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One of the biggest challenges facing our society is the issue of acute loneliness and social isolation, with older people being particularly vulnerable.
It’s important to remember loneliness can and does affect anyone, at any age, and may be described as negative feelings or sadness brought about by a lack of communication, companionship or relationships with other people. However, no other age group feels the effects of loneliness more than the elderly. Thousands of elderly people are lonely and cut off from society in this country, especially those over the age of 75.
According to Age UK, more than two million people in England over the age of 75 live alone, and more than a million older people say they go for over a month without speaking to a friend, neighbour or family member. The Silver Line helpline receive more than 500,000 calls from lonely and isolated older people, reporting that 53 per cent of their callers said they had no one else to talk to.
In 2019, the UK population reached an estimated 66.8 million people with one in every five people (18.5%) aged over 65 years. As the current life expectancy in the UK is 79.4 years for males and 83.1 years for females (Office for National Statistics), the UK population is an ageing one, with the number of people aged over 80 expected to treble in the next 20 years, while those aged over 90 will double.
The Campaign to End Loneliness report that there are nine million lonely people in the UK with four million of them being older people (over 65); and Age UK statistics state that 1.4 million older people in England are chronically lonely.
In a comparison with similar developed countries, evidence suggests that loneliness in later life runs deeper in England, with 13 per cent community-based older people feeling severely lonely compared with only 4 per cent of community-based older people feeling severely lonely in the Netherlands. One possible reason for this may be the erosion of multi-generational family units in the UK.
How Loneliness Can Make You Feel
Loneliness is not the same as being alone and has nothing to do with how many people you see; it is the quality of social contact that makes all the difference. It is possible to be in a relationship, or live with family, and still feel lonely. Even people surrounded by carers feel lonely, particularly if they are missing friends, family or a partner, or if they are not as active as they were.
Understanding the ‘internal’ experience of loneliness can help to combat it. When asked by researchers for the Campaign to End Loneliness, people said that loneliness made them feel:
- Not understood by other.
These strong emotions can influence how people behave and can make people cautious of social situations or regard interactions with others more negatively. This is a vicious cycle and whilst loneliness is not a mental health issue in itself, mental health problems, particularly depression and social anxiety, can cause loneliness. Vice-versa, loneliness can cause mental health problems. There is a similar relationship with dementia, where loneliness can cause cognitive decline, while dementia can lead to people becoming lonely.
If loneliness is considered an expected part of becoming older, either by the person themselves or the society in which they live, it can become a self-fulfilling prophecy and make loneliness in later life more likely.
What Makes Older People at Risk of Being Lonely?
Ageing brings many changes that can contribute to a more solitary life. One of the biggest issues for older people is that their social circles begin to shrink as the years go by.
Whilst retirement can offer more free time for hobbies and relaxation, it also can minimise or end relationships with former colleagues and friends. In addition, friends, significant others and family members may pass away or they may move away, making it more difficult to meet in person due to changes in mobility; this is especially true once an older person stops driving for safety reasons.
Research (Goodman and Symons, 2013) identified the following factors as “risk predictors” of loneliness in older people:
- Living alone.
- Low income.
- Sexual orientation.
- Poor health.
- Mobility limitations.
- Cognitive and sensory impairment.
- Poor hearing.
- Material deprivation of area of residence.
It also identified neighbourhood characteristics as relevant to the incidence of loneliness, for example:
- Structures of buildings and streets (high-rise living).
- The provision of local amenities (no local shops, libraries etc).
- Territorial boundaries.
- Residential turnover (neighbours moving).
- Area reputation (unsafe to walk the streets).
- Neighbourliness (i.e. frequency of contact with neighbours).
This research suggests that there are things that we can do as a society to combat loneliness and isolation in the older generation. However, there is no one-size-fits-all approach to addressing loneliness or social isolation, the individuality or the degree of loneliness experienced may cause difficulty in the delivery of standardised interventions.
Signs of Loneliness and Isolation
Loneliness does not happen overnight; it is something that usually happens over time as personal circumstances change. Recognising the signs early will mean you are able to get help for a friend or relative who may be at risk of loneliness or you may recognise some of these situations occurring in your own life.
- Verbal clues: When you speak to your friend or relative, they may mention that they are feeling lonely. Even if they don’t actually use the word ‘lonely’, try to read between the lines. For example, if they mention that they rarely have anyone to talk to or wish they could see friends more often.
- Mysterious health issues: You may find that your friend or relative complains about imagined illnesses – whether consciously or subconsciously – as a way of getting extra attention.
- Behavioural changes: Loneliness may lead them to appear sad, down or despondent. It may be the case that they become withdrawn or stop engaging with others. On the other hand, they may talk a lot more than usual when they have the opportunity or want extra physical contact, such as longer hugs when they see you. These are all signs of feeling lonely.
- Making friends with dubious people: One of the ways that devious scammers worm their way into older people’s lives is to make themselves indispensable for such things as DIY jobs around the home or even helping people with shopping or errands. If a friend or relative has started to spend time with someone you feel may be untrustworthy, try to speak to them about it. Older people are also more susceptible to scams including phone, postal, email and doorstep scams where scammers draw a lonely person in by providing warm and friendly connections.
Loneliness and Social Isolation as a Public Health Issue
The feeling that you lack fulfilling personal relationships doesn’t just affect your mental and emotional health, it can also take a toll on your physical health. Loneliness is thought to act on the body in a way that is similar to chronic stress.
Being lonely has a significant and lasting negative effect on blood pressure as it raises the levels of stress hormones like cortisol, which impairs immune responses and contributes to inflammation. It is also associated with depression (either as a cause or as a consequence), and research has found an association between feelings of social detachment and the development of brain biomarkers common in preclinical Alzheimer’s disease.
Other well-established health risks associated with loneliness can include increased smoking and alcohol consumption. Health issues arising from loneliness and isolation add pressure and have major cost implications on health and social care services. By intervening in this issue, we can improve older people’s quality of life, while limiting dependence on statutory services.
Covid-19 and Isolation
Social isolation is a lack of human contact and interaction and, importantly, it isn’t always negative. You can feel lonely in a crowded room and, equally, totally satisfied being alone. But unwanted and prolonged isolation such as that imposed by the pandemic can have a troubling knock-on effect on our attitude towards others.
Eventually, it can make us distrust and disengage even when we get the chance to interact, and can lead to loneliness. Finding ways to connect, even from your own home, is important. Just because we’re not currently able to socialise as freely as we could before the pandemic, it doesn’t mean we must stop socialising altogether.
Ways to Minimise Loneliness and Isolation in the Elderly
Simply chatting or being with people is not an automatic defence against loneliness and isolation. However, connecting with people where relationships are meaningful and satisfying can help to tackle loneliness, and talking about feeling lonely, like so many other emotions, helps too.
To help combat isolation, a change of scene can also improve their mood and help to lighten feelings of loneliness, even if it’s as simple as a trip to the shops or a walk in the park.
Here are some practical ways to help combat loneliness and isolation:
- Give people your time: Often we don’t listen enough to people, encouraging someone to express themselves can help you discover what they’re thinking and feeling and what interests and hobbies lie dormant, just waiting to be rekindled. Do your best to help them discover ways to adapt these hobbies or find new pastimes altogether. Once you know what they enjoy doing, you can use this information to plan further activities. Sometimes older people just need a creative push to step outside their comfort zone to find the meaningful interactions they long for.
- Learn from older people: Older people have a wealth of knowledge and skills about all kinds of things; ask them to teach you about their interest or how to do something they enjoy doing. This not only has the potential to be a great bonding experience but also can restore confidence and feelings of being valued. Asking for their help or advice about something they have done or been through can instil the feeling of still being needed.
- Teach new skills: It’s never too late to learn. This can also play a vital role in fostering relationships between generations; teaching tech to older people can also open up connections for them. Help them with purchasing devises (tech specs can be very off-putting) or pass on your own devises when you upgrade. Don’t forget to teach them about online security too.
- Send cards: Sending Christmas and birthday cards has lessened in recent years, but for older generations this gesture can mean a lot. As people age their peer group decreases, noticeable by fewer and fewer cards on significant dates, so encourage younger generations to keep up this practice as it brings so much pleasure to an older person.
- Offer to run errands: Offering to pick up some groceries when you shop can open up an opportunity to connect with an older person. Take time to have a conversation when you get the list and drop off the shopping.
- Encourage social activities: Older people may not be aware of what is available in the local area or may not feel confident about accessing some of the services. You can help by researching the information with them, and helping to overcome any barriers they may have, such as lack of transport. If they are not keen on organised activities then perhaps offer an invite to Sunday lunch or a family picnic.
- Suggest getting a pet: If the older person is able to look after a pet, this can provide a much-loved companion. Dog walking could help them to get out and about, and potentially meet new people. Taking care of a pet can lift people’s spirits, making them feel more positive and in control. Just ensure that they are aware of basic safety issues, such as walking in well-lit places and not going anywhere too remote. If they are unable to have their own pet, they might like to volunteer at a local animal rescue centre.
Where to Get Help and to Make New Contacts and Friends
The Silver Line operates the only confidential, free helpline for older people across the UK that’s open 24 hours a day, seven days a week, 365 days of the year. Call anytime on 0800 4 70 80 90
u3a is a UK-wide movement of locally-run interest groups that provide a wide range of opportunities to come together to learn for fun. Members explore new ideas, skills and activities together.
- Silversurfers is a website and social network aimed at older people. This includes the Silversurfers Forum where you can join in online discussions on a wide range of topics.
Re-engage exists to support older people who live alone and find it hard to get out.
Independent Age focus on the critical areas of health and care, loneliness and poverty.
NHS/RVS Good Samaritan Check-in and Chat (COVID scheme).
- Dial-a-Ride: local community minibuses or accessible cars operated for certain individuals in their local community to improve active independence, quality and choice.
The British Red Cross support line 0808 196 3651 provides support in more than 200 languages, supporting people who are lonely, worried, and finding it difficult to access food or medication.