The Risk of Aging in Place: Social Isolation

On: August 15, 2016

By Pamela Leland, PhD

For those of us who support Elders in our community, one of the big industry trends we are tracking is the increasing desire among older people to “age in place.”

Indeed, one AARP study found that 87 percent of adults age 65 or older want to stay in their current home as they age. Given that 1 in 5 Americans will be over the age of 65 by 2030, the sheer numbers of Elders who will be living independently in the community will have enormous implications for how we will meet the needs of these older adults.

While the desire to stay in one’s home until the end of life is understood, we may not appreciate the significant risks associated with aging in place.

Not insignificantly are the economic risks: Aging in place often costs money – money that many individuals and families do not have. Money may be needed to make physical accommodations required to live there safely. There are costs related to transportation once someone is no longer able to drive. And maybe most critical are the costs related to finding and keeping qualified caregivers to provide assistance with activities of daily living when these supports are needed. Aging in place can be a wonderful experience if money is not a concern; unfortunately most of us don’t – and will not – have the financial resources that are often needed to age in place successfully.

Another risk of aging in place is related to social isolation. It is well-documented that Elders often become more isolated as they age. Health issues, physical limitations, and a declining number of close relationships all contribute to social isolation. The concern here is that there is a growing body of evidence that Elders who are socially isolated are at greater risk of early death.

Social isolation is a measureable circumstance, indicated by the degree of contact and interactions with family, friends and organizations. It is different from loneliness. Loneliness is a feeling and therefore, subjective and difficult to measure.  Social isolation is more easily captured and the evidence is alarming. One British study of 6,500 men and women age 52 and older found that  “… social isolation was a more consistent predictor of not surviving than was loneliness, and was related to greater risk of dying even after age and background health were taken into account.”

In addition to premature death, social isolation is linked to the following: an increase in cognitive decline and dementia, an increase in depression, an increase in high blood pressure, an increase in the risk of abuse and neglect, and an increase in the likelihood of needing skilled nursing care.

So what can we do to reduce the risk and degree of social isolation among our older population? How can we more effectively engage older adults into the life of our communities?

  • Provide transportation. This includes not only a strong public transit system but informal supports and/or ride-sharing systems to promote participation in all types of community activities.
  • Cultivate a sense of purpose through volunteer opportunities, hobbies and social groups. Ask older adults to work for some purpose or cause.
  • Provide supports and structures to allow for continued participation in religious services. This could mean transportation to and from services, creating accessible entrances and exits, and/or providing technical devices for those who are visually or hearing impaired. It also means educating members to support and welcome those who are older.
  • Give an older adult a pet to take care of. Be sensitive, however, to the Elder’s ability to care for the pet and do what is needed to ensure the animal is well cared for. This may mean helping with daily walking of dogs, cleaning out the cat box or taking the animal to the vet for preventive and needed veterinary care.
  • Engage the neighborhood! Cultivate relationships among those who live near an older adult who lives alone. Encourage neighbors to “adopt” an Elder.
  • Address physical conditions that limit participation. These might be issues related to hearing, vision and/or mobility. They also might be issues of embarrassment and shame for those older adults who have incontinence or other physical conditions.
  • Recognize that special attention is needed for those Elders who have recently lost a loved one or spouse … especially if the Elder had been the primary caregiver for the loved one who passed away. These Elders’ lives have revolved around their loved one and suddenly they are all alone.
  • Invite older adults out to dinner! This could bring nutritional benefits but also create new relationships, strengthen existing relationships and promote a sense of well-being and community.
  • Involve public health and human service professionals in identifying those Elders who are socially isolated. Ensure a strong service system to meet the needs of those who are isolated.

Addressing social isolation among our older population is yet another example of “It takes a village.” It is incumbent on all of us to recognize and respond to the needs of those who are aging in place but who are also aging alone.