to consider his or her unique personality and history. Here are some strategies that provide a starting point:

• Check in with the seniors in your life as often as you can—but not just to monitor them.

  This can be a tricky balance. Many older adults are fiercely independent. However, grown children who ignore their parents can also cause a great deal of stress in seniors' lives. (After all, nobody likes to feel forgotten.) So keep the consequences of loneliness in mind, and try to take the time to check in. Many people find that scheduling specific times to talk can make keeping in touch a regular habit.

• If you're separated by distance, send cards and letters. (Or email or chat online if possible.)

  Encourage seniors to explore technology, even if they're intimidated by it. But be patient if they don't "get it" right away. (The user interfaces on electronic devices aren't always very senior-friendly, and that isn't the fault of seniors.) Also, send photos. When it comes to keeping in touch, a picture really can be worth a thousand words.

• Ask questions in order to encourage seniors to share their thoughts, and tell them about your own life.

  Ask for advice when it's appropriate to do so. Everyone likes to feel useful, and seniors often have a wealth of wisdom and past experiences that we overlook.

• When you're out shopping or doing errands together, be patient with your older friends and loved ones.

  Remember that something as simple as a trip to the grocery store might be a mundane task for you, but it may be a social event for someone who is isolated in daily life. Beyond being patient with the seniors in our lives, we can help the elderly in our community by recognizing their humanity and need for social connection. (For example, the older woman holding up the line by talking to the bank teller might be having her only conversation of the week.)

• Help explore transportation options.

  You might live too far away or be too busy to act as a chauffeur. But other options are available. Check out your friend or loved one's local Area Agency on Aging to find some alternatives.

• Stay alert for elder fraud.

  Lonely adults are more vulnerable to scammers and con artists.

• If you live far away, investigate volunteer contacts.

  Many volunteer organizations can arrange personal visits and provide other services that help lessen a senior's loneliness. For example, clients of Meals on Wheels have reported that an added bonus of getting meals delivered is that it reduces their feelings of loneliness. Other volunteer services can arrange regular phone calls. An Area Agency on Aging can help you find services that fit the needs of a particular senior.

• Talk to seniors about their living situations.

  Even the most active and engaged seniors can reach a point where they may need a different living situation. Fortunately, many options for senior living incorporate regular opportunities for social contact.

You Don't Have to Feel Alone

Chronic loneliness can have far-reaching effects in our lives. But there are many ways to improve our feelings of connection with other people. And there may be practical solutions you haven't explored yet, like assisted living, which can provide a lot of relief for both seniors needing care and their loved ones. So if you feel lonely, start talking about it with someone such as a medical professional. Remember: You're not alone in your feelings. And help is available.