The Effects of Loneliness and Isolation on the Elderly

The current drive to help older people live at home for longer may be creating higher levels of isolation and loneliness for them. While the move to help our seniors remain in familiar surroundings for as long as possible is generally made with the best intentions, the focus on meeting their physical care – rather than their full range of social and health needs – can lead to negative side effects.

Social isolation and loneliness are precipitated by a number of factors, including living alone, health problems and disability, and sensory impairment such as hearing loss. Major life events such as the death of a spouse have been shown by numerous studies to dramatically increase seniors’ vulnerability to emotional and social isolation.

This is made worse if there is a drop in communication with family or friends at the same time or even a move to an unfamiliar neighborhood. The same is true if family members move for work or other personal reasons, or aging siblings and friends die. An emphasis on senior independence under these circumstances can lead to increased physical isolation and social disengagement, and trigger instability and insecurity.

Research by Australian aged care provider, Whiddon Group, indicates that close to 50 percent of seniors living at home report being lonely, compared with around ten percent in the general population. And a 2014 working paper by the Council on the Ageing (COTA) Victoria says the number of socially isolated people will more than double by 2040, and is likely to increase further as the proportion of seniors in the population increases.

Apart from general feelings of sadness and loneliness, the impact of isolation and the shrinking of social networks can lead to a variety of negative physical and emotional effects in the elderly.

Loneliness, social isolation and mortality risk

According to a 2012 study in the U.S, in the Proceedings of the National Academy of Sciences (PNAS), social isolation and loneliness are associated with a higher risk of mortality in adults aged 52 and older. And a study by The University of Chicago showed major health risks were associated with loneliness; revealing that elderly people who are affected by ‘extreme loneliness’ are up to 14 percent more likely to die a premature death. This is backed up by the English Longitudinal Study of Ageing (ELSA), which reported that elderly people who are socially isolated are more likely to die earlier.Decline in physical and mental health

Regardless of the causes of isolation, seniors who feel lonely and isolated are more likely to also report having poor physical and/or mental health, according to a study using data from the U.S National Social Life, Health, and Aging Project.

In the United Kingdom, the Campaign to End Loneliness concludes that the lack of social relationships is as strong a risk factor for mortality as smoking, obesity or the lack of physical activity. Similarly, older adults who are lonely have an increased risk of dying sooner and are more likely to experience a decline in their mobility, compared to those who are not.

Interestingly, but sadly, there is a trend for older people to present to hospital emergency departments, not necessarily due to medical problems but for social interactions, or because they are simply not coping. Australian Government website My Aged Care quotes a study where people classified as ‘lonely’ are 60 percent more likely to access emergency services than those considered ‘non-lonely’ and are twice as likely to enter residential aged care facilities.

Long-term illness

In the PNAS study mentioned above, illnesses and conditions such as chronic lung disease, arthritis, impaired mobility, high blood pressure and depression are associated with social isolation.

Cognitive decline and risk of dementia

According to the U.S Senior Living Blog, Dr. John Cacioppo, a neuroscientist, and psychologist at the University of Chicago, has been studying social isolation for 30 years. One of his frightening findings is that feelings of loneliness are linked to poor cognitive performance, quicker cognitive decline and the increased risk of dementia.

Vulnerability to elder abuse

A study by the U.S National Center on Elder Abuse shows a connection between social isolation and higher rates of elder abuse. Researchers aren’t certain whether this is because isolated adults are more likely to fall victim to abuse, or it’s a result of abusers attempting to isolate the elders from others to minimize the risk of discovery. Irrespective of the cause, this vulnerability is a cause for concern.

Depression and pessimism

Numerous studies have shown that loneliness is a major risk factor for depression, with increased symptoms in both middle-aged and older adults. Socially isolated seniors are more likely to predict their quality of life will get worse, and are more concerned about needing help from community programs as they get older.

Long term care

According to a report from the Canadian Children’s, Women’s and Seniors Health Branch, loneliness and social isolation are major predictors of seniors needing home care, as well as entering nursing homes.

Isolation: A risk factor for unhealthy lifestyle habits

A study using data from the English Longitudinal Study of Ageing (ELSA) found that people who are socially isolated or lonely are also more likely to report risky health behaviors such as poor diet, lack of physical activity, and smoking.

MICHAELÉ HARRINGTON SENIORS’ HEALTH

Report finds aged care workers have no time to meet the social needs of older people

 

A joint UNSW Sydney, Macquarie University and RMIT study has found that aged care workers are so rushed and pressured to provide basic physical care for older people, they have no time to meet their clients’ basic social and emotional needs.

The report was prepared for the Health Services Union and United Voice, unions which represent aged care workers.

Care workers overwhelmingly say they have insufficient time to either talk to their clients or get to know their uniqueness, or to support their decision making and independence.

Evidence has long shown that older people value the relationships they have in aged care services, aspire to feel at home and valued, and define quality services as those where staff have time and flexibility to get to know them and attend to their needs. These aspirations are also a feature of Australia’s quality standards.

“Yet it has become structurally difficult to provide care in this way,” lead author Professor Gabrielle Meagher from Macquarie University’s Department of Sociology says. “The Australian aged care system has to meet increasing levels of demand, and to respond to the increasing complexity of need among older people related to daily living, behavioural issues or complex health care. But our research shows this has not been matched with appropriate funding, staffing levels or a mix of staff skills.”

The Meeting the social and emotional support needs of older people using aged care services report comes a week before the Royal Commission into Aged Care Quality and Safety is due to hand down its interim report on Thursday, 31 October.

The universities’ report found:

·         Numbers of aged care places have outstripped workforce growth, with no increase in the ratio of fulltime equivalent care workers to residential care places since 2003.

·         In the same period, residential care workers’ skill profiles have significantly deteriorated.

·         Personal care workers perform an increased proportion of direct care work in residential settings, up from 57% (2003) to 72% (2016). Correspondingly, the share of nurses and allied health professionals has declined.

·         Across residential and home care services, 90% of care workers agreed they had no time to respond to unexpected needs, or to spend time with an older person they found to be in low spirits.

·         More than three-quarters (78%) said they had insufficient time to support older people to do things for themselves, such as use a walker instead of a wheelchair.

·         Only 37% felt their managers understood the importance of workers’ relationships with older people, with many reporting they were seen to be “slacking off” if they attended to a client’s social and emotional needs.

“Care workers routinely observe that older people’s emotional needs are left unmet in the system designed to support them,” Wendy Taylor from RMIT’s School of Management says. “In the aged care system today, overlooking older people’s basic social and emotional needs has become part of accepted business practices.”

Dr Natasha Cortis, from UNSW’s Social Policy Research Centre, says the research shows that organisational supports for quality care are too thin: “We found that less than a quarter (22%) of aged care workers were receiving one-on-one support from a supervisor, and less than half (45%) were able to participate in team meetings to discuss the way they provide care. ”

“Insufficient time and support for relationship building and care makes it difficult to realise principles of dignity, respect and person-centredness in aged care,” Professor Meagher says. “This partly explains the very high rates of social isolation and mental distress experienced by older people.”

“Employment conditions and pay rates in aged care also fail to recognise the specific skills and demands of the work, leaving care workers and older people vulnerable,” says Professor Sara Charlesworth of RMIT’s School of Management.

The report recommends:

·         The psychosocial needs of older people be at the forefront of the design of aged care services.

·         Aged care funding be increased to sufficient levels to enable services to be provided to all older people who need support, and this funding be care-centred.

·         The aged care system’s human resources be regulated to ensure that rostering and daily work arrangements allow workers enough time to care and to offer continuity of care relationships.

·         Workers have relevant practice and relational skills to deliver high-quality care, and be supported by managers so that they develop meaningful relationships with older people.

 

Rosie Batty, Women’s Legal Services Australia team up for family law reforms

Former Australian of the Year Rosie Batty has partnered with women’s legal services across Australia to urge the federal government to enact reforms to keep women and children safe in the family law system.

Ms Batty, who was driven to campaign to end family violence after her 11-year-old son was murdered by her former partner, yesterday endorsed the new Safety First in Family Law plan, launched by Women’s Legal Services Australia.

Safety First comprises a five-point plan, advocating that the federal government: strengthen family violence response in the family law system, provide effective legal help for the most disadvantaged, ensure family law professionals have real understanding of family violence, increase access to safe dispute resolution models and overcome the gaps between the family law, family violence and child protection systems.

The plan “can be implemented right now, and is based on research, evidence and key recommendations from previous family law inquiries”, the partnership noted in a statement.

Ms Batty said it was critical for the government to act now to reform the family law system.

“Nearly 70 percent of matters lodged in the family courts involve allegations of family violence, but the system is not set up to deal with this – and neither are the many professionals who work within the system,” she said.

“The family courts don’t have case management processes specifically designed for family violence cases, so safety risks are not being managed. This is putting women and children at grave risk.”

WLSA spokesperson Helen Matthews added that the government needed to show its commitment to ending violence against women, and that one step that could be taken in achieving this would be to implement the reform plan developed by specialist women’s legal services around Australia.

“Women’s legal services across Australia work on the frontline to represent family violence victim survivors – we know just how urgent these reforms are, and how the current family law system is failing women and children,” she said.

“These reforms can and should be implemented now. If the government is serious about making the family law system safe for women and children, it must act and implement our recommendations”.

By Jerome Doraisamy|23 October 2019

Useful statistics – Violence against women is a widespread problem in Australia.

PREVALENCE OF DOMESTIC VIOLENCE
Source: 2016 Personal Safety Survey (ABS, 2017)

ANROWS has analysed the statistics related to women and personal violence.  It tells us a lot about the relationship between men and women.

Since the age of 15:
• Approximately one in four women (23% or 2.2 million) has experienced at least one incident of violence by an intimate partner (intimate partner = a current or previous partner with whom the respondent lives or has lived, or a current or former boyfriend, girlfriend or date with whom the respondent has not lived with).
• One in six women (17% or 1.6 million) has experienced at least one incident of violence by a partner (partner = a person whom the respondent lives with, or lived with at some point, in a married or de facto relationship).
• Three in ten women (30.5% or 2.85 million) have experienced physical violence (perpetrated by another person, irrespective of the type of relationship).
• Approximately one in five women (18% or 1.7 million) has experienced sexual violence (the occurrence, attempt or threat of sexual assault).
• One in six women (17% or 1.6 million) has experienced an episode of stalking (any unwanted contact or attention on more than one occasion, or multiple types of unwanted contact or behaviour experienced on one occasion, that could have caused fear or distress).
• Approximately one in four women (23% or 2.2 million) has experienced emotional abuse by a partner.

Across their lifetime:
• One in two women (53% or 5 million) has experienced sexual harassment
(experienced or has been subjected to one or more selected behaviours which they found improper or unwanted, which made them feel uncomfortable, and/or were offensive due to their sexual nature)

What midlife crisis?

Some people see a midlife crisis when people’s satisfaction in life declines with the loss of youth. I don’t think so. The article below makes the case that for many people, satisfaction increases with age. We are all different with different circumstances, but it seems there is hope for all of us.