One out of two Americans reports being socially isolated and lonely, according to Cinga’s 2018 Loneliness Index.
Social isolation and associated loneliness are public health epidemics. Nearly half of all Americans report sometimes or always feeling alone or left out. The negative mental and physical health consequences of this isolation are staggering. Being a primary care partner for an aging loved one exacerbates this nationwide trend.
How Does Social Isolation Affect Mental and Physical Health?
Endless studies show the vast negative effects of isolation. Loneliness associated with social isolation is the main contributor to these negative outcomes.
Lack of social contact and the resulting loneliness increase stress and one’s chance of depression. According to a study published by The American Health Association, it can also double the risk of dementia. Stress, depression, and dementia increase social isolation, thus creating a continuous cycle.
The consequences of social isolation on our physical health are even more staggering. Those who are socially isolated may also get less sleep and have a weakened immune system. According to a study in BMJ Journals, social isolation is linked with a 29% increase in heart disease and a 32% increase in stroke. The Proceedings of the National Academy of Sciences of the United States also published a study linking social isolation to increased inflammation and high blood pressure.
Why Are We Socially Isolated? (Especially When Part of a Care Partnership)
While social isolation and loneliness are nationwide epidemics, they compound in the context of care. Why?
Stigma: Ageism + Ableism
America values the young and the fit. Despite efforts, our world is not yet age-friendly. This means the realities of providing care are not valued, understood or supported. This makes it challenging for caregivers to go out in the world with their loved one since most don’t truly understand what they are going through.
While not perfect, we have made great strides as a culture to accept how childhood differs from adulthood. We have created structures to accommodate these differences like:
- High chairs, kids menus, and crayons in restaurants
- Changing tables in bathrooms
- A collective understanding that a baby cries to communicate
There is a very low understanding of the changes that occur when someone experiences dementia or other age-related problems. This translates to there not being accommodations made. Many caregivers end up staying home with their loved one rather than facing the obstacles to go out in an ageist and ableist world.
Social Structures Are Moving Online
Technology is a double-edged sword. With many social networks moving online there is a decrease in other ways of connecting, such as phone calls and visits.
It can also be very isolating to witness the seemingly endless feed of people on vacation and other ideal activities when caring for a loved one makes it challenging for caregivers to participate in these aspects of life.
Lack of Access to Social Engagement
Dr. Richard Taylor, a self-advocate living with dementia shared that, “Many think it is the disease that causes us to withdraw, and to some extent, I believe this is true. But, for many of us, we withdraw because we are not provided with meaningful opportunities that allow us to continue to experience joy, purpose, and engagement in life.”
Social norms around scheduling and efficiency do not accommodate the pace and way of being of caregiving. We as a society need to create more opportunities where caregivers and their loved ones are included.
Shift in Roles
Family members often switch roles from being a spouse or a child to 24/7 caregiver. There is a cultural morale that comes along with care and how you must act when you take on that role. Researcher Konstantina Vasileiou shares the theory that, “Despite the significance of the need for relatedness to others, the fulfillment of sociability cannot readily be prioritized over caregiving, perhaps in part due to the moral character of caregiving and the prescriptions of the role.”
10 Ways to Beat Social Isolation
If you’re feeling lonely, try one of these ten strategies to increase the social support you have and find new ways to participate in social interaction:
- Be mindful of the friend funnel. The friend funnel is how Dr. Bill Thomas explains our social relations across our life span. Throughout life we make friends, putting them into the top of the funnel. Throughout life friends also fall out of the bottom of the funnel when they move away, drift apart or die. To maintain robust social ties, seek out new friends to replace those that you lose. Take a moment and count off how many close social ties you have. These can be close friends or family you see on a regular basis and who you feel understood and supported by. Do you have at least five? The negative effects of isolation are overcome by having five to six close social ties. If your number was less than five, start adding more friends to the funnel.
- Find friends who understand. Caring for an aging loved one is rarely understood by those without first-hand experience. Being with others who share your experiences creates what Dr. Irving Yalom calls ‘universality’. Universality is the realization that we are not alone, an antidote to loneliness. Check out these:
- Memory cafés. Local inclusive meet-ups for those living with dementia and their caregivers. Each one has its own focus and theme.
- Dementia Friends of America. A national network making sure we support people living with dementia and their loved ones.
- Area Agency on Aging. Many communities have unique resources. Check with your local AAA to see what is available in your area.
- Museum programs. Many museums offer programs designed for people living with dementia and their caregivers. These can be a great way to meet people and continue to be engaged in your community.
- Focus on palliative life. The word palliative comes from the Latin word, ‘to cloak’. It is often used today in the medical world to focusing on ‘cloaking’ or reducing suffering when a cure for the underlying cause is not possible. If this is your last chapter with your loved one, what do you want to do with it? With anything you do, ask if it is increasing or decreasing suffering for both of you. Focus on the things that decrease suffering.
- Be a shrewd consumer when it comes to technology. Be mindful of your technology use. Is it increasing your social ties or is it adding to your feelings of loneliness? Develop a relationship with technology that works for you.
- Get help. Asking for help with caregiving responsibilities can seem difficult. Start small. Can a family member or friend come and stay with your loved one once a week for an hour? Hire a home care company for as many or few hours as you can afford. This way you can have more time to be present with your loved one rather than always focused on tasks.
- Grieve the losses. Acknowledge and grieve the loss of the future you imagined with your loved one. Let yourself grieve so you can appreciate who is present and emerging.
- “Yes, and…” According to improv and dementia guru Karen Stobbe-Carter, “What happens so often is that we want to pull our loved ones living with dementia back into our world…and then the person ends up angry and confused.” Use the concepts of improv to reduce stress and deepen the connection with your loved one.
- Be here now. “We need to prepare our heart and soul to love more deeply with everything that comes to us,” shares Sarah Rowan who has loved her husband and sister along their journeys with dementia. She sees everything life throws at us as an opportunity to love and live more profoundly.
- Be in care-partnership. Constantly being in a role where one is giving to others can contribute to isolation. By entering into a care-partnership some of this burden can be shifted. “We need to move away from labeling ourselves as caregiver and sufferer, towards becoming a care partnership,” urges dementia self-advocate Christine Bryden. By developing a new relationship with the person we are in a care-partnership with we can alleviate some loneliness.
- Connect across generations. Loneliness research shows that generation Z reports the highest rates of loneliness. This does not bode well for them as they age and social connection is made more challenging due to societal norms and structures. Connecting across generations helps ease loneliness for all involved. It also helps us change some of the structures and stereotypes that separate us.
The Solution? Nurturing Social Relationships
Social isolation and loneliness are huge problems with staggering consequences. Thankfully, the solution is simple. We need to connect to each other and be with each other along the journey of life. Think of someone in your life who has drifted away. Try to think of someone who may have become isolated because they have a chronic diagnosis or are caring for someone who does. Call them and reach out. The end to isolation can start with you.