Isolation

 Isolation, Loneliness, Listening and Connectedness 

The Elderly and Disabled at Home and in Facility Care Settings

“Social isolation is the distancing of an individual, psychologically or physically, or both, from his of her network of desired or needed relationships with other persons. Therefore, social isolation is a loss of place within one’s group(s)” (Biordi & Nicholson, 2009)  AARP Foundation Report – Framework for Isolation in Adults Over 50

Many of the daily supported callers to The Samaritans of Rhode Island’s  Hotline/Listening Line  are elderly or disabled living at home or in long-term facility care settings. Today, with countries around the world are recognizing isolation and loneliness as a global problem, we welcome their calls.

As we age and/or become disabled, and lose autonomy over how we live our lives, evolving circumstances in care can be overwhelming and are often traumatic especially for the elderly and disabled in facility care settings.

Changes in residential venues, caregivers, losses of lifestyle, losses of family members, failure to notice physical changes and the need for adaptive resources to respond to those physical changes (something as simple as hearing aids and glasses) as well as the lack of access to family, friends and community can create feelings of isolation and loneliness. These factors and more may contribute to confusion, depression, apathy and increased behavioral incidences in short and long term care facilities.

Suicide among the elderly can occur in facilities settings.  Loneliness, isolation and lack of meaningful connections are considered risk factors for suicide.

Research  and models of “patient centered care” demonstrate, after thoughtful consultation with the resident regarding their own personal needs, values and lifestyle history, feelings of loneliness and its associated negative health outcomes may be improved without pharmacological interventions.  Input from a primary caregiver and other family members may be helpful as well.

Because many causes for depression associated with loneliness may include issues impacting on overall medical and behavioral wellness, any care plan model for the elderly at home either living alone or with family members or other caregivers or proposed  by medical and professional staff of facilities, at any point of care,  should be reviewed in joint consultation with both primary care, the patient’s medical specialists and behavioral health providers.

What role does “connectedness” play? How can we determine what connections are missing and impacting on the emotional health of the resident?

Nonjudgmental listening or befriending to a resident can be an important tool in identifying those connections that matter most to him or her and most importantly build trust. Is it involvement with the person or persons with whom the resident has the most positive relationships? Is it a spouse, partner, child, sibling, or other caregiver with whom the resident has a warm and loving relationship? Is it a need to have consistent contact with family members? Is it a need to participate in faith based activities? It is a need to participate in social activities outside of the facility? Is it all of the above and more?

Loneliness and the lack of connectedness can have significant physical and emotional consequences. Listening, learning and responding to a resident’s unique view of how to address his or her individual circumstances of loneliness and connectedness can lead to positive outcomes and hopefully greater resident satisfaction.