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Why loneliness in seniors is a health hazard

February 24, 2020 by United Way Greater Toronto

A lonely senior woman looking out window.

Seniors are living longer than ever, but that doesn’t mean they’re living life to the fullest

As society ages and families become more dispersed, loneliness and senior isolation are on the radar of healthcare professionals. While ‘isolation’ isn’t an illness, it’s a condition that can impact a senior’s physical, mental and psychological wellbeing. United Way Greater Toronto spoke to industry leaders about the impact of isolation and innovative, community-based solutions that can help seniors, their caregivers and, ultimately, the healthcare system.

Why is seniors’ isolation on the radar of healthcare professionals?

“Seniors are living longer, and some of them with more complex care needs,” says Christina Bisanz, CEO of CHATS (Community & Home Assistance to Seniors), a United Way-supported agency that serves 8,300 seniors and their caregivers in York and Simcoe. Adult children move away; families are more dispersed. In some communities, grandparents are brought to Canada to raise their grandchildren, but are left without a purpose once the grandchildren grow up, especially if they don’t speak English or have social connections.

Isolation can also come about because of mobility or health issues. Perhaps they’ve lost their driver’s licence, don’t live close to public transit or require a cane or wheelchair to get around. If they have an initial diagnosis of dementia, they may isolate themselves socially, which also has an impact on their partner or caregiver, says Allison Sekuler, vice-president of research at Baycrest Health Sciences and managing director for the Centre for Aging and Brain Health Innovation.

Who is most at risk?

Those most at risk, according to a report  by the Government of Canada, are seniors 80 or older who live alone, have multiple health problems, have no children or contact with family, lack access to transportation and survive on a low income. Life transitions such as retirement or death of a spouse can further the risk of becoming socially isolated.

What is the impact of isolation on seniors?

“There’s growing concern about the health impacts of social isolation,” says Bisanz. “In the U.K., for example, they appointed a Minister for Loneliness, because they’ve recognized and acknowledged that loneliness is related to acute and chronic health challenges.” The Government of Canada report found that one in four seniors lives with a mental health problem ranging from depression to dementia, while 44 per cent of seniors living in residential care have been diagnosed with depression or show undiagnosed symptoms of depression.

“If you’re isolated and don’t have opportunities to interact with people, it can speed cognitive decline and lead to depression,” says Sekuler. “[Statistics Canada] estimated 1.4 million older Canadians suffer from loneliness right now—80 per cent of the time people 80 years and older feel lonely. The statistics are really crushing.”

What community-based supports are available?

From a mobility standpoint, transportation programs can help an isolated senior get out of the house for grocery shopping or medical appointments, as well as social outings. Adult day programs at healthcare facilities and community centres offer social and wellness activities for seniors—from crafts to field trips—along with companionship. Home-care services also play a role, from friendly visits to home upkeep and healthcare.

Along with adult day programs, CHATS also offers outreach programs for the region’s diverse communities, such as Iranian, Russian, Cantonese and Tamil. “We have a number of programs that we run for culturally and linguistically specific communities—some of those are funded through United Way,” says Bisanz. “They’re designed to bring people together in a situation where they feel cultural familiarity.”

Is the issue exacerbated for LGBTQ2+ seniors?

While all seniors are at risk of social isolation, LGBTQ2+ seniors face barriers to affirming support services and a great deal of social isolation and loneliness as they age, says Kate Hazell, coordinator of the LGBTQ2+ seniors programs at The 519. As part of its programming, the agency seeks to address social isolation in older adults, through programs like a weekly drop-in program. It also launched a pilot program called Pals Connect for LGBTQ2+ seniors experiencing high levels of social isolation, providing friendly visits to seniors who are unable to access group programming. “As it is a drop-in space, people aren’t required to disclose their name in order to get access to it, and that’s an important feature,” says Hazell.

How does this affect caregivers?

Adult day programs can promote independence and encourage social interaction; at Baycrest, programs include door-to-door transportation, therapeutic recreation, creative arts, counselling and support, as well as respite for caregivers. “At the same time, the caregivers can have a little bit of a break, and they have opportunities to interact with each other, which reduces their social isolation,” says Sekuler. “In fact, caregivers are more likely to develop dementia themselves than non-caregivers.”

Indeed, a report from Health Quality Ontario  found that one-third of caregivers looking after loved ones at home suffer from anger, distress or depression. Many caregivers ignore their own health while looking after a loved one, and experience emotional and physical distress such as low energy, headaches and chest pain. That’s why many programs that address senior isolation also provide respite for caregivers, including online support and peer meet-ups.

Can social robots really help?

While programs and services can help, so can new technologies. Baycrest’s Innovation, Technology and Design lab is working with the University of Toronto to develop a ‘social robot’ with emotion-sensing software to assist seniors with mild to moderate cognitive impairment. “The whole point is to address this issue of social isolation — it’s smart, it learns what you like,” says Sekuler.

Other projects include virtual reality applications that provide recreational and social support for homebound seniors with limited mobility — so they can go dancing or take a walk in the park via an avatar—and sensors that use artificial intelligence to detect falls and alert a caregiver. It’s early days, but it’s hoped new technologies can provide another option for isolated seniors.

Is there a GTA-wide strategy to address seniors’ isolation?

There are 14 local health integration networks (LHINs) around the province, which fund programs such as congregate dining, transportation services and adult day programs — along with cutting-edge research into new technologies that can reduce isolation and loneliness. “It’s about improving quality of life and quality of health so that hopefully we’re avoiding unnecessary hospitalization or more costly health care,” says Bisanz. “If social engagement supports that healthy well-being, physically, mentally and even spiritually, then seniors are able to remain as active members of their community.”

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