Age of Loneliness - How isolation can have devastating health effects on our elderly
Being alone is the biggest fear of our increasingly elderly population, according to a new study, and isolation can have devastating health effects.
For more than 30 years, Stella McKenna and her husband ran a B&B in their Dublin home. The house was always full of guests and they used to keep a map of the world pinned to the wall of their dining room and mark off all the countries their visitors hailed from.
"We had people from everywhere," says Stella (91) enthusiastically. "From Mexico to Yugoslavia, someone from every country in the world stayed with us."
But the house is quiet now and the map has long since disappeared, put away somewhere, she's not sure where.
Her husband passed away several years ago and they never had children. Though still mentally alert, Stella's body isn't as able as it was and she can't leave her house without a walking frame and someone to help. The impromptu lunches she used to enjoy with friends in town are gone, and bustling B&B days are just a happy memory.
"It's the same building in bricks and mortar," she says. "But it's a different house, the atmosphere is different. I was used to people coming and going and I enjoyed that. Now I'm alone.
"I have great neighbours and I love getting visits from my nieces and nephews but there would be some days when I don't see anybody and times when I do feel lonely."
A new survey released last week reveals that loneliness is one of the biggest concerns facing older people. The research, conducted ahead of the General Election 2016 by ALONE, a charity that supports older people to age at home, found that, along with worrying about poor health and financial difficulties, OAPs' biggest fear was feeling alone.
"It's always been an issue but now it's become a sort of plague of our time," says Sean Moynihan, CEO of ALONE. "One-in-three over 65s live on their own, a number that's only going to continue to climb, and a huge proportion of them feel isolated or lonely."
There are multiple reasons feeding into the rise of loneliness. Family sizes are smaller, more couples are separating or divorcing, increased emigration, changes in the composition of communities and housing. We're living longer but with that comes age-related issues such as decreased mobility.
Exacerbating the problem is the lack of suitable housing stock - there's an urgent need for an option for elderly people that falls between independent living and residential care - and there's also a stigma that dogs loneliness and prevents people asking for help.
"I've had patients where loneliness has been the major factor in their decision to go into a nursing home," says Dr Kevin McCarroll from Mercer's Institute for Successful Ageing.
"I also had one patient who came into hospital purely because they were lonely but pretended there was something else going on. Others just don't want to go home because they're on their own."
Such scenarios are heartbreaking to hear, that someone would rather sit in a hospital ward than in their own home, but the problem of loneliness in the elderly goes beyond being merely sad.
"Studies show that being lonely is the equivalent of smoking 15 cigarettes a day in terms of the negative impact it has on health," reveals Dr McCarroll.
It's hard to pinpoint whether mental and physical health issues precipitate feelings of isolation or vice versa, but it's clear there's a correlation.
"People who are lonely are more likely to be physically unhealthy and it's a big risk factor for depression," explains Dr McCarroll. "There's increased mortality, increased risk of institutionalism. Then there are associated behaviours, such as people who are lonely might be more likely to turn to alcohol abuse, have poorer access to health care and have a less healthy lifestyle."
Some studies have suggested that loneliness might also alter the cortisol stress response, cause dysfunction in certain parts of the brain and have a negative impact on the immune system.
"Some of that's conjecture and related to animal models," explains Dr McCarroll. "But it's clear loneliness is bad for your health."
"Loneliness kills, and it needs to be acknowledged as a killer," agrees Peter Kavanagh, head of communications and public affairs at Active Retirement Ireland, a national network of groups that seeks to stand up for and empower older people.
"I don't believe we, as a society, take the threat loneliness poses serious enough. In an age dominated by technology and social media, many people feel more isolated than ever before."
Certainly our youth-centric culture doesn't respect or revere age the way other societies around the world do. Some countries have gone as a far as legislating to ensure the younger generation reaches out to its elders.
China's Elderly Rights Law orders adult children to visit their ageing parents and "never neglect or snub" elderly people. Singapore, the Ukraine and France have similar tenets.
In Ireland we tend to equate value with youth and earning potential, and once someone is no longer working they can disappear off society's radar very easily. It's something that many old people are unprepared for.
"We all expect to slow down with age and people are very stoic about that," says Sean. "But nothing prepares people for the pain and isolation of nobody wanting to hear their opinions or listen to what they have to say."
Alone runs a befriending service which matches volunteers with elderly people looking for companionship. Every quarter another 35 volunteers are trained and matched up with someone to befriend. Older people can request the service or be referred, and the charity endeavours to match them with someone with shared interests who will visit them for an hour each week at a time that suits them both.
"It's a bit like a match-making service," laughs mum of three Yvonne Tumelty (54), who has been befriending Stella the past four months.
"You're asked about hobbies and interests, male or female, smoking or non-smoking and location - then matched with someone with those things in common."
Stella looks forward to Yvonne's meetings and loves chatting with her with about her former life as a nurse, working in Canada or running the B&B.
"We talk about the past," says Stella. "She's wonderful. I just look forward to her coming to see me and talking over a cup of tea."
Yvonne, a childcare manager, also enjoys their chats. When she signed up to the scheme it was because her children were older and she felt she had time on her hands that could be put to good use. But she's fond of the older lady's company and can empathise with something of what she's going through.
"My husband passed away a few years ago so we have that in common," says Yvonne. "You never think you will feel isolated but things change. For me, I thought I would grow old with my husband. Now I know I will be living on my own when I'm Stella's age.
"It wasn't why I signed up for the service but it did dawn on me that there are times when I'm lonely too and I'm also benefiting from our visits."
Perhaps we don't like to look too closely at the problems associated with age because we fear growing old ourselves, but 'elderly issues' are everyone's issue and the sad reality is that older people often don't, or can't, shout loudest for help.
"Loneliness is a preventable health issue," says Sean simply. "That's the awful thing, it can be fixed very easily. But we need to stop seeing it as an 'elderly issue' and accept that we all have a role to play, because it affects all of us."
For more information on ALONE visit alone.ie or contact (01) 6791032
The elderly in isolation: the facts
• One in three over 65s live on their own
• According to the organisation Age Friendly Ireland, one third of those aged over 65 has reported feeling lonely
• Some studies have shown that older people who experience high levels of isolation are almost twice as likely to die within six years compared to those who feel engaged in relationships and the community
• Loneliness has been shown to have links with mental and physical health issues including depression, a higher risk of dementia, cardiovascular disease and reduced immune system response
• Our population is growing by 20,000 additional older people every year. By 2036 it's estimated that 20pc of the population will be aged 65 and older
• It's estimated that, on average, those aged 80 plus spend 80pc of their time in the home
• A recent study in the UK found that two fifths of older people said that the television was their main source of company