Today’s Lesson

Loneliness and social isolation are the new shiny objects in the field of aging. Or that’s what I thought before this morning’s lecture at a local aging symposium.

My dismissiveness came out of my disdain for anything that portrays older people as pitiable people. Here’s just another way to marginalize old folks, I thought, paint them as lonely and alone, incapable of social connection, withering away from lack of attention. The older I get, the more my nerve endings are just waving around in the breeze picking up these slights.

Earlier in the year, at a meeting of the County Board, one supervisor bemoaned the terrible plight of old people during the pandemic. ‘They’re afraid to open their front doors’ or words to that effect. Cowering, afraid, alone, friendless. While he piled on, I looked down at my hiking boots and saw that I hadn’t scraped off all the mud from our morning trek in the park. I’d had to open the front door to go.

So, I had some belligerence about this morning’s lecture, a chip on my shoulder maybe. That dissolved pretty quickly into ‘just because this isn’t happening to you doesn’t mean it’s not happening.’

The name of the lecture was “The Forgotten & Parallel Pandemic: Loneliness & Isolation in Older Adults,” by geriatrician Dr. Carla M. Perissinotto. She is pretty much the national expert on the connection of loneliness and social isolation to health outcomes. If you’ve a mind to, you can read her groundbreaking research conducted in 2012: “Loneliness in Older Persons: A predictor of functional decline and death,” here.

The gist of her presentation is threefold. First, loneliness is a feeling, essentially, it’s the discrepancy between your reality and what you perceive others having. You can feel lonely anywhere but you’re probably more likely to feel lonely if you’re alone. Social isolation is a fact. You live alone, you have limited mobility, few social contacts, and don’t use technology. The two things don’t always go together, but often do, and can be measured by people’s responses to three simple statements: I feel left out. I feel isolated. I lack companionship.

Second, loneliness and social isolation are really bad for your health. Not just a little bit, either, but significantly, up to and including higher mortality. So, there’s increased physical suffering as a consequence as well as higher costs. People get sicker, they cost more money. That’s a crude calculus but it’s real. Sickness begets more sickness. We’ve all seen it happen. The ride downhill is a fast and scary. And expensive.

Third, loneliness and social isolation must be seen by medical personnel in order to be addressed. By seen, I mean asked about, discussed, recorded in the official record as something important. When it is seen, there are strategies to ameliorate loneliness and social isolation: volunteering, group activities, intergenerational programs, peer support, and technology. Dr. Perissinotto writes ‘social prescriptions’ for her patients, basically telling them to go to the senior center or to agree to be trained on how to use the iPad their kids gave them three years ago.

Thank you to the good doctor and to the folks who hosted her (all old themselves) for removing this particular piece of ignorance (and maybe arrogance) from my repertoire. Loneliness and social isolation may, in fact, be the new shiny objects in the field of aging but appropriately so. I live to learn another day.