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Thursday, 04 October 2012

Loneliness and Old Age

category_bug_journal2.gif It has been conventional wisdom for a long time that loneliness in elders leads to decline in health and, possibly, early death. In June, a widely-reported, six-year study of 1600 people age 60 and older from the University of California at San Francisco seems to confirm that. According to SFGate

”...people who reported being lonely were more likely to suffer a decline in health or die over a six-year period than those who were content with their social lives.”

I can't read the full study because it requires a subscription to the Archives of Internal Medicine, so I am relying on the media who appear to have done a reasonable job with the gist of the study.

According to Judith Graham, reporting in The New York Times, the researchers, attempting to quantify the feeling of loneliness, found that

”About 13 percent of older adults said they were often lonely, while 30 percent said loneliness was sometimes an issue,” writes Ms. Graham (Judith is an online acquaintance of mine.)

“What did change over the six-year period was the health status of elderly men and women who felt isolated and unhappy. By 2008, 24.8 percent of seniors in this group reported declines in their ability to perform the so-called activities of daily living — to bathe, dress, eat, toilet and get up from a chair or a bed on their own.

“Among those free of loneliness, only 12.5 percent reported such declines.

“Lonely older adults also were 45 percent more likely to die than seniors who felt meaningfully connected with others, even after results were adjusted for factors like depression, socioeconomic status and existing health conditions.”

Reading this, I was reminded of the famous Terman study which seems to contradict this latest research.

The Terman longevity project is the most extensive study of long life ever conducted. Beginning in 1920, it followed 1500 Californians through more than 80 years with the goal to assess what behavior, personality traits, experience, relationships and more contribute to long, healthy life.

Results were published last year in a fascinating book, The Longevity Project that debunked some long-held beliefs as myths. Among them: married people live longer, happy thoughts reduce stress and extend life, and worrying is bad for your health. All wrong according to the Terman study.

Regarding loneliness, the Terman researchers reported that in terms of longevity,

“Overall, sociability was a wash. It didn't help or harm one's expected life span. The finding is an excellent reminder that supposed health benefits are often not what they first appear to be.”

And although “social ties emerged as critically important, they can cut two ways”:

”...loneliness and the absence of friends can be stressful and unhealthy unless you are seeking solitude, calm and self-reflection.”

I have no doubt that the health of some lonely, isolated elders suffers and some may die earlier than they might have otherwise. Over the years, we have often discussed how this happens.

We lose the daily camaraderie of the workplace when we retire. Adult children may move far away as do old friends and neighbors sometimes. They, and spouses, also die.

And as we get older, we don't get out and about as easily or often as we once did and that isn't always related to reduced mobility. An old friend in his seventies has mentioned several times - half in jest but there is truth here too - that when he gets an invitation, he asks himself if he really wants to get dressed.

I know the feeling; I sometimes have the same thought. And in my dotage, I'm not good at spur-of-the-moment invitations. I need time to plan so I can husband my energy and a last-minute engagement, if I accept, can disturb that balance for a couple of days.

But many elders, even without these limitations, say they don't know how to make new friends. For sure, however, you won't meet any if you stay home. In most towns, there are interest groups that meet regularly, volunteer opportunities, library book discussions, political organizations and more. If you look, there are plenty of opportunities to find like-minded people.

I've written many times that I consider blogging – as a blogger or commenter - an almost perfect pastime for elders. It's an excellent mental exercise that helps keep brain cells active and our minds nimble but what's relevant today is that it also keeps us socially engaged.

Close friendships are not uncommon among people who meet on blogs. I'm guessing that half the people I consider close I've met online during the years I've produced this blog. I've been pleased to meet a good many in person too either because we live near one another or one of us travels to the other's town.

This week, I met a TGB readers here in Portland, Oregon. Our first contact had been an email argument over something I'd written. At a long lunch on Tuesday, we left that behind and found many things in common.

So I am wondering what your experience is with loneliness, how you have or are dealing with it, and what advice you have for people who are feeling lonely (which we all know is different animal from being alone by choice.).


At The Elder Storytelling Place today, Jackie Harrison: The Last Rose


Posted by Ronni Bennett at 05:30 AM | Permalink | Email this post

Comments

I live alone, but I would say that I am rarely lonely. I still work as a teacher so there is a lot of social interaction in my day. Lately, as I think about retiring, I wonder if I will become lonely. I do not have a big social life. I do not have a vast "support system". I do not have a deep spiritual belief. In fact, I have very few of the measurable things researchers would say I need to live a long life, but I kind of like long stretches of being alone, and having just a few close friends. Hmmm...now you have me thinking about things I thought were settled in my life. Maybe I need to get back to you about this topic.

I live alone, work full time and am in my late 60s. I volunteer for literacy, am president of a golf group and have many friends. Still, lately I noticed most of my friends are either 'coupled up' or moved back with their kids. I am definitely at a later-life crisis point as to the future direction of my life and am strongly considering relocating back to my children up North. I would say I have lots of friends, but not many deep friendships to sustain me.

One thing that isolates older people is hearing loss. I saw this happen with my dad, and now with my husband. He has hearing aids, but does not wear them. I try and insist on his wearing them at least for dinner. He ends up in his own little world a lot of the time, and I in mine. I feel loneliness is in my future and that I will need to find ways to join other social groups for intellectual stimulation, since I'm 9 years younger.

Great post. I agree hearing loss can be an isolating factor. But I wonder: were those 13 percent of elderly adults who say they are often lonely also lonely when they were younger? My guess is that they were.

But here's the problem I'm seeing: As a 60-something, a lot of my friends are retiring, some are still working, some have health problems, some are moving away. Old friends are drifting away, finding other interests, retreating to their homes and their families. The old crowd, tied together by work and family, is splitting up. So how do we hang on to those old friends? And how do we make new friends when finding new friends at this stage in life seems hard to do?

Interesting point, Alexandra, about hearing loss and loneliness between spouses.

I wonder if others here have thoughts about those who don'/won't wear their hearing aids...

I feel lonely when I'm with "friends" who are self-involved. I feel drained and lonely in their company, even hours or days later. This post reminds me to let go of expecting them to change, and, instead, to direct my attention and energy to my many genuine and satisfying friendships.

Have never understood what being 'lonely' felt like. As an only child, I grew up alone. I also never recall being lonely, and at 75 am still alone and never lonely.

I'm not a recluse. I like other people, have a couple of 'friends' whom I see for lunch once in a while, and a son who lives nearby. But like being able to pick and choose when I go and where I go. Am totally content to work in my home office (I'm 75 and still working almost full time as a bookkeeper out of my home office). My favorite thing is reading and am happy in a home full of books and now, with a new Kindle Fire.

Ronni:
I always heard the stories about lonely old people and their concomitant problems.

When I retired two years ago, I left a make-work job, my last, which I had taken for financial reasons. I then retired into what I wanted to do: Write, read, and learn.
I live alone and love it. You're right; blogging has replaced conventional socializing.
Since retiring, I have found that there are not enough hours in the day for me to do everything; I get up at 5:30 a.m., and suddenly - or so it seems - it's 11-ish, and time for bed. I occasionally call or receive a call from a friend or family, but I must admit that I receive more calls than I make.

Regarding spontaneity, I agree with you. A friend called me late last Saturday morning to ask if I would like to accompany her to a play at 3 p.m. I thanked her for the thought, and told her I had made other plans.

Many people confuse the words "alone," and "lonely." I revel in the former; I don't think I have time for the latter.

I have often found it strange that I don't feel lonely. I was surrounded by people when I was a child. I grew up living in the end of a lodge building where tourists congregated. Our family was close and Aunts and Uncles were often present during my early years. I was rarely alone.

Here I am in my elder years completely alone. My family all live in other States and do not visit often. As mentioned by Alexandra, a hearing loss has further isolated me. I have a few friends here, but only see one often.

Strangely enough, the only time I feel lonely is when I am in a crowd. Because I cannot hear what is being said I feel completely left out; thus, alone.

I bless the computer, where I have made many friends, and the captioning on my phones for keeping me in touch with the outside world.

If you are busy, you do not have time to be lonely and unless you are so disabled that you can no longer read or are not mobile there are ways to combat loneliness. Even then, think of the paralyzed man that wrote a book by blinking the letters.

Of course that man was remarkable and I am not trying to imply that we could all be so courageous, but there are ways to combat loneliness. I think it comes down to choices. Our lives change, sometimes drastically, in old age. We have a choice; we can make the best of it or we can let it destroy us. I don't want to sound like Pollyanna, but keeping busy with things we like to do is therapeutic and combats being lonely.

From my own experience, I would have to question which is cause and which is effect in that study. I've said this previously, so it's old news, but two years ago, I was jogging several miles a day, kayaking, mountain biking on single tracks, and part of a community symphony orchestra. I had an active social life with a group of people who had retired to the same community to which my husband and I had retired. Then I was slammed with the effects of an autoimmune disease I didn't know I had until after I had an adverse reaction to a flu shot. I couldn't participate in the orchestra any longer. I was often confined to my house and sometimes to my bed. Planning outings or social events at our house was nearly impossible because I couldn't predict when I would be well enough to participate. All those friends? They dropped away. I no longer saw friendly neighbors every day when I was jogging or working in the yard. One neighbor checked on me frequently but only one. I couldn't drive, and grocery shopping was a physical task that was beyond me, so I no longer had even casual interactions such as, "Paper or plastic?" It wasn't all a grim life. I decided that since I couldn't do anything else, I now had time for the Open Culture classes I wanted to take, to watch foreign films that had long been on my list, to revive my fiction-writing career. And I had my family. So, I'm not asking for pity, but rather saying that I was lonely and I saw a physical decline, but the physical decline was the cause and not the effect.

I'm glad you pointed out that loneliness and being alone are not the same thing. I treasure my solitude, and find myself missing it very quickly on those rare occasions when I'm with others. I worry that I "should" have friends and "should" get out more, and that when the inevitable health emergency occurs, I won't have a "support system" in place. Still, I prefer being alone -- no stress, no pressure, no expectations from anyone else.

I suspect that the studies linking isolation and physical decline have many confounds. It has to be incredibly difficult to tease out the various factors that are contributing to the loss of the ability to perform such activities as "the so-called activities of daily living — to bathe, dress, eat, toilet and get up from a chair or a bed on their own." That 24.8 percent of seniors in this study who fell into this group suggests to me that something else that had not been identified was going on. The loss of such basic abilities is rare and much more representative of something like Alzheimer's or one of the other dementia related conditions. Since it is so very difficult to diagnose some of these, it seems to me much more likely that this is what was going on, perhaps in early stages. There are things called telomeres which are like little caps on the end of genes, and recent studies of these suggest that they determine much more of our biological destiny, our longevity, than perhaps anything else other than fatal accidents or diseases. It's possible that the stress of loneliness, experienced by some people could affect these structures and shorten their lives, while those who don't experience alone-ness as loneliness or stress might not be affected in this way.

People are so different. I like a lot of solitude. I do need some contact with other humans, but I prefer to have it in planned doses.

I know other people, however, who cannot ever be happy when they are alone. I wonder if those are the people who report being lonely in their old age. Or do they not have any outlet for socialization at all?

Actually, I did not state that correctly. Telomeres are at the end of chromosomes, not genes.

Ronni, you could probably write a column just on hearing aids and the ramifications of hearing loss as we age. I recall my great frustration with my father for not getting his ears tested for hearing aids. Then when he finally did many years later, unfortunately, he didn't have the trust in them and tenacity it took to make the adjustment of actually wearing them. I felt it left him isolated and often confused in conversations. People who didn't realize he was hard of hearing often got short with him or gave him funny looks.

After he died, I tried on one of his hearing aids. What an eye, no, make that ear opener! Not as easy as I assumed it would be to just pop them in and hear everything clearly.

Now I wonder if the best advice to anyone with hearing loss is to make that move to hearing aids as early as possible making the adjustment and living with hearing aids a routine. Trying to do it when the loss is more severe and changes are more difficult can compound the process. At the time I felt it was rude of my Dad to not try to hear what people, including me, were telling him. And at times I think he liked not being able to hear what was being said. There are volume controls for that, but I digress.

My main point is not hearing or misunderstanding what people say can affect our reactions to being with people and making or maintaining friendships; and it can affect how people react and relate to us.

Darlene, I don't know your situation, however, you might find interesting a website for Dogs for the Deaf. They are in southern Oregon and train dogs to assist people with hearing loss. Having volunteered for them, I can attest to their amazing works. I admire Ronni's aversion to promoting businesses, but this is a non-profit and dogs are placed without cost.

Ronnie.....look at these amazing notes. Oh how I understand and sympathize. Yup, even at the movies, often the music combined with my tinnitus overwhelm the dialogue leaving me asking, "what did they say?" I'm sure this drives my husband mad.

Once long ago and far away, I told my husband that I was vastly older than he and this would cause problems later. It has. I try very hard to be flexible. When the arthritis is winning, riding in a scooter isn't losing my independence, it's letting me get out of the house. These days, I even find myself at Comic-Con having a ball. We go to conventions, and I volunteer while sitting down. As I move forward into this wearing out stuff, finding new ways to do it offers all sorts of adventures.

Here, we have a blind center that offers a variety of services. G's father had macular degeneration, and not only did they teach him adaptability, but gave him machines to help him with books and the radio while teaching him braille. We also have senior centers, day care centers, and other meeting places for adults that offer classes, meals, and company all day...most free.

I'm forced into being social through another disease. I'm an alcoholic, and one of the best cures is AA. Sometimes getting to an AA meeting is a struggle as public transportation is limited. I'v made friends there over the years because I volunteer at meetings and care.

I make friends at the American Cancer Society's Discovery Shop too. There are wonderful folks who give their time there, and for me, I get to be the book lady two days a week. For me, this volunteering opportunity is better than being paid.

Just like many others, I like being alone, but I don't have to be. I retired and went back to school. I had a stroke and took up a new form of art...photography. Some forget that there are a vast number of causes that really need volunteer help out there, schools that are free, and causes calling. Often we forget there are projects that can be done at home quietly. Scan the family photos. Enter the generations in Ancestry.com.

Sometimes it takes a jackhammer to get me out of bed in the mornings, but once I get going I'm off somewhere wonderful. Thanks Ronnie.

Thank you for giving both sides of the question. As some answers above suggest, I think temperament has a lot to do with it. The distinction between loneliness and being alone is also very important. In childhood although I had a brother and caring parents, I lived on a farm and had no playmates. I found aloneness a normal way of being and enjoyed reading and practicing the piano.

For the relatively brief period of college and then my married life until divorce -- about 16 years total, I lived with other people but have lived alone every since. Once off the farm I had friends but only a few at a time and sometimes not very close, intimate friends. I felt alone, but also felt I was a whole person when alone. I felt loneliness when I wanted to share deep feelings and none of my friends were compatible; this I still feel. At 74 I have retired to a new community, made many new friends (but none intimate)and am happy with the situation. I must add that that happiness now includes living close to family which now includes not grandchildren and great grandchildren. It's as if at last I have found a situation I didn't know I missed but am happy to have found.

Thank you for this post and thanks to everyone for sharing their thoughts. I've got much to consider. I'm 44 and I'm an only child. My nest is almost emptied and my mother frequently reminds me to be more social. But the fact is I enjoy being alone. I have a handful of acquaintances and I engage with them on occasion, but I much prefer the pleasure of my own company. My mother says I'm too young to be alone; although she prefers being alone, apparently she thinks I'm too young to feel this way. She doesn't understand that I have been actively ending relationships that have been inconsequential at best, and stressful and dramatic at worst. That's the worst--contrived relationships.

Thanks for letting me learn and vent at the same time! Cheers!

People can be divided into two types, those who are energized by social contact and those who are drained by it. Of course, most of us fall somewhere along this continuum. I can be social and enjoy people but I need more and more time alone to ‘recharge my batteries’. I know people who are the opposite, they thrive on frequent human interaction. I imagine being older is harder on the latter group because of the decreased socializing that comes with retirement and being less active. For the rest of us, the quiet is a relief.

We all have individual desires and needs. My need to be in the company of others is minimal; consequently, I spend much of my life alone. This is my choice because it is what I like. I rarely feel lonely.

I agree with several responders who observed that loneliness can be subjective and has a lot to do with individuals and their personality type. I've been pretty much an introvert all my life in a world that seems to view extroverts more positively. Although I've learned to be "social" when I have to be, I rarely seek out social contact. I'm married to a wonderful man (also a bit of a loner), still work P/T and volunteer at a rescued cat adoption center. Occasionally, I meet a friend/acquaintance for lunch or dinner. That's it.

Admittedly, my situation vis-a-vis loneliness could change, especially if my husband predeceases me. We've had a great relationship for 35 years, and I can't imagine my life without him. He's in good health but he'll be 83 soon (I'm 75), and "stuff" can happen at our age. That is something I'll just have to deal with if it happens, but I know I'd miss him terribly.

Golly, I'm so glad to read all these comments. I've always felt a little guilty for preferring my own company. Closing in on 90 now, I live alone and prefer it that way.

I wonder if people who are truly and painfully lonely are not writing comments, perhaps because they are ashamed of being in a sense dependent.

There's a lot to be said for being a person who needs people.

I am more comfortable alone, and reluctant sometimes to go out and see people, but I make sure I belong to a number of groups. When these meet I am stimulated and comforted by the presence of other minds with other ways of seeing life.

i am heartened by the number of posts by people stating what i have held as a truism for decades: that alone does not mean lonely. i am a lifelong bachelor, the eldest of 10 siblings, who has had social stretches, and companions, but has always felt most at home with myself. living in wyoming now, i find many lonely people who are basically afraid to be with themselves, afraid to be with their own thoughts. who have never cultivated solitary habits of reading, contemplation, music, nature. i have no fear or reluctance for society, but my tolerance for foolishness (and worse) lessens with the years, as my wit sharpens toward the sometimes acerbic. the internet has ameliorated a lot of the need for society, though, conversely, it has curtailed my reading, which is to a degree detrimental to my growth as a person.

i'm starting to ramble.

'hey! you kids get off my lawn!'

The interesting and extremely revealing posts above have stolen my thunder! I am pleased that my opinion has been explained and elaborated so well. I am finding that what I previously thought was loneliness is actually aloneness.
I'm finding it precious. May it long continue.
Thanks for the post.

From the perspective of having reread this post, I understand that Ronnie is asking about loneliness and specifically mentions that we all know that it is different from aloneness by choice. My first post reveals that I didn't pay attention to the post!

One very easy method is to simply keep track of friends and acquaintences and visit them when they have been ill or have had an operation. I guess I am saying to reach out and focus on others rather than on oneself.

I really thought about this off and on all day long. I was feeling a little odd that I enjoyed my own company so much. I had a follow up comment, (my comment was the first one above) as I know all of you were waiting to hear my dazzling insights, but when I came back and read through, so many of you said it better than I could, and helped me think a little more about it this morning. Thanks

I hope Norma is still reading the comments on this post because I want to thank her for her good advice.

I have known about dogs for the hearing impaired for years and once looked into it. Unfortunately, I was unable to participate. You have to attend classes with your dog as both of you need to learn how to work together. I no longer drove and transportation to attend the classes was so difficult that It would have been nearly impossible to take part. I would have to walk my dog twice a day as I do no longer have a yard the dog could use for elimination purposes. Due to spinal stenosis and a hip replacement I no longer walk far and that would present another problem.

I really don't need a hearing dog as I have a CI and can hear the doorbell, phone, fire alarm, etc. The dog is handy for those purposes.

I do appreciate the thought, Norma.

I do think hearing loss occurring late in life is a subject worth its own column. My beloved grandmother was hard of hearing and flatly refused to consider hearing aids. She drove everyone nuts because she didn't understand half what was said to her. It made her seem unintelligent (which she was NOT) at times.

I want to answer quickly because I am eager to read the comments - many so thoughtful and deep. So, for myself, I'm frankly terrified of living alone. The only time I did, I think I lost my sense of mental balance. I was only 30, so maybe now that I'm older, I'll have more resources (less dramatic, more steady, more appreciative of solitude, more realistic about what's really going on out in the world). This, however, was before the Internet. I suspect that will be my lifeline. Thanks for a thoughtful post. Now to the comments.

I am 58 and hope to overcome fear of loneliness in time. I do love solitude but only if temporary. June's comment above resonated most for me. A senior community can offer lots of companionship while still preserving solitude. It's great to read how others manage this somewhat taboo subject. Thanks to Ronnie for creating this forum.

Like other introverts, I recharge my psychic batteries with inner pursuits. I enjoy being with my students and with like-minded people, such as those at the Center for Jungian Studies events. I associate loneliness with being bored, and I can always find something to interest me. I recently joined a dinner club and discovered that it is torture to be with people whose only interest is meeting people who want to dine out. Too much small talk.

I run a program that was designed to meet the need that our local Area Agency on Aging found in their 2003 survey: that loneliness and isolation are the greatest un-met needs of seniors still living independently in their homes. The program recruits, trains, and matches volunteers to a senior for a weekly visit (outings, doing hobbies, etc.) and social connection. I meet MANY seniors for whom the dwindling family and friend connections, and finally the loss of driving has turned "enjoyable solitude" into an agony of existence. Working to match like-minded individuals together has resulted in many deep and permanent friendships for both volunteer and senior, and even though it is just one friendship, its value is incalculable. I believe it's not the NUMBER of friendships - it's the QUALITY of the connection that feeds and sustains us.

Was out of town last week but wanted to add the thought that I find it interesting that nothing has been stated about the rewards of having pets in combatting loneliness.

I've lived alone since 1988 (am 53 now). While I do get frustrated at times that I don't have anyone to call up for going to a movie or out for a hike, my time spent in and around my home with my cats feels truly like a wonderful oasis from the world of awful commutes to and from work, dealing with incredibly frustrating people at work, etc.

But, back to pets. If people are mobile, there is nothing like having to walk a dog that gets you out and about getting exercise and meeting neighbors. I had a dog that died in 2003 and still miss my daily walks with her and talks with neighbors. And, it is not the same if you are just walking by yourself. People are not as apt to stop and talk to you unless you are casually walking with a dog. I do plan on rescuing another one when I retire.

And, in the home, I never feel lonely in the company of cats. I'm constantly talking out loud to them. With so many (seven), there is always something to do!

Syd and I will be married (if we make it) 50 years in April. We are our own best friends. We also allow ourselves to do the indiv. things that we enjoy. Living in our own home allows us to do that. I play the piano and computer. Enjoy movies on tv and books on tape. As for friendships - we are personable people outside but we are fine.

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