My dad, who had congestive heart failure, lived on the second floor of a garden apartment building that had no elevator. As the disease made him weaker, he could no long walk down the stairs. And for the last year of his life, he was trapped in his own apartment. An “outing” was a slow walk, and eventually, a wheelchair ride about 100 feet to the end of the outdoor catwalk outside his door.
I got thinking about my dad when somebody called the other day asking about isolation among seniors. And it reminded me about what a huge–and widely ignored–challenge this is. We worry, rightly, about our parents’ safety and financial security. But those of us who are caring for our parents may think too little about the pain of isolation in old age.
My parents never considered leaving their apartment. With the help of a home health aide, my mother made sure my dad was comfortable and well cared for. My wife and I visited regularly. But my dad, who was a gregarious guy, must have been terribly lonely.
While we all want to age in place, we forget that loneliness and isolation can be a huge problem. As we become more frail, our friends stop visiting (perhaps because they are slowing down too, or perhaps because they don’t want to see their own futures). It is a key reason why losing the inability to drive is so traumatic. Finally, like my dad, we may no longer be able to leave our home at all.
Yes, by remaining at home we are maintaining that all-important independence. But we may be paying a price. It is a particular problem for elderly widows but men suffer too. And the victims are often caregivers as much as those receiving assistance.
In Frances Norwood’s powerful book about death and dying in the Netherlands, The Maintenance of Life, she describes “social death,” where those nearing the end of life lose those personal connections to others that are so essential to living.
What can we, as family caregivers and as a society, do to ease this pain? Sadly, many traditional government-funded services are being shuttered in the wake of budget cuts. As I wrote recently, California will stop funding more than 300 adult day centers, a key resource that not only helps seniors but also provides much-needed respite for their caregivers. Similarly, public transportation, already insufficient, is being scaled back.
So what can communities do?
Volunteers can make a huge difference–making friendly visits or phone calls, or offering rides. Formal organizations such as senior villages, faith communities, and fraternal organizations, as well as informal groups of neighbors can help. Engaging seniors as volunteers, giving them an opportunity to stay active and contribute to their communities is a powerful defense against isolation. None of this requires much money, but it does take a bit of time.
Sometimes, staying at home is not the best option. Senior communities of all kinds, assisted living, continuing care communities, and–yes–even nursing homes, may be more appropriate, in part because they can be less isolating. The time may also come when some seniors need to leave their home and move closer to an adult child.
There are many cures for isolation but they all start by recognizing the problem.