Is Loneliness Hurting Your Older Loved One’s Health?
Loneliness can have serious consequences for your loved one and may even contribute to their cognitive decline. Here’s what to watch out for—and how to help your older adult get the connection and social interaction they need.
When John Larson’s* wife passed away, his three grown children wanted him to move closer to them, but he was reluctant to uproot himself. They understood his hesitation, but they were concerned about his health. Symptoms of Parkinson’s disease were making it more difficult for John to get around. He was also spending too much time alone.
“When he was younger, he was very sociable,” says his son, Paul.* Even as he got older, friends often came to visit or would pick him up and take him out. But by the time John was in his mid-80s, many of his friends were deceased or dealing with their own health challenges. “He had no relationships with people left in his area, and we were worried that the lack of human interaction was starting to take a toll,” says Paul. John’s spirits began to sink and “he became less enthusiastic about life,” Paul adds. “He told us he was content, but we could tell he wasn’t. We knew we had to do something.”
The Impact of Social Isolation
What John was experiencing is a common scenario, according to Shadi Gholizadeh, PhD, MPH, Director of Memory Care for TheKey. “Social connections tend to dwindle as people age,” she says. In fact, a 2020 report from the National Academies of Sciences, Engineering, and Medicine found that approximately one in four adults aged 65 and older are considered to be socially isolated. The numbers today are likely even higher because the COVID-19 pandemic has kept many older adults away from others for long periods, says William Mobley, MD, PhD, Associate Dean of Neurosciences Initiatives at the University of California, San Diego, and a member of TheKey’s Scientific Advisory Board.
Social isolation, which is defined as a lack of social contacts and routinely having very few interactions with others, can have damaging effects on the well-being of older adults, says Dr. Mobley. Especially worrisome to him is the link between social isolation and cognitive decline. “Social isolation is one of the 12 contributing risk factors that accounts for about 40 percent of your risk for dementia,” he says, citing a 2020 report from the Lancet commission. Although researchers are still trying to determine why this is, a 2022 study published in the journal Neurology may help shed some light: It found that people who reported more social isolation had a lower volume of gray matter in areas of the brain involved with learning and thinking.
Loneliness—a related but distinct concept—is problematic in its own right. “It’s a subjective experience, a negative feeling or perception that there’s an absence of the kind of social connection you desire,” says Dr. Gholizadeh. When someone is yearning for more connection and that need goes unmet, they may feel depressed, stressed, and generally adrift in the world, she adds.
What’s more, there is a two-way relationship between loneliness and memory loss, explains Dr. Gholizadeh. “We know [loneliness] is a risk factor for memory loss, but awareness of memory problems or early dementia symptoms in older adults can also lead to loneliness. If they’re aware of their own cognitive decline, older adults may stop reaching out because they’re not sure how to act. Others around them may also feel uncertain and pull away for the same reason,” she says. Hence, they become lonely.
Both isolation and loneliness can have serious health ramifications. In older adults, these feelings are strongly associated with depression and anxiety as well as high blood pressure, heart disease, a weakened immune system, and the aforementioned cognitive decline. Research has found that a lack of social connection might be as bad for a person’s health as smoking 15 cigarettes per day.
Assessing How Lonely Your Loved One Is
If you suspect an older adult might be lonely, it’s important to find out for sure—and then do something about it. To start, you can simply ask them if they’re lonely—although you won’t necessarily get an honest answer, warns Dr. Gholizadeh. Inquiring how often they see friends or interact with others could provide some clues, but because loneliness is a subjective emotion—meaning a person could see friends a few times a week and still feel lonely—it may not accurately convey what they’re experiencing.
Geriatricians often use a formal assessment tool, such as the UCLA Loneliness Scale or the Lubben Social Network Scale, to determine loneliness. Try weaving some of the questions included in these assessments into conversations with your loved one, Dr. Gholizadeh suggests. The easiest way to do this is to use a condensed, scientifically validated version of the UCLA scale called the UCLA 3-Item Loneliness Scale, which consists of these three questions:
- How often do you feel that you lack companionship?
- How often do you feel left out?
- How often do you feel isolated from others?
In the formal test, respondents are asked to answer each of the questions with “hardly ever” (1 point), “some of the time” (2 points), or “often” (3 points). The researchers then add up the points. A total score of 6 or above means the person’s loneliness might be a problem. To keep things more conversational, you could just ask your loved one the questions from the test as a way to get them to share their feelings.
In addition to talking with your loved one, pay attention to changes in their behavior, says Dr. Gholizadeh. “If someone is going out much less frequently than they used to, that might be a sign,” she says. But if they were always more of a homebody, keeping to themselves might not be an issue.
Stay alert for signs of depression, which can contribute to loneliness or result from feeling lonely. Depression is characterized by such things as persistent feelings of sadness, worthlessness, and hopelessness, but these feelings are not always evident. Easier-to-spot symptoms include changes to your loved one’s sleeping or eating habits and lack of interest in activities they previously enjoyed. If Dad is suddenly opting out of his weekly bocce game or saying no to visits from the grandkids, something might be amiss.
How to Combat Loneliness and Isolation
Once you’ve established that your loved one is lonely, it’s critical to take action for their happiness and mental and physical well-being. Here are six strategies that can help you get them the support and connections they need.
1. Take Them for a Hearing Test
Hearing loss is a major contributor to loneliness, says Dr. Gholizadeh. The reason: You can’t contribute to a conversation if you’re missing out on what’s being said. Make sure your loved one has recently been screened, and that hearing aids, if prescribed, are being worn properly.
2. Foster Family Relationships
Even if you don’t live close enough to visit your loved one regularly, frequent calls and video chats will help them feel loved and supported. Get the grandchildren involved as well, suggests Dr. Mobley. Forming a strong bond with the youngest generation makes older adults feel more connected and relevant, he says.
3. Explore Volunteer Opportunities They Can Participate In
Volunteering often gives older adults a sense of purpose and provides them with the chance to forge new connections with other volunteers or those they’re assisting. Finding a good fit is essential, says Dr. Gholizadeh. Depending on your loved one’s personal interests, they might want to volunteer at a community garden, lend a hand in a soup kitchen, or fundraise for a cause that’s important to them. If you’re not sure where to start looking for options, check out AmeriCorps Seniors, which helps adults age 55 and up find ways to give back. “What matters most is looking at the person’s values and what they enjoy doing,” says Dr. Gholizadeh.
4. Help Them Get Moving
Physical fitness and socialization can go hand in hand. And two major long-term studies recently found that regular exercise can help reduce the risk of dementia, and that doing any type of exercise or activity the person likes can be beneficial. Other research has shown that even just six minutes a day of activity can give older adults a much-needed mood boost. Help your loved one find a walking buddy through their senior center, community center, or place of worship, or simply point them to an exercise program for older adults like SilverSneakers.
5. Check Out Local and Online Classes
Colleges, community centers, and numerous online education platforms offer “just for fun” classes on almost every topic imaginable. While in-person options provide the best chance to connect with others, don’t discount Zoom classes. Dr. Mobley studied the impact of a mindfulness class that was conducted online during the pandemic. He found that rates of stress, anxiety, and depression decreased while feelings of connection increased, especially in those over age 65.
6. Consider Hiring a Companion for Them
Enlisting a professional caregiver to provide companionship to your older loved one, even for a few hours a week, can go a long way toward relieving their loneliness. While many families hire caregivers to assist with physical and health challenges, they are often unaware that a professional caregiver can also serve as a companion who can engage in conversations with their loved one, take them places, and do activities with them.
What to Do If Your Loved One Says “Thanks, but No Thanks”
If your older adult is resistant to the idea of companion care, think about what kind of specific help they might enjoy. For instance, certain older adults would be happy to have help with their hair and makeup; others would love to have a personal cook or a driver. “Some will say, ‘I don’t need a caregiver,’ but they’re fine having a ‘personal assistant,’” says Dr. Gholizadeh. “You don’t have to use the word ‘caregiver.’” Work with them to choose potential candidates that fit their needs, and interview prospects together. [RELATED: How to Get a Parent On Board with Home Care When They Don’t Want Help]
Of course, finding the right match is crucial. A few years ago, John Larson’s family hired several different caregivers for him. He was always polite to them, but distant. The caregivers were all friendly enough, but John never really connected with any of them.
That changed in early 2022, when Pamela*, a caregiver from TheKey, became his live-in caregiver. She was exactly what John needed. Pamela has an upbeat, encouraging personality, and she drew him out of his shell, Paul says. Although John was reluctant to leave the house at first, “Pamela wouldn’t give up,” Paul explains. “She was very motivating. She’d say, ‘let’s not just sit at the kitchen table, let’s go out to breakfast.’” Slowly, John started venturing out.
Now, Pamela takes John, who’s 91, to restaurants, the theater, museums, and the park. “It has really changed his outlook on life and made him so much more positive,” says Paul. “My dad and Pamela have a wonderful connection, and he is not isolated anymore. He benefits—and so does our entire family—because we know he is happy.”
*Names have been changed
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