Lone­li­ness in se­niors can be eased

Like be­ing hun­gry or thirsty, be­ing lonely mo­ti­vates peo­ple to change their sit­u­a­tion

The Hamilton Spectator - - HEALTH - JU­DITH GRA­HAM

It’s widely be­lieved that older age is dark­ened by per­sis­tent lone­li­ness. But a con­sid­er­able body of re­search con­firms this isn’t the case.

In fact, lone­li­ness is the ex­cep­tion rather than the rule in later life. And when it oc­curs, it can be al­le­vi­ated: It’s a mu­ta­ble psy­cho­log­i­cal state.

Only 30 per cent of older adults feel lonely fairly fre­quently, ac­cord­ing to data from the Na­tional So­cial Life, Health and Ag­ing Project, the most de­fin­i­tive study of se­niors’ so­cial cir­cum­stances and their health in the U.S.

The re­main­ing 70 per cent have enough ful­fill­ing in­ter­ac­tions with other peo­ple to meet their fun­da­men­tal so­cial and emo­tional needs.

“If any­thing, the in­ten­sity of lone­li­ness de­creases from young adult­hood through mid­dle age and doesn’t be­come in­tense again un­til the old­est old age,” said Louise Hawk­ley, an in­ter­na­tion­ally rec­og­nized author­ity on the topic and se­nior re­search sci­en­tist at the Na­tional Opin­ion Re­search Cen­ter at the Univer­sity of Chicago.

Un­der­stand­ing the ex­tent of lone­li­ness is im­por­tant, in­so­far as this con­di­tion has been linked to el­e­vated stress, im­paired im­mune sys­tem func­tion, in­flam­ma­tion, high blood pres­sure, de­pres­sion, cog­ni­tive dys­func­tion and an ear­lier-than-ex­pected death in older adults.

A new study, co-au­thored by Hawk­ley, high­lights an­other un­der­ap­pre­ci­ated fea­ture of this af­flic­tion: Lone­li­ness is of­ten tran­sient, not per­ma­nent.

That study ex­am­ined more than 2,200 Amer­i­cans ages 57 to 85 in 2005 and again in 2010. Of the group who re­ported be­ing lonely in 2005 (just un­der one-third of the sam­ple), 40 per cent had re­cov­ered from that state five years later while 60 per cent were still lonely.

What helped older adults who had been lonely re­cover? Two fac­tors; spend­ing time with other peo­ple and elim­i­nat­ing dis­cord and dis­tur­bances in fam­ily re­la­tion­ships.

Hawk­ley ex­plains the re­sult by noting that lone­li­ness is a sig­nal that an es­sen­tial need — a de­sire for be­long­ing — isn’t be­ing met. Like hunger or thirst, it mo­ti­vates peo­ple to act, and it’s likely that se­niors reached out to the peo­ple they were clos­est to more of­ten.

Her study also looked at pro­tec­tive fac­tors that kept se­niors from be­com­ing lonely. What made a dif­fer­ence? Lots of sup­port from fam­ily mem­bers and fewer phys­i­cal prob­lems that in­ter­fere with an in­di­vid­ual’s in­de­pen­dence and abil­ity to get out and about.

To al­le­vi­ate lone­li­ness, one must first rec­og­nize the per­cep­tions un­der­ly­ing the emo­tion, Hawk­ley and other ex­perts said.

The fun­da­men­tal per­cep­tion is one of in­ad­e­quacy. Peo­ple who are lonely tend to feel that oth­ers aren’t meet­ing their ex­pec­ta­tions and that some­thing es­sen­tial is miss­ing. And there’s usu­ally a sig­nif­i­cant gap be­tween the re­la­tion­ships th­ese peo­ple want and those they ac­tu­ally have.

This isn’t the same as so­cial iso­la­tion — a lack of con­tact with other peo­ple — al­though the two can be linked. Peo­ple can be “lonely in a mar­riage” that’s char­ac­ter­ized by con­flict or “lonely in a crowd” when they’re sur­rounded by other peo­ple with whom they can’t con­nect.

In­ter­ven­tions to ad­dress lone­li­ness have re­ceived height­ened at­ten­tion since 2011, when the Cam­paign to End Lone­li­ness launched in Bri­tain.

Here are two es­sen­tial ways to mit­i­gate this dis­tress­ing sen­ti­ment:

Al­ter per­cep­tions. Lone­li­ness per­pet­u­ates it­self through a gloomy feed­back cy­cle. We think peo­ple don’t like us, so we con­vey neg­a­tiv­ity in their pres­ence, which causes them to with­draw from us, which re­in­forces our per­cep­tion that we’re not val­ued.

Chang­ing the per­cep­tions that un­der­lie this cy­cle is the most ef­fec­tive way to re­lieve lone­li­ness, ac­cord­ing to a com­pre­hen­sive eval­u­a­tion of lone­li­ness in­ter­ven­tions pub­lished in 2011.

This kind of “cog­ni­tive re­struc­tur­ing” is an es­sen­tial com­po­nent of LIS­TEN, a promis­ing in­ter­ven­tion to treat lone­li­ness devel­oped by Lau­rie Theeke, an as­so­ciate pro­fes­sor in the school of nurs­ing at West Vir­ginia Univer­sity. In five twohour ses­sions, small groups of lonely peo­ple probe their ex­pec­ta­tions of re­la­tion­ships, their needs, their thought pat­terns and their be­hav­iours while telling their sto­ries and lis­ten­ing to oth­ers.

Join­ing a group can be ef­fec­tive if there’s an ed­u­ca­tional com­po­nent and peo­ple are ac­tively en­gaged, ex­perts said.

In­vest in re­la­tion­ships. With lone­li­ness, it’s not the quan­tity of re­la­tion­ships that counts most. It’s the qual­ity.

If you’re mar­ried, your re­la­tion­ship with your spouse is crit­i­cally im­por­tant in sus­tain­ing a feel­ing of be­long­ing and pre­vent­ing lone­li­ness, Hawk­ley said.

If you haven’t been get­ting along, it’s time to try to turn things around. Re­mem­ber when you felt most con­nected to your spouse? How did that feel? Can you em­pha­size the pos­i­tive and min­i­mize the neg­a­tive? If you’re badly stuck, seek pro­fes­sional help.

In­vest­ing in re­la­tion­ships with fam­ily mem­bers and friends is sim­i­larly im­por­tant. This is the time to move be­yond old griev­ances.

“If you want to re­cover from lone­li­ness, try to deal with dif­fi­cul­ties that are dis­rupt­ing re­la­tion­ships,” Hawk­ley said.

Train­ing in so­cial skills can help lonely peo­ple deal with prob­lems such as not know­ing how to re­new con­tact with an old friend or ini­ti­ate con­ver­sa­tion with a dis­tant rel­a­tive. And learn­ing cop­ing strate­gies can en­large their arse­nal of adap­tive re­sponses.

Both of th­ese strate­gies are part of a six-week “friend­ship en­rich­ment pro­gram” devel­oped in the Nether­lands. The goal is to help peo­ple be­come aware of their so­cial needs, re­flect on their ex­pec­ta­tions, an­a­lyze and im­prove the qual­ity of ex­ist­ing re­la­tion­ships and de­velop new friend­ships.

One sim­ple strategy can make a dif­fer­ence. “If you have good news, share it,” Hawk­ley said, “be­cause that tends to bring peo­ple closer to­gether.”

DREAM­STIME

Lone­li­ness is the ex­cep­tion rather than the rule in later life. And when it oc­curs, it can be al­le­vi­ated, ac­cord­ing to new re­search.

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