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Social isolation and Loneliness – Keystone Elder Law – Mechanicsburg PA

Social Networks and Health Part II

Last week’s article introduced the concept of social networks and their complexity. A variety of disciplines have conducted studies involving social networks and their impact on the lives of older adults.  One popular focus of study in this area is social isolation.  A 2012 AARP paper on this topic defined isolation as “the experience of diminished social connectedness” occurring when the effects of existing risk factors for isolation are greater than the effects of  measures which would counteract isolation.

As we consider social isolation, it is important to be aware that social isolation and loneliness are two separate concepts.   Loneliness is one of the subjective factors used to evaluate social isolation, and although both conditions may exist together (and often do); the experience of loneliness is not dependent upon social isolation and an individual who is socially isolated may not necessarily feel lonely. However, studies of both concepts demonstrate that the presence of one or both of them can have negative consequences on the health of older adults.

The following situations place individuals at risk for social isolation and/or loneliness:

  • Living alone
  • Sensory impairments such as limited vision or decreased hearing
  • Multiple chronic health conditions
  • Difficulties with mobility
  • Urinary incontinence
  • Long-term insomnia
  • Major life transitions such as the death of a spouse or a move
  • Being a caregiver for an individual with significant needs
  • Limited financial income and resources
  • Cognitive deficits or psychological issues
  • Living in an area that is rural, has poor accessibility to other people or services, and/or is perceived to be unsafe
  • Limited ability to speak English
  • A small social network or limited social support

Some of these risk factors can also be consequences of social isolation and loneliness. An individual who experiences little mental and physical stimulation during the day may experience increased cognitive decline, and take frequent naps which create a cycle of nighttime insomnia.  The lack of opportunity or encouragement by others to participate in regular physical activity will result in further reductions in mobility.  Other consequences of social isolation and loneliness include increased risks for falls, inadequate nutrition, suicide (in men), institutionalization, and mortality (from all causes). In contrast, when older adults have social supports available to provide encouragement and assistance, they are more likely to comply with medical treatment, avoid behaviors which would have negative effects on health, and have the motivation to ask for help when it is needed.

When determining interventions to address social isolation and loneliness, it is important to distinguish which of these conditions is present and the underlying factors contributing to the condition. Does someone who is socially isolated need transportation assistance or to be educated about opportunities for interaction with others who have similar interests?  Perhaps someone who is lonely holds negative perceptions about themselves which interfere with his/her ability to engage in social situations.  Interventions which target specific factors, are realistic and appropriate for the situation, and have intended outcomes which match the individual’s goals are more likely to be successful.

Research has also demonstrated that within social networks, an individual’s level of engagement with others also impacts health and well-being. While there may be a benefit to attending an activity or social event; purposeful participation can further enhance an individual’s overall well-being by boosting the person’s sense of identity and creating a sense of belonging.

To re-iterate from last week’s article, the quality of one’s relationships is of greater significance than the number of relationships within their social network. Participation in activities and relationships generally requires conversation. James Lubben, a professor of social work and the director of the University Institute on Aging at Boston College, has stated that “Social conversation is one of the most challenging cognitive activities there is.”  He recommends talking to others over doing crossword puzzles in order to stimulate the mind.  Meaningful conversation will not only help fight cognitive decline, but also help build and maintain connections within one’s social network, allowing you to talk and listen your way to better health!

Karen Kaslow, RN