APA Format Assignment

Elderly Isolation

How to Identify and Address the Symptoms

GERO XXX

University of Maryland University College

Elderly Isolation

How to Identify and Address the Symptoms

Elderly aging issues are not on mainstream society’s mind and they’re not a priority nor a daily thought. The elderly across the U.S. and in many countries are collectively a large majority of the world’s population who require sustainment and assistance. If there are not smarter methods to identify, encourage or take preventative measures for the elderly population, the remaining population will have to manage the long-term consequences that may arise from ignoring the predictable and preventable problem of isolation. As the U.S. Baby Boomer population continues to age in large volumes, there are more signs of elderly persons who are becoming isolated and lonely, either because they have no one to connect to; they live in suburban neighborhoods or choose not to be a burden for assistance. These are the isolated statistics that are becoming more prevalent as the Baby Boomer generation continues expand and show inherent issues that have never had the required studies or advocacy. The isolation problem is not only prevalent in the U.S., but there is a growth in studies and analysis conducted around the world on multi-national elderly, immigrants and their isolation problems (Victor, C., Burholt, V., & Martin, W., 2012).

First, the basic definition of elderly isolation must be understood and what factors play into social and self-isolation. Also, what affects isolation has on the elderly population’s cognition, health and caregivers. Secondly, there are some new innovative ideas that can assist the elderly population in changing their isolation status, but a change of conventional ideas must be accepted to find new solutions to this growing problem. The generation who are most affected are the ones coming up with the solutions, to include those in the medical field who see the statistics walking into their offices daily. Finally, moving forward with the assistance of the medical and Gerontology communities who can bring attention to this problem, not only in their field of work but by advising those in the greatest denominator of our world population, the elderly. Addressing the symptoms and root cause of loneliness and isolation can help mitigate the growth of more elderly falling victims to isolation. (Kirkevold, Moyle, Wilkinson, Meyer & Hauge, 2013) The more elderly become isolated the less they can receive the care and help they need to live a quality of life worth living. Does social and self-isolation happen overnight or is it a culmination of several factors and a common trend that can be curbed; what exactly is elderly isolation?

Elderly Isolation on the Rise

Elderly isolation is on the rise world-wide, without proper analysis of the toll it has on cognition, health, and caregivers. There are many definitions of elderly isolation that relate to social disconnects, loneliness, and self-worth in advanced age. As Blanchard (2013/2014) was trying to pin-point why and how the elderly come to a state of isolation and loneliness she found a particular definition by Norwood’s (2009) in her research to be most effective, “social death brought on by a loss of one’s physical capacity to engage in essential activities and relationships that define social identity, enhance self-worth, and sustain meaning.” (as cited in Blanchard, 2013/2014, p. 10). Once an individual no longer feels like they contribute to family, friends, society or their own lives, their loneliness may spiral downward into deep isolation. Often times, they may only emerge for survival essentials like food and medical treatment, if they are still mobile enough. Before the elderly get to this stage of isolation there must be indications that they are becoming separated from their network of friends, family and acquaintances. They must deliberate if they have options to identify “how, where and with whom they want to grow old” (Blanchard, 2013/2014, p. 9); some aging may not have anyone to turn to and must seek out community, state or federal support. Growth in elderly isolation is not only exclusive to the U.S., but a British study identified that there are negative health factors associated with loneliness and isolation, such as depression, anxiety, over-eating, smoking, drinking which reduce overall quality-of-life and often lead to “self-imposed” isolation; there is minimal research to identify means for mitigating such factors of “age-related life events” (Dury, R., 2014, p. 126-127) that lead to these symptoms. A Dublin study focusing on healthy aging and the relationship between loneliness and cognition, found that those who reported being lonely and isolated had a decay in cognitive functions, such as “visual memory, psychomotor processing speed, global cognition and high risk of developing Alzheimer’s disease” (O’Luanaigh et al., 2012, p. 347-348). What this study also found to be true, is that if the elderly did not practice mentally stimulating skills continuously, they most definitely lost the cognitive function as they became lonelier; these rates showed a decrease with a change in less loneliness and minimal isolation. (O’Luanaigh et al., 2012)

A British study of multi-cultural migrants contends that ethnic minority elders who are immigrants in other countries are often not considered when elderly isolation and loneliness studies are conducted; these immigrants have more than the normal elder problems to manage, like discrimination, racism, limited work/income and should be included in future studies (Victor, Burhold & Martin, 2012, p. 67). This study also found that cultural dynamics must be considered as the ethnic minority elderly are not only self-isolated within the country they live in, but are also lonely and long to be with their native communities and have minimal contacts “back home” (Victor, Burholt & Martin, 2012, p. 65-66) to mitigate loneliness; their loneliness rates often correlate with rates of studies in their native countries, which proposes that culture has a large influence in aging not matter what country one is living in. Now leading back to aging in place and the studies conducted in the U.S. on the Baby Boomer population; the normal suburban living customary in the U.S. may be an elderly trap that can lead to loneliness and isolation mostly due to the distance away from the commercial shopping areas, medical facilities, and family. Pekmezaris et al. (2013) study on aging in suburbia identified multiple negative factors, including the following, that an overabundance of elderly will be facing soon due to their current living arrangements:

limited public transportation, two story house/increased falls, limited family support for daily tasks, increase in chronic ailments due to limited mobility and access to medical treatment/medicine, increase financial stress and poverty, inability to prepare meals

The U.S. customary housing structure plays an enormous role in suburban elderly isolation, where many elderly continue to retire to, rather than finding community dwellings where they can cohabitate with others their age and build a stronger network. Can American’s change the socially accepted and adapted way of living in singular family homes to community housing and is there ways to for the medical community to be proactive in screening for isolation in the elderly?

Changing Conventional Thoughts

Challenging and changing conventional and archaic thought processes will bring change and attention to elderly isolation. The quantity of Baby Boomers who currently live in suburban neighborhoods and are choosing to age in place should be alarming to anyone in the Gerontology field, as these individuals will at some point become isolated and immobile without the social services necessary to sustain their daily needs (Pekmezaris et al., 2013). As cities continue to grow and continue to push the boundaries of their city limits with endless suburban neighborhoods, they must also consider the services needed to support those aging populations that will not want to leave their homes and will need medical services, groceries, daily interaction, to have quality of life in advanced age. There is a new way of living that the Baby Boomer generation created to resolve a growing problem which will plague their peers soon. According to Blanchard (2013/2014), “aging in community” (p. 7-9) no longer works due to expensive living accommodations, such as nursing homes and suburban living, a new means of building communitarian housing where elderly neighborhoods network and age together instead of lonely and isolated is on the rise. The American culture of single home living will need to transform to accept the “village model” (Blanchard, 2013/2014, p. 9) as a new means of aging in place to provide networks of caregivers; many other cultures already have this type of blended family concept, but Americans have moved away from the blended family concept that many immigrants bring with them to provide a caregiver to their elders. Many of these new “cohousing, shared housing, village” (Blanchard, 2013/2014, p. 9-11) concepts are options for the middle and upper class elderly who are most educated and have the resources to participate, not necessarily a solution of low-income elderly; these new concepts have a means to cut down on loneliness and isolation and is a preventative method to long term symptoms of elderly isolation.

Nicholson (2012), found in his study an innovative idea borne from seeing multiple studies on the negative factors of isolation and loneliness in the elderly community with no means to change this growing problem or provide any protective factors to decrease the increase in numbers. He proposed to involve the medical community in being a preventive intervention by screening elderly patients and identifying symptoms of isolation and loneliness (Nicholson, 2012, p. 138). Once the patient is screened and identified as a potential patient, the screeners should conduct a more thorough assessment of the patient to provide the most effective referral opportunities and contacts for the elderly patient to find social services that can assist in preventing their more entrenched isolation. The study focused on three main areas where isolation affects the elderly community when no preventive measures are taken to mitigate the start of isolation, “health and behavioral habits, psychological and cognitive, and physiological” (Nicholson, 2012, p. 140), these areas can all affect quality of life and longevity. Changing the medical community’s current screening/in or out-processing of a patient, could have the potential to improve a long-term preventive outcome on elderly patients by assessing and providing outreach support to those who will become isolated; this can reduce future hospital and medical expenses and issues common to isolated and lonely patients. This is a great example of an effective and innovative means to mitigate isolation and loneliness, what other mitigation options are available?

Mitigating Elderly Loneliness and Isolation

Medical and Gerontology experts world-wide are learning how to enable, address, and teach the elderly and caregivers on overcoming loneliness and isolation, but the symptoms and factors of loneliness and isolation must be taught and included in future schools and study to ensure the field is aware and always cognizant of how symptoms can be identified and addressed. A British study on elderly found that loneliness has an impact on physical and mental health problems, it also identified that policy within the medical and social services on corrective actions to prevent loneliness is an important new area that could increase preventive factors (Dahlberg & McKee, 2014). Understanding different personal points of view on aging could open our eyes to how different personalities and cultures define and cope with symptoms and factors of aging; some positive coping can be adopted as a preventive method for improving health factors. A study conducted in three locations, Australia, Norway and UK, found that there was a major difference in coping and maintaining active after major personal losses, such as physical abilities or spouses, between those elderly who considered themselves “not lonely” and “lonely” (Kirkevold, Moyle, Wilkinson, Meyer & Hauge, 2013, p. 399); the difference provides positive and negative health effects that are preventable if the elderly are guided in coping skills to prevent isolation and loneliness. There are many regular social service support activities which are now making house calls to those who are home bound. Some examples of these services which are becoming more common and widely used that can help the elderly who are isolated and lonely have an outlet and acquire much needed support are medical doctors and nurses, mail prescription refills, pet services, grocery delivery, library book delivery, home cleaning services, and non-profit support like meal delivery or elderly companion. Of course some of these services come with a cost, which those with limited income cannot afford, but for those who do have the financial means these services can be life-saving.

A study was conducted in multiple Australian residential aged care facilities to identify how social interaction and leisure activities relates to health factors. One of the most important rated items was the ability to communicate with other residents, family, friends and staff, but there was limited ability to actively communicate within the facility; without the ability to communicate residents felt isolated (Thomas, O'Connell, & Gaskin, 2013, p. 245). For those elderly who age in place within their home and must rely on a caregiver for social, physical and daily care there are outlets that can assist these caregivers in networking and ensuring they have a central location for questions and assistance. An example of these networks is a grass-roots movement that began in Norway and whose influence has reached the U.S; “memory cafes” (McFadden & Koll, 2014, p. 68) allow patients with Alzheimer’s, their caregivers and friends to meet frequently without any stigma or shame to discuss and overcome challenges in their lives and begin a network to provide continued friendship, support and professional assistance. This type of outreach can be used as a prevention to isolation, both for the elderly patient and the caregivers who need outlets, networks and active participation. A study in Turkey on the elderly’s use of the internet to reduce loneliness showed some positive results; it revealed that individuals who used email and online friendships to communicate found some relief and satisfaction when feeling lonely, but those who only used social media remained lonely (Sar, Gokturk, Tura, & Kazaz, 2012, p. 1054). The same study revealed that the more educated the elderly were the more they were open to learning and using computers to communicate and socialize compared to the less educated; this difference yielded an increased quality of life and less reported loneliness (Sar et al., 2012, p. 1057). This result is similar to the request of residents in Australian residential aged care facilities where one of the residents most important requests was to be able to communicate; a computer in the facility would ensure they could communicate with family members outside the facility (Thomas et al., 2013, p. 252-253). There must be innovative ways to identify and prevent isolation and loneliness and to mitigate the inception of the invisible elderly that need help but can neither be seen nor heard because they are a silent majority. Understanding the factors and symptoms associated with isolation is the best preventive method in assessing and referring individuals to seek help for this often taboo subject of elderly care needs.

Conclusion

As the Baby Boomer population continues to age, there are more signs of elderly persons who are becoming isolated and lonely, either because they have no one to connect to, they live in suburban neighborhoods or choose not to be a burden for assistance. These are the isolated statistics that are becoming more prevalent as the Baby Boomer generation continues to expand and show inherent issues that have never had the required studies or advocacy. As seen in the multiple studies conducted abroad, the U.S. is not alone in this elderly isolation problem; it would be wise for U.S. Gerontology and Medial experts to seek multi-national sources on different ideas and preventive methods that could improve our local practices. There are basic methods to identify isolation and its symptoms, offer assistance and referrals to those who can assist or find outlets for these individuals. First, the basic definition of elderly isolation was reviewed to understand what factors play into social and self-isolation in the elderly population. Also, what toll isolation is having on the elderly population’s cognition, health and caregivers. Secondly, there are some new innovative ideas that are showing positive and progressive change in the elderly’s isolation status, but age old conventional ideas must be let go to allow new solutions to flourish. The elderly are generating solutions to resolve their own problems, since they know exactly what to mitigate; medical technicians who are the gateway to many who live in isolation are also becoming innovative and identifying mechanisms to pre-screen the elderly population for isolation. Finally, the Medical and Gerontology communities can be used as advocates to bring attention to this problem and make isolation a less taboo subject by providing preventative solutions will make this a more commonly talked about subject. Addressing the symptoms of loneliness and isolation can help mitigate the growth of more elderly who will fall victims to isolation who may think they are alone without any outlets. The more an elderly person becomes isolated, the less they can receive the care and help they need to live a quality of life worth living. What the community cannot do, is to let this large population simply vanish because they are unseen and unheard; the due diligence lies in the Gerontology networks ability to reach this growing population and mitigate their isolation symptoms. Loneliness and isolation are hard enough to confront when a person is of sound mind and physical health, but it is definitely most challenging and often not combated when a person is feeble and of advanced age.

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