All the lonely people, where do they all belong?
--“Eleanor Rigby” by Lennon-McCartney
At this month’s Coalition of Agencies Serving the Elderly (http://www.sfseniors.org/) meeting, UCSF geriatrician Dr. Carla Perissinotto presented “Examining Loneliness in Older Adults: Too much hype or a true medical concern?” She found that loneliness is independently associated with functional decline, placing one at risk for nursing home admission, and increased rate of death.
Dr. Perissinotto analyzed data in the Health and Retirement Study, which asked 1,604 older adults the following three questions to screen for loneliness:
1. I feel left out
2. I feel isolated
3. I lack companionship
Participants were classified as lonely if they responded “some of the time” or “often” to any of these questions.
Loneliness is the distress that a person subjectively feels about being alone (http://psychology.uchicago.edu/people/faculty/cacioppo/jtcreprints/hc09.pdf). Social isolation (a complete or near-complete lack of contact with society) by itself does not account for loneliness, said Dr. Perissinotto. Thus, one can be lonely without living alone. Her research found that 62.5% of married/partnered participants felt lonely, compared to 26.7% of participants who lived alone felt lonely. She also found the following groups reported more loneliness: women, non-white, slightly older and lower socioeconomic status. Further, most lonely participants are not depressed.
Dr. Perissinotto believes we can make a difference by asking about loneliness (like asking about chronic disease risk factors) and offering interventions from existing community programs to help adults feel more socially connected.
Lemon trees and raised vegetable beds surround outdoor dining area at On Lok (“peaceful, happy abode” in Cantonese) Gee Center
Carp (or koi, homophone for “love” in Japanese) and lotus pond at On Lok Gee Center
Loneliness as public health crisis
In a related article published this month, “The Lethality of Loneliness” (http://www.newrepublic.com/article/113176/science-loneliness-how-isolation-can-kill-you), The New Republic science writer Judith Shulevitz notes that loneliness causes or exacerbates Alzheimer’s, obesity, diabetes, high blood pressure, heart disease, neurodegenerative diseases, and even cancer. Researchers differ on whether loneliness is a subjective feeling that wreaks havoc on the body and brain, or a failure of social networks to take care of the lonely.
Shulevitz reports that the lonely are outsiders: the elderly, the poor, the bullied, the different. People who feel discriminated against are more likely to feel lonely than those who don’t, even when they don’t fall into the categories above, due to feeling rejected. For example, psychologists discovered that closeted gay men who had to be guarded about their true identity for fear of exposure/blackmail, were more sensitive than others to the pain of rejection, increasing a fight-or-flight response system arouses stress hormones that compromise their immune system—such that closeted men infected with HIV died an average of two to three years earlier than out men.
Similarly, a common “alone-on-the-savanna moment” that could put the body in fight-or-flight mode is going off to college and having to make a whole new set of friends. When I left home as a teenager to attend a women’s college over 2,000 miles away, I had to adapt to the intense, competitive and consciousness-raising experience of living on-campus with the typical age 17-22 group. Since I had been privileged to grow up in a multi-generational household, I really missed the safety and mellowing “been there, done that” wisdom of older adults.
Please Touch Community Garden
Letters spelling out "TO SEE A WORLD YOU OTHERWISE COULD NOT SEE" lean against wall behind raised vegetable beds. May is Healthy Vision Month (http://www.nei.nih.gov/hvm/): For healthy vision, National Eye Institute recommends eating a diet rich in green, leafy vegetables like the ones grown at Please Touch Community Garden.
Quality over quantity of relationships
Another “alone-on-the-savanna moment” could be moving to an age-segregated retirement resort in Florida
I planted these mugworts (Artemisia vulgaris) from The Free Farm last year. Mugwort's bitter leaves can be made into a tea for use as a digestive tonic. In Traditional Chinese Medicine, acupuncturists burn mugwort in moxibustion.
How can we address loneliness and the stigma of being “different” to allow people to be authentic instead of “passing” as someone else out of fear of rejection? How can people connect better to develop strong bonding that reinforces ties between similar groups, as well as bridging social capital among diverse groups? A cultural humility approach coupled with an introvert’s power to listen and ask follow-up questions can help with understanding to find common ground and mutual acceptance.
According to Dr. Melanie Tervalon, cultural humility involves practicing lifelong learning and critical self-reflection (awareness of potential bias), recognizing and challenging power imbalances (using person-focused interviewing and meeting people where they are to facilitate mutual respect), and accountability (readjust if necessary to remain open-minded) (http://info.kaiserpermanente.org/communitybenefit/assets/pdf/our_work/global/Cultural_Humility_article.pdf).
Cultural humility respects “voice by choice,” or giving people the space and time to speak up voluntarily—and not putting people on the spot and assuming they should respond the way one expects because one is already culturally competent. People are complex, however much one may want to simplify by classifying individuals into “cultural” groups or stereotyping. Only when people’s true voices are heard first, then we can begin the process of understanding and empowering people with self-determination to choose how we age or live our lives. When we are free to be you and me, building community together, we unleash the power of age!
This bright pink seed-planting table is accessible to persons using wheelchairs
GK created this totem pole using ceramic animal figures from Santa Clara Valley Blind Center
Loneliness Is Deadly
ReplyDeleteSocial isolation kills more people than obesity does—and it’s just as stigmatized.
By Jessica Olien|Posted Friday, Aug. 23, 2013, at 12:15 PM
http://www.slate.com/articles/health_and_science/medical_examiner/2013/08/dangers_of_loneliness_social_isolation_is_deadlier_than_obesity.html
http://fiercewithage.com/digest-of-boomer-wisdom-inspiration-spirituality-20/
ReplyDeleteMind Over Medicine: How to Help Your Body Heal Itself
ReplyDeleteDr. Lissa Rankin, whose special airs on PBS stations this month, explains what doctors can't do for you
By Lissa Rankin, M.D. | August 28, 2013
The scientific literature shows that to keep the nervous system in relaxation response so the body can heal itself, we need a different kind of medicine. To the nervous system, medicine is being loved just as you are. It's helping those in need. Medicine is expressing your creative genius. It's seeing the glass half full, and laughing out loud. Medicine is the unconditional love of animals. It's speaking your truth, and knowing you belong. Medicine is communing with nature, and nourishing the body with real food. Medicine is tapping into your higher power. It's being unapologetically you.
When you give yourself this medicine, you turn off your stress responses, turn on your relaxation responses and allow the body to do one of the things it does best – heal.
That's why you can't hand your body over to your doctor like you would your car . . .
http://www.nextavenue.org/article/2013-08/mind-over-medicine-how-help-your-body-heal-itself
Why Loneliness May Be the Next Big Public-Health Issue
ReplyDeleteJustin Worland
March 18, 2015
Loneliness kills. That’s the conclusion of a new study by Brigham Young University researchers who say they are sounding the alarm on what could be the next big public-health issue, on par with obesity and substance abuse.
The subjective feeling of loneliness increases risk of death by 26%, according to the new study in the journalPerspectives on Psychological Science. Social isolation — or lacking social connection — and living alone were found to be even more devastating to a person’s health than feeling lonely, respectively increasing mortality risk by 29% and 32%.
“This is something that we need to take seriously for our health,” says Brigham Young University researcher Julianne Holt-Lunstad, an author of the study. “This should become a public-health issue.”
The researchers emphasized the difference between the subjective, self-reported feeling of loneliness and the objective state of being socially isolated. Both are potentially damaging, the study found. People who say they are alone but feel happy are at increased risk of death, as are those who have many social connections but say they are lonely. People who are both objectively isolated and subjectively lonely may be at the greatest risk of death, says Holt-Lunstad, though she notes that more data would be needed to know with certainty.
“If we just tell people to interact with more people, that might solve the social-isolation issue, but it might not solve the loneliness issue,” she said. “I think we need to acknowledge that both of these components are important.”
Many social scientists say technology and housing trends are increasing the risk of loneliness. More Americans are living alone than ever before, and technology like texting and social media has made it easier to avoid forming substantive relationships in the flesh and blood. Yet research shows that relationships can improve health in a variety of ways, by helping us manage stress, improving the functioning of the immune system and giving meaning to people’s lives.
Holt-Lunstad says that maintaining meaningful and close relationships, as well as a “diverse set of social connections” is key. Policy interventions for loneliness may be more difficult to imagine but could range from encouraging doctors to identify at-risk patients to rethinking the way neighborhoods are designed, Holt-Lunstad says…
http://time.com/3747784/loneliness-mortality/
Loneliness triggers biological changes which cause illness and early death
ReplyDeleteDanger signals activated in the brain by loneliness ultimately affect the immune system, scientists have found.
By Sarah Knapton, Science Editor
8:00PM GMT 23 Nov 2015
Loneliness is not just an emotional state of mind, it actually triggers genetic changes which cause illness and early death, a study shows for the first time.
Previous studies have found that social isolation is a major health problem that can increase the risk of premature death by 14 percent.
However until now, scientists have been unsure what is driving the phenomenon.
Now researchers at the University of Chicago and the University of California have discovered that loneliness actually triggers physical responses in the body which make people sick.
It appears to trigger the ‘fight or flight’ stress signal which affects the production of white blood cells. It also increases activity in genes which produce inflammation in the body while lowering activity in genes which fight off illness, promoting high levels of inflammation in the body.
Essentially, lonely people had a less effective immune response and more inflammation than non-lonely people. They feel socially threatened which has an enormous impact on health.
John Capitanio, of the California National Primate Research Centre at the University of California, Davis said: “Perceived social isolation is a risk factor for chronic illness and all-cause mortality but the molecular mechanisms remain ill understood.
“In humans, loneliness involves an implicit hyper-vigilance for social threat.”
The study examined loneliness in both humans and rhesus macaques, a highly social primate species.
Why are we all so lonely? Even when surrounded by people we love
They found that loneliness predicted how active the CTRA gene was, even a year later and vice versa. People who had high gene activity were still lonely after 12 months. They also showed higher levels of the fight-or-flight neurotransmitter, norepinephrine.
Previous research has found that norepinephrine can stimulate blood stem cells in bone marrow to make more of a particular kind of immune cell (monocytes) which ramps up inflammation in the body.
Both lonely humans and monkeys showed higher levels of monocytes in their blood. In an additional study, monkeys repeatedly exposed to mildly stressful social conditions such as unfamiliar cage-mates also showed increases in monocyte levels.
The researchers also showed that, in monkeys at least, the loneliness changes allowed simian immunodeficiency virus (the monkey version of HIV) to grow faster in both blood and brain.
Finally, the researchers determined that this monocyte-related CTRA shift had real consequences for health. In a monkey model of viral infection, the impaired antiviral gene
The "danger signals" activated in the brain by loneliness ultimately affect the immune system, the researchers conclude, as they warn against living ‘chronically on the social perimeter.’
The research was published in the Proceedings of the National Academy of Sciences.
http://www.telegraph.co.uk/news/science/science-news/12012663/Loneliness-triggers-biological-changes-which-cause-illness-and-early-death.html
Loneliness is bad for your health. This new campaign aims to curb isolation.
ReplyDeleteNovember 26, 2016
Judith Graham
A new national campaign aims to raise awareness of a hidden but devastating complication of aging: loneliness.
Tens of millions of adults are chronically lonely. And a growing body of research has linked that isolation to disability, cognitive decline, and early death.
The first-of-its kind campaign, organized by the AARP Foundation and the National Association of Area Agencies on Aging, aims to help seniors assess their social connectedness and suggest practical ways they can forge bonds with other people.
"This is a public health issue of growing concern," said Lisa Marsh Ryerson, president of the AARP Foundation.
Addressing stigma will be a priority. "Who wants to admit that, 'I'm isolated and I'm lonely?'" said Dallas Jamison, a spokeswoman for the National Association of Area Agencies on Aging. "It's a source of shame and embarrassment."
Her organization represents 622 agencies across the country that provide meals, transportation, in-home help, and other support to seniors. They'll take the lead in identifying older adults who are isolated and linking them to resources, in part through the federal government's Eldercare Locator. The campaign will also encourage families to talk about these issues during the holidays.
These efforts come as research highlights the physical and emotional toll of isolation in later life.
A seminal study of more than 1,600 seniors age 60 and older found that lonely people were far more likely have difficulties with walking, bathing, dressing, and climbing stairs than those who were not. They were also 45 percent more likely to die during the six years that researchers tracked them, from 2002 to 2008.
Some 43 percent of seniors interviewed for that study said they were lonely — a subjective feeling of not being meaningfully connected to other people. Based on a separate analysis, AARP estimates that 42.6 million adults age 45 and older are chronically lonely.
That feeling of isolation sounds an "I'm not safe; all is not well" alarm in seniors, raising blood pressure, sparking inflammation, inspiring stress, and interfering with the immune system's response.
"If you're lonely, you feel there aren't adequate people around to support you and that means you have to surveil your environment continuously for every kind of threat," said Linda Waite, director of the National Social Life, Health, and Aging Project and a professor of sociology at the University of Chicago.
"This consumes cognitive, physical, and psychological resources," Waite said, "and makes it harder for you to do other things that might be beneficial to your health."
Social isolation may mean that you rarely get out of the house and lack a support system of people who will notice when you're feeling sick, bring over chicken soup, go out and get a decongestant, or take you to the doctor. About one in five seniors reports being isolated, Jamison said.
Still another line of research suggests that loneliness and isolation doubles the risk of Alzheimer's disease in older adults by inducing changes in the brain that are not yet well understood.
"Humans evolved to live in social groups, and we're most comfortable when we feel part of a group — more relaxed, happier, with lower blood pressure and cortisol levels," Waite said.
Along with the coming campaign, the AARP Foundation plans an initiative called Connect2Affect that will highlight research on loneliness and innovative attempts to address the issue.
http://theweek.com/articles/662732/loneliness-bad-health-new-campaign-aims-curb-isolation
Loneliness is a hazard of old age. A phone call can mean a lot
ReplyDeleteMichele Hanson
Tuesday 20 December 2016
Some of us enjoy solitude. But when you have no choice, and are stuck with too much of it, it can easily turn into loneliness, which is no pleasure at all. There are more than a million older people in England whose lives are blighted by loneliness …
There is nothing more miserable than sleeping, waking, eating and doing more or less everything alone – especially for anyone single, separated or widowed, and in poor health – while the rest of the country seems to be playing happy families, or at least trying to. And most of us are much too busy to help some old person whose existence we’re not even aware of. Age UK has launched a befriending service in which older people are matched with volunteers to receive a 20–30 minute phone call each week. It doesn’t sound much, one call a week, but when your weeks stretch endlessly ahead, punctuated by nothing except perhaps the odd lightning visit from a carer who has barely a moment to speak, then a friendly weekly phone call and chat can mean a lot.
Last week I sat in one morning with the charity, and heard Nicky chatting to Mavis… The calls may sound lightweight, but the cheery small talk can often conceal a heartbreaking situation…
It must be very hard to have thoughts of such an event swirling round your head. But talking to someone sympathetic, even a relative stranger such as Stephanie, who is happy to listen, seems to help. The sadness in Eva’s voice is deeply affecting, although she is trying to disguise it and, like many lonely older people, she is putting on a brave face.
Bette Davis was right when she said: “Old age is not for sissies.” In later life, after a break-up or death of a partner, you can’t go off to work, or anywhere much, to distract yourself from thoughts of what you have lost and miss. Almost more than anything else, you may need someone to talk to. Three years ago Sally Lubamov, 86, was asked by the Today programme what she most wanted from her home carers. She replied, “For them to have enough time for a chat and a sit-down and a hot meal with me.” It’s not much to ask. Last week Today visited her again. She had been very ill, but was thrilled to have at last had that hot meal, three weeks ago. “First time for a year!”
The telephone relationships work both ways. Dean, a 24-year-old Tottenham supporter, chats to Joe, an 80-year-old Birmingham City fan, every week for half an hour. They talk football, and “all the things Joe has been through, the hurricanes in Jamaica, how the winds made the fruit crash from the trees,” says Dean. “We come from very different worlds, and our friendship has really changed me. He has a contagious spirit and he’s given me the confidence to speak to people I don’t know. I’d consider him a friend … [It’s] not just something I do because I volunteered.” Joe’s wife died in 1991, and he now has very limited mobility, but talking to Dean also cheers him up: “He’s like another grandson to me – very pleasant to talk to.”
Older people are also very pleasant to talk to, and interesting and amusing. They have a lifetime of experience to talk about, given half a chance. But they need to talk all year round, not just at Christmas.
To sign up to Age UK’s phone befriending service, visit ageuk.org.uk/no-one or call 0800 169 6565 free of charge
https://www.theguardian.com/commentisfree/2016/dec/20/loneliness-old-people-age-uk-christmas
Seniors find lifeline in phone support groups
ReplyDeleteBy Claudia Boyd-Barrett, Center for Health Reporting
Monday, December 26, 2016
The phone rang the other afternoon inside 91-year-old Lynnie Rayburn’s disheveled South Berkeley apartment. Although confined to a wheelchair and unable to move more than a few inches, she had little trouble picking up the receiver.
…Senior Center Without Walls in Oakland …small nonprofit is among several organizations in the region striving to tackle a growing and frequently unrecognized problem among seniors: loneliness and social isolation.
For Rayburn, who lives alone, has no surviving family members and is besieged by a variety of health issues, the call-in groups are a lifeline. …A retired Alameda County social worker, Rayburn is convinced her mind would have long ago floated “into outer space” if not for the mental stimulation and social interaction the calls provide.
“I have this need to be of service,” Rayburn said. “I couldn’t handle life without being needed.”
In the United States, an estimated 1 in 5 adults over age 50 are socially isolated, according to the National Association of Area Agencies on Aging. That’s at least 8 million people nationwide.
In San Francisco, about 22 percent of the population is over age 60, according to estimates by the California Department of Aging. That’s the highest concentration of people over 60 in any of California’s 12 most populous counties. Of that group, about 24 percent reside by themselves, compared with a statewide average of 18 percent. A report by the San Francisco Department of Aging and Adults Services described isolation — social, physical and cultural — as a “bright red thread” of concern when it comes to providing services to the elderly and disabled population.
Dr. Carla Perissinotto, a geriatrician with UCSF who visits homebound seniors and sees others at the Over 60 Health Center in Berkeley, said she encounters deeply lonely elderly people every day. They may have hearing or vision loss that prevents them from interacting with others or even enjoying simple activities like watching television. Others are reeling from emotional losses such as the death of a spouse. Some feel they no longer have a purpose after retirement.
Loneliness “is everywhere, you just have to ask,” Perissinotto said.
It is more than an emotional or social predicament. Scientists are increasingly tying loneliness to a higher risk for physical health problems, cognitive decline and early death. Research suggests a lack of social connections is as dangerous to human well-being as smoking and alcohol abuse, and even more of a heath risk than obesity and lack of exercise.
…Clinicians typically don’t screen patients for loneliness, and even if they do, there’s little research to help them decide what treatment to suggest, she said. Several Bay Area organizations are leading the way in figuring out how to help lonely seniors.
An example is San Francisco’s Friendship Line, the only accredited crisis intervention line in the country targeting older people. Founder Patrick Arbore started the program in 1973 after he realized the regular suicide prevention line where he worked rarely received calls from seniors despite the fact that seniors account for a disproportionate percentage of suicides in the United States.
...Ernestine Moore, 77, who lives alone in the Duboce Triangle neighborhood, gets Friendship Line calls twice a day….“if you constantly bombard your family with your feelings of insecurity, they soon pull away from you,” she said. “This way I can burden the Friendship Line with that and then when my family calls, I’m grandma.”
Senior Center Without Walls, meanwhile, has almost 600 seniors who regularly call in to their classes and group chats. …A survey of callers to the organization revealed a marked increase in participant’s feelings of social connection, improved mental health and intellectual stimulation, said director Amber Carroll…
http://www.sfgate.com/health/article/Seniors-find-lifeline-in-phone-support-groups-10819575.php
Easing Old People's Loneliness Can Help Keep Them Healthy
ReplyDeleteJanuary 1, 20178:35 PM ET
ANNA GORMAN
San Francisco-based nonprofit called Little Brothers, Friends of the Elderly… works to relieve isolation and loneliness among the city's seniors by pairing them with volunteers.
…started in France after World War II and now operates in several U.S. cities, including Chicago, Philadelphia and San Francisco.
Cathy Michalec, the executive director of the local nonprofit, said older adults often become less mobile as they age. Cities like San Francisco, because of hills, crowded streets or old housing stock, are difficult for many seniors. That can lead to isolation and loneliness, Michalec said.
"Those 50 stairs you used to be able to go up and down all the time, you can't go up and down all the time," she said. "The streets are crowded and sometimes unsafe. ... Sometimes, our elders say, it's easier to stay in the house."
Across the nation, geriatricians and other health and social service providers are growing increasingly worried about loneliness among seniors…fueled by studies showing the emotional isolation is linked to serious health problems. Research shows older adults who feel lonely are at greater risk of memory loss, strokes, heart disease and high blood pressure. The health threat is similar to that of smoking 15 cigarettes a day, according to AARP. Researchers say that loneliness and isolation are linked to physical inactivity and poor sleep, as well as high blood pressure and poor immune functioning.
A 2012 study showed that people who felt lonely – whether or not they lived with others or suffered from depression – were at heightened risk of death. It also showed that 43 percent of people over 60 felt lonely.
"If someone reports feeling lonely, they are more likely to lose their independence and they are at greater risk of dying solely from being lonely," said Dr. Carla Perissinotto, a geriatrician and researcher at the University of California, San Francisco who authored the study.
There can be many causes of loneliness, Perissinotto said, including illness, hearing loss or life changes such as retirement or the loss of a spouse. "The usual social connections we have in younger life end up changing as we get older," she said.
…There isn't much research about the effectiveness of programs such as Little Brothers. But Perissinotto said they can help seniors build new social connections. Other efforts to address loneliness include roommate matching services in various states and, in the United Kingdom, a call-in hotline.
"Maintaining connections, that touchy-feely thing, is actually really important," Perissinotto said. "It's hard to measure, it's hard to quantify, but there is something real. Even though we don't have the exact research, we have tons of stories where we know it's [had] an effect in people's lives."
AARP Foundation also recently launched a nationwide online network to raise awareness about social isolation and loneliness among older adults. The network,Connect2Affect, allows people to do a self-assessment test and reach out to others feeling disconnected.
AARP, the Gerontological Society of America and other organizations are hoping to help create more understanding of isolation and loneliness and to help lonely seniors build more social connections.
"Loneliness is a huge issue we don't talk enough about," said Dr. Charlotte Yeh, chief medical officer of AARP Services. "There is a huge stigma."
http://www.npr.org/sections/health-shots/2017/01/01/506724900/easing-old-peoples-loneliness-can-help-keep-them-healthy
The Blindness of Social Wealth
ReplyDeleteBy David Brooks
April 16, 2018
…BRobert Hall, drew out the lesson in his book “This Land of Strangers,” noting: “The truth is, relationships are the most valuable and value-creating resource of any society. They are our lifelines to survive, grow and thrive.”
There’s a mountain of evidence suggesting that the quality of our relationships has been in steady decline for decades. In the 1980s, 20 percent of Americans said they were often lonely. Now it’s 40 percent. Suicide rates are now at a 30-year high. Depression rates have increased tenfold since 1960, which is not only a result of greater reporting. Most children born to mothers under 30 are born outside of marriage. There’s been a steady 30-year decline in Americans’ satisfaction with the peer-to-peer relationships at work.
Former Surgeon General Vivek Murthy summarized his experience as a doctor in an article in September in The Harvard Business Review: “During my years caring for patients, the most common pathology I saw was not heart disease or diabetes; it was loneliness.”
Patients came to see him partly because they were lonely, partly because loneliness made them sick. Weak social connections have health effects similar to smoking 15 cigarettes a day, and a greater negative effect than obesity, he said.
…loneliness and social isolation are the problem that undergird many of our other problems. More and more Americans are socially poor. And yet it is very hard for the socially wealthy to even see this fact. It is the very nature of loneliness and social isolation to be invisible. We talk as if the lonely don’t exist.
I was really struck by this last week, when Mark Zuckerberg came through Washington. Most of the questions he faced at the congressional hearings and most of the analysis in the press were about Facebook’s failure to protect privacy. That’s the sort of thing that may be uppermost on your mind if you are socially wealthy, if, like most successful politicians and analysts, you live within a thick web of connection and feel as if your social schedule is too full.
But the big issue surrounding Facebook is not privacy. It’s that Facebook and other social media companies are feeding this epidemic of loneliness and social isolation. It’s not only that heavy social media users are sadder. It’s not only that online life seems to heighten painful comparisons and both inflate and threaten the ego. It’s that heavy internet users are much less likely to have contact with their proximate neighbors to exchange favors and extend care. There’s something big happening to the social structure of neighborhoods.
The British anthropologist Robin Dunbar observes that human societies exist on three levels: the clan (your family and close friends), the village (your local community) and the tribe (your larger group). In America today you would say that the clans have polarized, the villages have been decimated and the tribes have become weaponized.
That is, some highly educated families have helicopter parents while less fortunate families have absent parents. The middle ring cross-class associations of town and neighborhood have fallen apart. People try to compensate for the lack of intimate connection by placing their moral and emotional longings on their political, ethnic and other tribes, turning them viciously on each other.
The mass migration to online life is not the only force driving these trends, but it is a big one. Such big subjects didn’t come up in the Zuckerberg hearings because socially wealthy and socially poor people experience Facebook differently and perceive reality and social problems differently. It’s very hard to quantify and communicate the decline in quality of relationships. But it is nonetheless true that many of us who are socially wealthy don’t really know how the other half lives.
https://www.nytimes.com/2018/04/16/opinion/facebook-social-wealth.html
Loneliness and Social Isolation: Podcast with Carla Perissinotto and Ashwin Kotwal
ReplyDeleteAug. 19, 2021
Carla: …in the study that I conducted in 2012, the prevalence that we saw amongst people over the age of 60 was a prevalence rate of 43% of people feeling sometimes lonely.
Ashwin: …loneliness is deeply intertwined with physical and psychological symptoms…like pain, difficulty sleeping, depression, anxiety…found that individuals who are more lonely tended to use these medications more frequently, sometimes twice the rate of benzodiazepine or sleep aids compared to people who are not lonely…We see this in the pandemic as well,…now they don't have those social relationships to distract them, to kind of improve their overall health…pain that they might have had before isn't relieved by Tylenol anymore…
Carla: … what actually goes into someone's health, bulk of it is actually social and much less what we're taught in medical school…if you are only asking about health and medical things and not asking about social things and giving that to the social workers, you're not doing your job…to understand all the things that are affecting my patients health.
Be it food security, be it safety in the streets, be it loneliness, it's all these…social determinants of health…
Ashwin: … One of the key requirements for accessing home hospice, though, is having a 24-hour home caregiver…social isolation can impact people's well-being in so many different ways that clinicians need to be aware of… mobilizing these external support services so that people aren't falling through the cracks of our healthcare system,…that really relies on kind of social relationships and caregivers to help people through hard times.
…another way that we'll sometimes get at social isolation, especially during the pandemic is assessing people's access to technology, and how they're using the internet or video devices or other things to connect…work with our interdisciplinary team, social workers, community health workers to get people connected to community programs that may help.
Carla:…majority of the people that were lonely were not depressed,…Majority of people that were lonely were living with other people…My hypothesis, frankly, is that we have many people that we are treating for clinical depression and not addressing their loneliness and therefore not getting better. And I have a feeling we're treating people with SSRIs, when really we should be focusing on their loneliness…what's in your purview is asking if someone wants your help… do you have any insight as to why this may be and what may help?
Ashwin: …This is classic geriatrics, taking an individualized approach to address situations where the evidence hasn't quite caught up yet…often asking what do people think might help, and trying to think about the individual contributors to loneliness that might be going on in that situation…
Carla: …pandemic has really made isolation and loneliness front and center to many people…We have been trying to prevent deaths by protecting from COVID, not realize that we were actually probably causing deaths in the process…
Ashwin: …start valuing social well-being in a similar way that we value the treatment of disease and traditional medical symptoms…especially among older adults, where social well-being can be a core of people's overall quality of life, can impact health in so many different ways.
Carla: …since many of our older adults live in poverty, and many are dual eligibles and have Medicaid benefits, I actually think that using an in home support service workers and having a social companionship program as part of that…
Ashwin: I completely agree. Programs that start with the social needs and then potentially move out to addressing medical needs that come up, I think that's a really nice way of providing a good foundation for relationships and solving a huge gap in our healthcare system right now.
https://www.geripal.org/2021/08/loneliness-and-social-isolation-podcast.html