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  • Julie Cheney RN

Loneliness for elderly people - more than being alone

Earlier this year a Facebook post told the story of 80 year old Han Zicheng. He posted a notice within his community to be adopted by another family because he was lonely.

This in itself is a chilling notion, that an elderly person is so alone with no family member to turn to, they are willing to connect in any way they can, but it is not a once off case. Loneliness is a global problem. In the UK there is now a Minister for Loneliness. In Australia numbers are predicted to grow to over 3 million living on their own in the next twenty years. Research has linked poor health outcomes such as from heart disease and arthritis, Type II diabetes, dementia and suicide as increasingly resultant from loneliness. Older people are especially vulnerable for social isolation as the numbers of their friends diminish and their families are more spread out.

A British organisation called Mind for better mental health has offered some strategies for combating loneliness.

  • Think about what is making you lonely

  • Make new connections

  • Open up

  • Take it slow

  • Be careful when comparing yourself to others

  • Check how you are feeling

  • Get some help

We’re just going to look at a couple of them here today. These two issues are sometimes hand in hand for older people. That is ‘what is making you lonely’ and ‘check how you are feeling’. We are not talking about people who are often alone and are enjoying their own company and not feeling concern or distress. That is simply being alone. Loneliness is where something feels wrong about being alone, or even feeling lonely whilst surrounded by others.

So, the first step is to consider what is making you feel lonely? Is it that you very rarely see someone or talk to another human being? Is it more that people of your age or interests are too few and far between? Is it more that you don’t feel capable of connecting to others? Is it about your physical capabilities holding you back from moving around and going places? How much of it is about fear or embarrassment? How much is about confusion or uncertainty in this rapidly changing world? Once you’re clearer about why you feel lonely it’s easier to start working on some solutions for how to get help.

When you also look into how you are feeling, you might come up with some answers to some of the blocks you have to connecting, or you might realise you have a variety of concerns that are either fueled by the loneliness or make the loneliness worse because they interfere with your functioning. So give yourself a feelings review - that is check out how you are feeling.

Are you sleeping well? You could be sleeping too much and slowing your body down or messing up usual activity patterns. You could be sleeping too little and lacking energy. There could be a problem that needs investigation to find a health solution.

Stress is caused by many things, but it is also part of loneliness. You can feel increasingly stressed by the state, then develop more anxiety and a cycle can be set up. Loneliness > stress > anxiety > withdrawal > loneliness ... Ask yourself, how stressed do I feel about this problem? Give it a number. Is it 10 out of 1 – the maximum stress cause in your life? Then it’s time to do something.

How’s your self-esteem? This can also be a vicious cycle of increasing the impacts from loneliness. That is if you are a person with poor self-esteem you might avoid connections with new people. If you have spent a lot of time alone you might feel that you are not worthy and feel a bit ‘rusty’ on how to connect, in turn leading you to feel less worthy and less capable. Poor self-esteem can be telling you with an unpleasant inner voice that you should not connect with people, that you are not capable, that you are not interesting enough. But the voice is usually wrong. It’s often there because you let it take over your thinking. You can change it to a more pleasant and reassuring one if you take a bit of time and conscious effort to hear another version.

How much do you move? I know, I know, you’ve heard the exercise thing ad nauseum. Perhaps exercise is hard for you, because of some physical restrictions. Or is it that you can’t be bothered. But even small start points of movement can help you to the next step and can slowly rebuild strength and endurance, and improve the chemicals in your brain that impact on mental wellbeing.

There are other benefits of moving too, even when you think you can’t move very far. Think about this scenario for a minute. You don’t do much more than move about within the house for your daily ablutions and meal preparations. You feel restricted and lonely. Then one day you get up and walk, even with a walker or a stick, to the front door and to the entrance of your home. Then you walk back. That’s not so hard thus far. The next day you get up, go to the front door, walk outside and walk to the side of the house and stand for a minute (or sit if you need to for safety). What do you see as you stand there? What do you hear and smell? Are there birds, children’s calls, sports noises, vehicles, dogs barking, wind in the trees?

Your senses tell you a thousand messages. These are things that stimulate your brain, they add to your daily information firing your brain cells. Do you see the rubbish bin or the path way, or do you notice the fence, the next door yard, the back reserve, the verge where people walk or a tree waving in the breeze that was put in 23 years ago and you still remember your neighbour watering it? All of these things are small, but add to your picture of the world and its ongoing connections and activities. They can also give you a point to talk about, a start to a conversation when you thought you had none. For example, ‘I looked at the fence and thought back to the day I helped my dad build a fence when I was 6’. Such a comment can lead others to another memory or a thought and so a conversation is born.

The next day walk to the other side of the house. Think about what is different there, what is the same. Think about what it would take to walk all around the house. You might need something done to improve the safety, you might plan how you ‘re going to make the whole circuit.

That process of planning and thinking about a goal, no matter how small is also stimulates thousands of electrical impulses through multiple parts of your brain. Your decision to move can spark a decision to improve the area you wish to walk in, can lead to awareness of your surroundings and appreciation of more, it can lead you to wanting to tell people about what you have done and what you have decided.

Now, about eating. This is not the place to talk about diet, but it is a chance to think about what you take in. Foods and fluids influence your energy, your brain function, your comfort and your sleeping. Eating times and eating amounts impact on your wellbeing. Take the time to think about what you do with food and fluids. For example, if you have a coffee at 9 pm then can’t sleep until 1 am every morning, it could be that you can’t tolerate the level of caffeine which is a stimulant. Simply changing your nightly drink might improve your sleep, your daytime energy, your interest in life and your ability to find solutions to your loneliness problem.

A problem that a lot of older people either don’t believe in or don’t consider as relevant to them is mental health problems. Depression is high amongst older people, and it’s often under-treated or not even recognised as older people will not speak of their feelings or shy away from the perceived ‘weakness’ of mental health concerns. The longer this is left unchecked and unsupported the more the chemicals in your brain responsible for your mood will go awry. Then it’s hard to think, to make decisions, to keep up your connections to others. It’s also another nasty chain link of the cycle of loneliness and mental health deterioration – depression > withdrawal > loneliness > depression > withdrawal … and so on.

Now, we’ve only barely touched on the recognition of the problem at this stage. There’s a whole raft of options that could be available to you to improve your situation. We’ll leave that for another blog. At least give yourself a once over in a loneliness review, and be honest about how you feel, and what is influencing your feelings. This helps find solutions. Be systematic, map it out, write it down. When you write things down you are also stimulating parts of your brain. But the visual impact of the written word or a diagram makes it easy to sort your thoughts more clearly. The answer might jump out at you, or you might see the need to look into things more deeply.

The important thing is to start looking at what makes you lonely and how you feel. Take it seriously and start considering how to change what you don’t like.

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