Social Isolation and Loneliness

Social isolation can stem from the reduction of a senior's social participation or social contact, which may cause loneliness or other emotional distress.

 

The National Seniors Council of Canada defines social isolation as a low quantity and quality of contact with others.  A situation of social isolation involves few social contacts and few social roles, as well as the absence of mutually rewarding relationships.  Social isolation is different than loneliness, which is the senior’s perception of a lack of interaction or contact with others.  Social isolation increases the likelihood of loneliness, but a person can perceive being lonely even when in the company of others.

Loneliness can be defined as a subjective, unwelcome feeling of lack or loss of companionship. It happens when we have a mismatch between the quantity and quality of social relationships that we have, and those that we want (Perlman and Peplau, 1981). Loneliness is linked to social isolation but it is not the same thing.  Isolation is an objective state whereby the number of contacts a person has can be counted.  One way of describing this distinction is that you can be lonely in a crowded room, but you will not be socially isolated.

Isolated seniors – a profile

Social isolation is a concern because of the negative impact on individuals and their families.  Research has found that social isolation and exclusion are associated with:

  • increased chance of premature death
  • lower general well-being
  • depression
  • disability from chronic diseases
  • poor mental health
  • increased use of health and support services
  • reduced quality of life
  • caregiver burden
  • poor general health.

James S House, Karl R. Landis and Debra Umberson (1988) state that “social relationships, or the relative lack thereof, constitute a major risk factor for health –rivaling the effects of well-established health risk factors such as smoking, blood pressure blood lipids, obesity and physical activity”.  Today, the lack of social relationships continues to contribute to poor health and/or mortality.

In addition to these personal consequences, socially isolated seniors are not able to participate and contribute to their communities.  Many seniors are the backbone of voluntary services.  Seniors enrich the organizations they participate in and provide patronage to local businesses and events.  Losing these contributions is a significant loss to organizations and to society.

Which seniors are at risk of social isolation?

Social isolation may result from circumstances and situations that involve personal and social factors.  Keefe and her colleagues (2006) studied Canadian data to begin to put together a profile of the individual and social characteristics and situations that make seniors in Canada vulnerable to social isolation:

Seniors were found to be vulnerable to social isolation if they had:

  • limited assistance with routine activities such as meal preparation, shopping, and transportation
  • low emotional support
  • had low support with routine activities
  • had reduced physical leisure activities
  • lived alone.

Some seniors experienced social exclusion in a number of areas of their lives.  Keefe and Fancey (2007) measured ways that seniors can be excluded socially in their:

  • interaction with family and friends
  • involvement in community and volunteer activities
  • feelings of comfort in one’s neighbourhood.

They found that almost three-quarters of seniors experience high amounts of exclusion in a least one of the three areas, most frequently in “involvement in community and volunteer activities”.  As well, close to half of seniors experience high amounts of exclusion in two or all three areas, especially in “interactions with family and friends” and “involvement in community and volunteer activities”.

Seniors most likely to experience the most social exclusion:

  • are older
  • are living in urban areas
  • have no partner
  • have activity limitations due to health
  • were born outside of Canada
  • have lower levels of education.

Together, these two bodies of research create a picture of who is most vulnerable to social isolation, and who is actually experiencing social exclusion.  Organizations can look for these characteristics among their clientele to identify who may be at risk.

What are the indicators of social isolation?

Social isolation is indicated when there are reductions in a senior’s social participation or social contact that cause loneliness or other emotional distress.

Normal changes related to aging (such as changes in vision and hearing) or crises (such as loss of a loved one or relocation) may also make a senior more vulnerable to social isolation.  Losses and other challenges do not necessarily lead to social isolation.  Whether or not (or to what degree) social isolation occurs will depend on how well a senior is able to use her/his usual coping skills and on the availability of support from friends, family and community.

What are the contributing factors (Risk Factors) for social isolation?

There are many individual, social and environmental factors related to late life that increases seniors’ risk of social isolation.  The literature review completed by the F/P/T Working Group indicates that the following factors may place seniors at risk for social isolation and loneliness:

  • disabilities
  • loss of a spouse
  • living alone
  • reduced social networks
  • aging
  • transportation issues
  • place of residence
  • poverty
  • low self-esteem
  • poor health
  • gender

Generally the more risk factors present, the greater the likelihood of social isolation occurring.  For example:

  • lack of information and poor health are associated with poverty, especially for seniors from minority groups and for seniors with disabilities
  • poverty is linked to education and skill disadvantages, which further limits participation
  • low income affects the ability of family members to provide care
  • low self-esteem is linked to the risk of financial abuse and contributes to social isolation
  • loss of a spouse frequently leads to living alone and to a reduced social network which together escalate the risk of social isolation.

Social isolation may result from conditions in our society that excludes some seniors from full social participation.  Seniors who experience ageism, abuse, racism, sexism or homophobia may restrict their activities resulting in increased risk of social isolation.   This is linked to the undervaluing of seniors in our society – negative images of seniors make them feel not needed, not valued and not able to contribute.

What are the protective factors?

Protective factors can be defined as traits, situations or circumstances that contribute to seniors’ social integration.  There are numerous protective factors that can reduce the risk of social isolation:

  • being in good health
  • adequate income and housing
  • residing in a neighbourhood where one feels safe
  • communication skills and resources to find and obtain needed services
  • satisfying personal relationships
  • having a social support network
  • feeling connected to and valued by others
  • having access to health services
  • experiencing meaningful roles in society
  • having secure housing
  • having access to transportation
  • having higher levels of education and social support.