A TGB READER STORY: Carole's Debate
Sleeping – or Not – While Old

Old Age and Loneliness

It has been known for years now that loneliness can be devastating to the health and well-being of old people. According to a report from the National Poll on Healthy Aging at the University of Michigan published earlier this year,

”Research shows that chronic loneliness can impact older adults’ memory, physical well-being, mental health, and life expectancy. In fact, some research suggests that chronic loneliness may shorten life expectancy even more than being overweight or sedentary, and just as much as smoking.”

Other reports have found that one-third of American elders are lonely. More women say they are lonely than men and living alone has a high correlation with loneliness.

The people who hand out advice online tell us that loneliness can be relieved by what has become a fairly standard list of prescriptions that includes volunteering, joining a tai chi class or a choir, practicing gratitude or adopting a pet. One list of this type includes buying an Amazon Echo to talk with.

Uh-huh.

Undoubtedly, much younger people are the ones making these lists. They don't often take into account such things as physical limitations or transportation difficulties, for example. Further, all the studies I've looked at assume that any person who says he or she is lonely, even those who choose the “sometimes” answer, are miserable about it.

News flash: I feel lonely sometimes. I have felt lonely sometimes throughout my life. Usually I can move on after a good night's sleep.

What has become clear in my case over the years is that I need a lot more time alone than many people I have known. No one who studies loneliness seems to have considered the fact that some of us enjoy our own company a great deal of the time.

None of that is to say that loneliness is not painful, hard to live with and often associated with depression. And old people have the added difficulty that if you live long enough, a lot of the people who mean the most to you, who you may have known for decades, die.

Sometimes I wonder if one of the reasons I enjoy keeping in touch with my former husband is that he is the last human on earth who knew me when was 17. There is comfort in that.

For a story about elder loneliness last March, Time magazine interviewed Dr. Carla Perissinotto, associate chief of clinical programs in geriatrics at the University of California San Francisco:

“She says loneliness refers to 'the discrepancy between actual and desired relationships' — so it’s possible that someone who lives alone doesn’t meet that definition, while someone in a house full of busy people does. 'It gets to the quality of the relationship,; she says.

“Perissinotto says it’s important to address each person’s underlying cause of loneliness, whether it’s the death of a spouse, medical problems that make it difficult to socialize or leave the home or unmet social expectations.

“Doing so takes 'understanding and being honest with yourself about whether you could be experiencing loneliness,; Perissinotto says.”

There is at least one place in the world that has done more about elder loneliness than any of those lists could. I was alerted to it by TGB reader John Gear.

This short video explains clearly what has been happening in Frome, England, after a doctor there created a system in which loneliness is treated as a medical condition. Take a look:

I'm not sure that the same approach would work everywhere but a good start would be to make loneliness an integral part of healthcare, something physicians, nurses and other healthcare professionals ask patients about. Of course, the hard part comes next - finding ways to help. I suspect what works in a small town would be difficult in larger cities.

What do you think?



Comments

I love this idea and with some attention, caring and compassion this could happen in other places.

Bravo to the doctor who noticed this trend in her patients and conceived a way to combat it. I don't like to be one who always touts that things used to be better. But I can't help but think that when I was 6-7 years old, there was a 98-year old woman who lived across the street. Although this woman was not my mom's favorite, and perhaps they didn't have a lot in common, my mother routinely visited her. This was common in those days. In the 1990s I lived in an apartment building where my closest neighbor was a 98 year old, deaf and blind woman. Our whole building kept an eye out for her, checking to make sure she was ok. Our society has lost a lot when cities and towns have to print reminders for people to "check on your elderly neighbors" when power goes out or storms dump a foot of snow.

Ronni, this topic is precisely how I found your wonderful blog just a week or so ago. I don’t know if 58 is considered old age, but this is a problem I wrestle with. If it wasn’t for a couple of my sisters (who live far from me but we connect thru email) I’d be in real trouble. I never married or had kids, so they’re the only family I’ve got.

I was able to save & invest thru the years, managed an early retirement a few years ago. I guess I didn’t realize all of my physical relationships were work-related ones. I was naïve at the time to think I’d maintain the friendships I had there. Anyway, was just coming to my senses that I needed to be more proactive about this a year or so ago, when I developed chronic TMD after a kidney operation (a jaw disorder which limits my speaking & diet). So… reading others blogs (and writing my own) has been a real help.

My mother lived a short life, my aunt her only sibling lived to 100 and married at least 3 times only to divorce them..She was rich and had many possessions but nasty and tart so to speak..a brother called me to go on and on about his inheritance from her, I stopped him as I got tired of the yada yada and said I don't care, she was miserable, rich and nasty..You sound just like her so good luck living to 100 all by yourself..he hung the phone up and never called me again, thank god for favors..This other woman who treated me better than most in my family lived to 95 she outlived her husband about 30 years and missed him a lot, I entered her life when she was about 59 and she was nicer to me than most of the blood relatives ever were, she lived a long and happy life adored our only child and thought of me and my hubs like her own, she enhanced my life..It is a matter of perspective living alone, but I tried to visit this lovely lady as often as I could and showed her the love I was denied from my so called blood relatives..I was lucky I have had strangers and people I am not related to treat me like family and they are still alive and knew my Mom, they felt I was cheated because my Mom passed young..I truly think it is people who love and care about you and show it that matters, single, married, divorced whatever...I read your blog a lot and pray to a spirit to heal you yes I do..take care of yourself..ciao and peace and love...!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Your comment of knowing a person from early on struck right home with me. You never spoke a truer word. I am 82 and my sister is 84. She lives in England and we have a weekly telephone call often lasting for well over an hour. We leave these calls so vivified and ready to get back into our lives. Very often the talk is about early memories and our comments are about school days and marriages. We were both widowed but I have remarried.

We are lucky in our children. Her son lives very near her on their shared land and while her 2 daughters and 1 grandchild are in Australia they keep in touch well, also, and visit her at least once a year.

My daughter and her family are over 1,000 miles away in Texas but we, too, telephone weekly and now that my granddaughter has started at the Univ. of Texas she is beginning a telephone relationship with me--surprising and delightful.

I am outgoing and gregarious but chronic sickness keeps me at home and I am the last of a close friends' circle to still be living. Without my husband and the telephone and daily family and other friends emailing I can see that I would be lonely indeed

Again, thank you very much for the time and thoughtfulness you spend here--so very much appreciated,
take good care of yourself, Erika W.

Almost 10 years since my husband died and I am lonely for him every day. Sometimes desperately, sometimes moderately but I am never without that longing. What seems missing in most of the discussions of loneliness in old age is the loss of someone who filled your life. I am graced with loving children and grandchildren, colleagues and friends old and new, but no one can take his place.

Thanks so much, this blog post arrived in my mailbox just in time!!
I am usually alone, often lonely, but often needing alone time, and to see this issue discussed clearly and in its complexity made me smile on this lonely autumn day!
(It turned out to be good alone time ... here as time goes by)

Went to a new doctor last month. (There were several factors that caused me to look for one, but that's off topic here.)

We had a blazing chat. It was interesting, vigorous, touched on lifestyle and its relationships with health. The doc was clearly LISTENING and giving feedback on my responses to her questions. At the end of the visit, she gave me the latest Medicare "how do you feel" questionnaire. It targets emotional health, asking about depression, loneliness, falls, and such. Just another form, but I filled it out. Perhaps we'll discuss it another time.

Truthfully, I left the office feeling rejuvenated and alive, and I think it was because this new doc and I had such a wonderful chat. Most people think I'm quite gregarious, and they don't recognize that I am actually lonely when I spend too much time alone. I volunteer and take lifelong learning classes at a nearby college. If I were confined to my house, I'd probably do nothing but watch TV and sleep.

A good lesson, I think, that I need to get up and go to be happy.

My wife and I still enjoy each other's companionship. I also really enjoy my alone time.
Thirty years in a toll booth and many years alone make my private time valuable. I do,
however, feel sorry for my Mother. She's 95 and her generation is almost gone. She's been
single for many years. Her last boy friend was 101 when he passed. She comes from a different world, before WWII and during the depression. We visit, but it's just not the same
for her. She says now she only wants to live until 97, not 100. Like a much younger friend of
mine pointed out: "Only in the US can we afford to keep people in closets".

Solitude and retirement. I relish them. After a lifetime of catering to other people's demands, needs, deadlines, and preferences, I can finally do my own thing at my own pace, without consulting anyone else. That may sound selfish or something, but I'm very shy and introverted and what seemed like a "normal" life for others was always stressful for me. Just sayin', some people love solitude.

So wonderful, so simple, do-able. I'm going to take this info to my two regular docs. The senior center as well.

Much as I need a lot of solitary time, people are most definitely important to me in many ways. Being housebound day after day, with little or no company, as the woman in the film, and many elders everywhere, would be so very discouraging.

The Village movement is doing things to address loneliness. Local information at villagesnw.org

I am really lucky cause I live in a retirement community of 250 people. We have loads of activities and can enjoy each other in the dining room as well. I started a memoir group where we share at a deeper level. Lots of laughs throughout the day. But it's easy to go to my apartment when I need alone time. I still have friends from church and Al-Anon as well. If I ever do feel lonely, I reach out to someone -- possibly someone who needs a buddy just then.

At over 80 I live alone, never had children. I do feel lonely some of the time, but I can also see that I isolate myself, and I can do something about that. I do get out, I have a few friends, and I have pets that make a nice family.

The thing I'm really lucky about is my membership in Alcoholics Anonymous: First, because the illness forced me to look for treatment, and if I hadn't been alcoholic, I would've just muddled through miserably, having been brought up by a critical and belittling mother who had narcissistic personality disorder (quite a bit like Trump, actually). That left me with defensive reactions that have always had an impact on my relationships with others, even as an adult.

My alcoholism got me to AA, where I found the support, love, and training to be an adult that I never would otherwise have found. AA taught me everything from how to pay my bills and clean the house to how to make and maintain friendships, to remember that what the other person does is mostly about him, not about me, the power of just being useful, and to recognize that we are ALL connected in the universe.

Now, almost 50 years later, going to AA meetings and doing some kind of service there--open the meeting, make the coffee, talk with newcomers--keeps me in touch with people who are certainly my friends. I can go to meetings every day. I invariably feel better afterward, and have perhaps been useful to someone else, too. AA continues to transform my life.

What a great Scheme, program they show. Almost 50 years ago I worked for a social service agency in Jax. Florida, JFCS, and we had referrals, and I was the lone caseworker with about 35 individuals or couples to make calls on, take shopping, etc. We did referrals to a nursing home, and HUD units as well, I was very young, just out of college and loved visiting and calling, and thinking this can be done, as we did also utilize volunteers like the man she referred to. Now I'm almost the age of many of my clients, and part of a sandwich generation, my Mom gets lonely, but know she likes her home, and alone time too.

I'm basically a total introvert so rarely experience loneliness. However, my husband who will turn 90 next month, is a big part of my life. I can well imagine Ann BW's situation, as it would undoubtedly be the same for me if he predeceases me (I'm approaching 83). Given physical pain, in addition, I don't think I'd want to linger much longer if that occurs.

This seems a huge topic. Although loneliness is worse for older adults, because of isolation, I think it affects the whole society. We've lost our sense of community and the sense that we all belong to the same world.

I'm not sure how you fix that without changing society, but where I live (Boulder, CO) there's a senior peer counseling group that pairs senior counselors with seniors who are going through difficult times, including loneliness. It's based on the idea that seniors know best how to talk to other seniors; we share similar issues.

The Plans to help the elder lonely, some mentioned already, are wonderful. However! In the U.S. anyway, you unfortunately almost always have to live close to New York City, Chicago, Los Angeles, or the San Francisco Bay Area to participate. And although it's probably a good idea for most elderly to move nearer to places with services like this (and some of us would love to!), most of us cannot do it due to physical and/or economic and/or spousal (he/she refuses to move--my main reason) reasons. I heard about a wonderful-sounding program called Elder Orphans for people such as me with no children (or none willing/able) to help them in old age. However, as with so many of these wonderful things I hear about, it turns out to be like a desert mirage: not located anywhere near to here or it's not even in operation at all anymore.

Volunteering (if you're even still able to, physically, transportationwise) can possibly help with boredom relief but usually, as recent research shows, will not result in friendships. What seems to work with making friendships is lots & lots (hence why it takes years for true friendships to grow) of shared (being in each other's physical presence) experiences, where you just happened to be at the same place (such as work or school but not anything forced & therefore artificial seeming like volunteering or meetup groups or clubs). I've noticed that the therapeutic/counseling/psychiatric community has finally caught on to this and is no longer advising people to get out there & mingle to make friends; they seem to have caught on to the fact that that will only alleviate boredom or help you get physical exercise. In fact, a book I recently read that was discussing narcissists advised against taking up people making even mild as "wanna go grab a cuppa coffee" type "friendship" overtures; apparently the therapeutic community think that it's usually narcissists that do this since some1 they've been using caught on, dumped them and now the narcissist is desperate for some1 else to use. Apparently people that simply want to be friends are supposed to realize that they have to put in a lot of hours (or years!) to get to the coffee invitation.

And altho a lot of us seem to be distrustful of those darn "experts", I'm afraid they're mostly right about a lot of this. You see, my nephew & his wife, who between the 2 of them have worked for years in every phase (independent living, assisted living, nursing facilities, in-home assistance) of elder care, have sadly verified this for me. My niece-in-law, who had worked her way up from a nursing aid position to activities director, got so burned out on trying to get elder to try to make friends or have fun for a scheduled hour every week that she is now back to working as a nursing aid doing physical care. (She said the only way to make most elderly happy is if you made them 30 or 40 again. Or have them go back in a time machine & raise their kids to expect to help out when they get elderly--or even have kids in the first place!--or somehow turn them religious so they think they have a wonderful afterlife to look forward to.)

But, hey, you know what? Being amongst the lonely elderly makes you a member of a large club! I know it's the only time I've ever been a member of a large club; yay me! Ha.

Smiling. Dr. Vivek Murthy, the immediate past US Surgeon General, has made this his 'platform' - and has written and spoken about - and speaks about - this extensively. (I was privileged to interview him. I'm in the meetings/conferences/hospitality industry where people are brought together or choose to come together and yet can be lonely amidst a crowd. It's worth searching his name for what he's said/written.)

A strong "Introvert" on Myers Briggs - and even long before I knew that I KNEW that: as a child I was happiest in my room with a book. My mother (z"l), an Extrovert constantly suggested I 'go outside' and play with others. I did ...now and then. My way of connecting is through activities like community service. And since 1992 when I first discovered the internet and chat rooms, and now the ability - like here in our discussions - to interact virtually with many, the desire to connect is available.

Lonely? I don't know. I have the ability to be with people and yet, for ease am happy to just be with myself...and a book and cats! (Yes, I have a spouse and they are also introverted - so I'm fortunate I know.)

There was such a long list of comments, I am amazed for how many this resonates. I have an additional difficulty in that I have never had very good social skills. I'm certain that if I were in "school" today, I would be diagnosed high functioning autistic. There are many adults for whom the social environment depicted on television in retirement communities is just out of reach. I would rather be alone than try to go through the gauntlet of people with whom I don't fit, or whom I offend without realizing it. Even volunteering can be awash with social conflicts, as people jockey for position, as it were. Add to that childless, and you have a recipe for loneliness in old age. We recently moved to a real neighborhood again, with children, ice cream trucks and the older set walking and often with their dog. We are marginally less lonely, and we do have people to wave at and occasionally talk to. My husband is recovering from a life-threatening surgical complication, which makes us even more isolated. We are trying, but I can't help thinking, what happens when there is only one of us?
Loneliness may mean something slightly different from person to person, but however we may define it, this is a real factor for the elderly. I remember seeing a hallmark commercial years ago of two old women on a bench, comparing wallet pictures, wishing for just one call. Since that time, I call my mother, who is now 96 and no longer can hear me on the phone very well, every week. But there won't be anyone to call me. Sounds boo hoo, huh. I think my conclusion is, no prescription to combat loneliness will work for everyone, and aging with a social disability really compounds isolation.
I found that writing a memoir, and confronting loneliness head on, helped me to think about what other women my age had done; and since my grandmothers weren't particularly social, and my mother is a recluse at 96, I used the memoir to try to seek a better "mentor" in my past and imagine a more positive future. It definitely helped.

Me too. Most of the time I prefer solitude. It's so much easier. Isn't occasional loneliness part of the human condition?

I feel less lonely in general than lonely for specific people who have died, moved away, moved on. My senior center, with its wonderful social worker, various support groups, activities, educational presentations etc. serves my community in much the same way as that health care facility in England. I wish everyone had access to something like that.

I'm apparently just not very likable, or maybe just not much fun. Or maybe too assertive/abrasive/contentious, despite my best efforts. Despite being a joiner and as much an extrovert as an introvert on every questionnaire I've ever filled out, I just don't know how to make the next step to form a friendship that involves doing something...a movie, say. Or the person can't make it and the offer is never reciprocated. And...much as I like company and a little small talk, I dislike it when people never stop talking. Or when the conversation bores me. Or when I'm looking at the art, say, in a museum, and the person I'm with is talking about her annoying daughter-in-law. So I think I'm with the folks who suggest that loneliness isn't about warm bodies nearby, but about someone who cares about you and, maybe more importantly, *gets* you. I am lonely...but lonely for someone to share things with.

I agree that volunteering puts you in contact with people but I didn't find a lot of connection outside of the volunteer site. I am not really lonely right now because of the family around me and a few close friends but at 70 I can see that once they are gone I will be lonely for their company. As we all age health and limited mobility will make it difficult to get together, even now we all think long and hard before traveling to see each other.

For the reader who mentioned Elder Orphans, that is a Facebook group that posts almost daily discussions about every issue from loneliness to estranged/deceased family, last wishes, pets, etc. by those who are members. Post a question and there may be over a hundred comments, almost always supportive. Only requirement is that you are dealing with being older alone, without family nearby if at all, and having few people to talk to about all the issues that go with that.

Some have discovered others live near them and have formed in-person groups. It is a free group, just ask to join.

And Ronni, check out your community paper this week, Senior section, for my column on this subject.

Thanks Meggie - after writing this post I will go to facebook. I too am alone although I have 2 estranged daughters which I think makes it worse ... although to have two ungrateful daughters living with their constant critiques would certainly be worse than living without them I am 85, have COPD, and thank god, I have enough money to live very well although not wealthily. I recently joined a Hospice Group. We meet for 2.5 hours once a week and it has been wonderful for me. What lovely brave people we all are - all facing the grim reaper! I also swim once a week which I love [the only thing I can do that looks and feel somewhat the same as when I was a young thing]. I used to simply hate long weekends when it seemed everyone, except me, was with someone. Now I plan to clean up my bookmarks, watch movies, cook and freeze my meals or whatever and rather enjoy them! Take care all and especially Ronni.

Thanks for this subject w/ all the comments. My one most difficult problem is dealing w/ the alienation of both sons due to post-divorce damage by x. I remarried after living alone for 10 yrs. & now my husband just turned 84. His physical, as well as mental health have deteriorated over the past five yrs. I'm adjusting consistently & at least am glad that he is still able to live at home. I've mentioned before here that two of my dearest longtime friends died 2 yrs. ago within 4 mos. of one another. My favorite cousin and I lived in completely different areas of the East Coast but spoke on the phone several times a week for 30 yrs. She also died. Although I've had some tough bumps to get over, I'm finding now that I've been really adapting gradually to the changes. I'm not interested in making new friends because I just don't have the time since I have to be with my husband 24/7. I have always loved reading. I would be lost without my computer because I read the news & my fave bloggers every morning while sipping my coffee. I do lots of research because I'm always interested to learn about some little thing I've read online or in a book. I love music & my 2 rescue senior pets. Luckily, there is one dear friend remaining with whom I stay in touch. I realized recently that the most lonely & painful thing I will never get over is the loss of my children. Other than that, I am content with my life due to my ability to adapt & be realistic. I'm fortunate my vision & hearing are good. I've also got my beautiful gardens & wildlife in this little corner of the world which give me so much pleasure. Again, Ronni, thanks for the topic.

Meggie, I'm the person who posted about Elder Orphans. I'm not on Facebook but my sis-in-law is and she checked EO on Fb & said that there were no Elder Orphan groups anywhere near me. This leading to something I point out to much-younger people that I interact with (usually online only): if at all possible, people should try not to strand themselves in a middle-of-nowhere place so lacking in services as I did (long story why); you may love the "peace & quiet" at first, but it really becomes a problem as you get older. And if young people think that when the time comes to move closer in to civilization with services that elders need, they'll just move. Um, not so fast; you may not be able to afford to (even if you are able to sell your place, not a sure thing these days): moving from a rural/semi-rural area closer to a city always costs more. Like someone I talked to online with, who had worked for years in Georgia & wanted to move back to the Los Angeles area where she had grown up & still had a few family members and friends: even tho she got a great price for her GA. house, it wouldn't buy a dumpster to live in within 400 miles of L.A. So it's something that younger people, if possible, should try to plan ahead for but most of us don't think like that when young unfortunately.

Thanks to all for your illuminating and moving comments. Anonymous, you have found what broadly would be called "fellowship". It's an old word we don't use much anymore.

Used to be everyone I knew as a kid (I am 71) belonged to a faith community, a service club, AA, bowling league, golf club, garden society, you name it and usually more than one. Now people come home, watch a movie, surf the net.

There has to be less live social interaction all the way through adult life. Then we get old and realize those ties, whether casual or life-saving like yours, have not been secured.

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