The worn-looking house at the end of the block, where the gardens are overgrown and the driveway now sits empty.
The grieving widow who refuses all your dinner invitations and didn’t seem to even want to open the door when you stopped by with a piece of misdelivered mail.
The neighbor you used to bump into in your apartment building hallways but haven’t seen in months.
In a culture where images dominate most of our communications, there is one social phenomenon we only have the faintest sketches of — social isolation.
Lonely people don’t take selfies and post them to their Facebook timelines. Many of us might stop and wonder about the people inside these quiet homes, but we can’t fill in the outlined images of lives lived mostly in seclusion.
To treat what is increasingly being viewed as a health threat as insidious as obesity and smoking, we need to see more than the broad strokes. That’s why the North Jersey Alliance of Age-Friendly Communities was gratified to see the advance of state legislation requiring a deeper look at the growing epidemic of social isolation.
Studies have linked social isolation to increased risk of cardiovascular disease, dementia, depression, and anxiety. Older adults are particularly at risk, with the AARP Foundation estimating that one in five Americans over 65 is socially isolated.
The age-friendly movement’s mission is to create community cultures in which people age with dignity and remain actively engaged in their communities as long as possible, an outcome most older adults desire, and one that ultimately saves government money on expensive care in institutions. Achieving that goal means urging local and state leaders to rethink policies on everything from housing to transportation to home care. While it can be hard to gain traction on many of those tough issues, at least there’s no shortage of proposed fixes.
A different kind of problem
Social isolation is a different kind of problem, and the social workers, public health nurses and community leaders who make up our alliance work continually to understand its many nuances. Some older adults become isolated after a health setback, the death of a spouse or other loved ones, or because they can no longer drive. Others isolate themselves for more complex reasons, such as undiagnosed mental illnesses, undetected cognitive losses, or personality changes brought on by declining health and mobility. Some lonely older adults were introverts to begin with, and their small worlds became even smaller as the years passed.
The legislation, signed into law by Gov. Phil Murphy on Jan. 21, calls for the state Department of Human Services to study the causes and frequency of social isolation.
Concern about increasing rates of loneliness and its negative health impact is growing around the world, with the United Kingdom last year appointing a “Minister of Loneliness.”
Older adults are not the only ones considered vulnerable. The state study will also examine the extent of social isolation among people with disabilities, those suffering from mental illness, veterans, active military personnel and other populations.
The resulting report would compile all available research on social isolation, while also looking at practices being used to alleviate it in New Jersey and in other states. Researchers will speak with members of those vulnerable populations, as well as with their families and caregivers and the provider organizations that work to assist them.
A comprehensive study like this could offer more useful strategies to those who spend their days trying to expand the shrunken worlds of the isolated.
As the longtime director of Meals on Wheels North Jersey, Jeanne Martin was motivated to help found Westwood for All Ages — one of our alliance members — because of the stories and scenes she’s witnessed in serving a homebound population.
Prey to phone scammers
Some of her clients have been victims of telephone scams, largely because they appreciated a voice to talk to. Others live with the television as their only companion. Many still have families, but not nearby, and the phone calls and occasional visits don’t fill enough of the lonely hours.
For many, the volunteer who brings their daily meal might be the only face they see all day, and although each driver can only visit for a few minutes before leaving for their next delivery, Martin’s organization makes sure those volunteers are trained to spot and report signs of both physical and mental duress. Her meals organization is now piloting a friendly visitor program; and to raise awareness of social isolation, Martin has for years enlisted town mayors and other elected officials to deliver meals with her for a day. “It really opens their eyes to people they never see or hear from in their communities,” she said.
Darleen Reveille, the public health nurse in Garfield, says she’s seen loneliness eat away at her clients’ mental health. Getting help for those sinking into depression can turn into a bureaucratic maze through a “one-size-fits-all” mental health system bogged down by insurance rules and program waiting lists, said Reveille, a leader in the Generations for Garfield age-friendly initiative, another of our alliance members.
As providers in the trenches, Martin and Reveille have some ideas on how to decrease rates of social isolation. Easier-to-access mental health services and increased social services at the community level would help. So might an active push within communities to increase volunteerism — both to find people to visit the homebound and to find volunteer roles that isolated older adults could take on as a way to make new connections.
Both women say the challenges will likely keep growing without new strategies, especially because social isolation is increasing among all age groups. That’s happening in part because social media and digital communications are too often replacing face-to-face interaction — something that becomes a more essential ingredient of good health when people get older.
Our affiliated communities are working to ward off social isolation through a variety of methods: organizing intergenerational gatherings; offering ride-service discounts or promoting transportation options so older residents don’t have to skip attending social events or their favorite classes; publishing resource guides so that vulnerable older adults with health or mobility challenges can find the services needed to keep them engaged and active; sparking community-level conversations, from the meeting rooms of libraries to the chambers of municipal buildings, to help make older residents more visible and heard.
These are some of the solutions that our community leaders have identified. We’ll be glad to have the state’s help in finding others.