“Where’s the energy? I wonder,
Where’s the productive life?
It’s not in Bingo or Yahtzee.
These activities fill waiting
time until death.
Am I unique to avoid them?
Do others in the ALF have
longings to explore away from here?
Can we not provide for residents
who want to do something in and for the outside community? …
I’m not psychologically ready to
live institutionalized, physically I am.
That’s why while living in an
ALF, I’ve engaged in the outside world.
I teach, volunteer, write, take
courses, work out.
I pursue acts of giving back to
society.
That’s what one who is living
long, like me, should do…
It takes a village to accompany
elders on their final journey of life.
But in today’s fragmented and
mobile society,
families no longer live together
in a single household
Once it took a village, today it
takes an ALF.”
“The Thin Edge of Dignity: Assisted Living Documentary” (2014)
by Dick Weinman, Assisted Living Guru and AARP Blogger
by Dick Weinman, Assisted Living Guru and AARP Blogger
At age 65,
Dick Weinman retired from Oregon State University to care for his wife who had
Alzheimer’s disease. At age 72, while
driving to visit his wife at a care facility, he was involved in a car crash
that put him in a coma, then rehabilitation and a wheelchair. Next his children sold his house, decided he
could no longer live alone and placed him in an assisted living facility (ALF),
where he became “108” (his room number) and dependent on the kindness of caregivers. Since then, this former Speech Professor has used
his eloquent voice to advocate for improved long-term care facilities. Though residing in an ALF, Dick
epitomizes community living!
I like this
diversified Life Portfolio (Health + People + Pursuits + Places) for Retirees by
Anna Rappaport, a 78-year-old retirement benefits consultant who shifted her
focus from plan sponsors to individuals during her phased retirement of the
past 15 years. Her
point is people who view retirement as an endless vacation (a break from what
we normally do) likely will be disappointed or bored within a year or two, so
diversify your life!
Since residents
in assisted living and skilled nursing facilities have their basic
physiological and safety needs met, one would think they have time for higher
needs such as belonging, esteem and self-actualization. (After working with older adults struggling to remain in their homes and avoid homelessness, this sounds almost like a
suburban Problem that has No Name created by Betty Friedan?) Instead, they tell me they are lonely
among “peers” (who may have cognitive/sensory impairments so meaningful interpersonal
interactions are more challenging) and staff (professional boundaries prevent
closeness) in their age-segregated (ranging from age 55 to 111 years old!)
environment. They exist outside the
Grandmother Hypothesis: traditionally women lived long beyond childbearing age
because they had a purpose for their existence—helping to raise their
grandchildren within extended families (which made up 17% of U.S. households in
2014). The occasional outings and visits by family,
friends, volunteers and contractors from the community are not enough to
address loneliness.
At Loneliness & Brain Health Forum,
Community Living Campaign (CLC) Community Connector Glenda Hope talked about
joining CLC to get to know her neighbors through organized activities after her
retirement; she challenged us to think, “What makes you come alive?” I sat next to a recently retired school
teacher who told me she missed socialization at work, and retirement is not
just about keeping busy with activities, but belonging to a community.
UCSF behavioral
neurologist Serggio Lanata, MD, discussed the challenge of operationalizing the
concept of loneliness, which is not the same as being alone. For example, many younger people are
surrounded by people yet they feel loneliness, which might be defined as “too
few nurturing connections”—a condition that may be exacerbated by social media use (virtual v. tactile experience). Dr. Lanata said our brains are
hardwired to connect, so living alone may place people at higher risk for
loneliness: in San Francisco, nearly 30% of adults age 65+ live alone. This isolation can affect behavior, which
gives cues of not belonging to the environment; and the health effects of
loneliness include cardiovascular disease, mood disorders, immune conditions,
the equivalent of smoking 15 cigarettes per day, etc.
(Dr. Lanata,
who is a familiar face on this blog here and here again, received the 2019 UCSF School of Medicine Population Health and Equity Scholar Award for his outreach work to vulnerable groups, which include old people.)
Phaedra Bell,
an Atlantic Fellow at the Global Brain Health Institute (GBHI) at UCSF Memory
and Aging Center, mentioned social prescribing in the UK and the nexus between loneliness and
substance use to compensate for not belonging.
She then discussed her proposed intervention to reduce loneliness by
pairing an older adult with two younger students to produce a creative project
for 3 to 6 months, and then showcase the project to celebrate new friendships. She said something about allophilia, building cognitive reserve by
face-to-face interactions, … and then she was cut off. This evening program started late, but needed
to end on time. When an audience member
attempted to ask a question about cholesterol-lowering statins that bring on
brain fog, Glenda said presenters would be available to answer questions
one-on-one, and then invited us to visit resource tables.
I’ve been reading
about interventions for loneliness, a common complaint of residents in
long-term care facilities. Different approaches are needed to address the different degrees (sometimes, always),
types (emotional, social, collective, existential) and causes (perception,
disappointing relationships, loss of hearing or mobility, death of loved one)
of loneliness. John Cacioppo, PhD, who coined the term “social neuroscience,” was researching a pill (based on
pregnenolone) to cure loneliness before his death last year. His widow Stephanie Cacioppo, PhD, of University of
Chicago’s Brain Dynamics Laboratory, continues his work on loneliness and
offers this advice:
·
Introspection:
express daily gratitude, have a sense of purpose in life
·
Connection:
do something helpful or nice for others (give without expecting anything in
return)
·
Interaction:
engage with people (including strangers) on different levels and on a broad
range of topics, and listen to them; share positive news (rather than negative
information) and expect the best from people
Older Women’s
League (OWL) San Francisco hosted Advocating
for Important Issues Affecting Older Women in 2019 at Northern Police
Station Community Room (“Feel More in the Fillmore”). California Alliance for Retired Americans (CARA)
Executive Director Jodi Reid, presented on the following priority bills:
·
HR
1384 Medicare for All Act of 2019: introduced by Congresswoman Pramila
Jayapal, would include comprehensive long-term care, hearing, vision and dental
coverage so Nancy Altman urges, “Seniors Should Be The Strongest Supporters Of Medicare For All.”
·
SB
228 Master Plan on Aging: direct Governor to appoint an Aging
Czar and 15-member Aging Task Force to work with state departments and
stakeholders to develop a Master Plan for Aging, including expanding access to
coordinated, integrated systems of care.
California’s long-term support services (LTSS) are very fragmented,
involving multiple entities including the Departments of Health Care Services,
Social Services, Aging, Rehabilitation, Transportation, Housing and Community
Development, Insurance, Veterans Affairs, etc.
(In his January 2019 State of the State Address, Governor Gavin Newsom called
for a Master Plan for Aging after losing his father to
Alzheimer’s over the winter holidays.)
·
SB
512 LTSS: request $1 million budget to study benefits and costs of
subsidy program to help middle-income seniors and people with disabilities who
do not qualify for Medi-Cal/In-Home Support Services to buy LTSS, including
home care.
·
AB
1434 Increasing SSI/SSP grants and COLA: reinstate SSI/SSP COLA in 2020,
mandate monthly payments to 100% of 2019 poverty level.
E. Anne
Warren, Legislative Committee Chair of California Senior Legislature (CSL), discussed
transportation to medical appointments for seniors and persons with
disabilities who live in rural areas (her proposal was picked up by
Assemblymember Rudy Salas, AB 970), affordable rental housing for veterans (SB
725), and fall safe housing (SB 280). She
also mentioned the need to raise $250K each year to maintain California Senior
Citizen Advocacy Voluntary Tax Contribution Fund (Code 438) on the California
Personal Income Tax Return; this fund is used to pay for one staff and to
conduct work of CSL.
My last
OWL-SF attendance was almost three years ago, when I attended Empowered Elder Workshop and Women & Money panel.
At this month’s meeting, I saw many of the same faces from three years
ago. Then I learned that the national OWL dissolved two years ago due to aging leadership: OWL-The
Voice of Women 40+ (1980-2017) R.I.P.
However, local chapters continue, like OWL-SF The Voice of Midlife and
Older Women.
At UCSF
Medical Center’s Asian Health Institute, bioethicist Anita Ho, PhD, MPH delivered
a bilingual Cantonese/English presentation on Advance Healthcare Directives.
She shared her own family’s
experience, including her grandparents who were in and out of hospitals until
their deaths at age 98 and 99, and the Chinese culture of filial piety, living
life seriously and accepting its end peacefully. While we still have capacity, we can prepare
ourselves psychologically and document our own decisions about health care, including
what makes life meaningful, deathbed wishes, spiritual needs/religious beliefs,
and life sustaining treatments (cardiopulmonary resuscitation which has 10-20%
recovery rate, ventilator, dialysis, feeding tube, blood transfusion, surgery,
etc.). We should distribute executed
copies to our family, friends and medical provider; have discussions; and
update should circumstances change.
Zeroing In on Isolation and Loneliness—Boosting Social Capital
ReplyDeleteBy Ashwin Kotwal and Carla Perissinotto
…“successful ag¬ing” involves not only a focus on physical and mental health, but also on social well-be¬ing and connectedness…
Social isolation relates to a quantifiable deficit in the number of relationships or volume of con¬tact with family, friends and community. Risks for being socially isolated include living alone, be¬ing unmarried or unpartnered, having no children or having minimal contact with others.
Loneliness…is a subjective and distressing feeling of isolation, lack of companion¬ship or a perceived discre¬pancy between ideal and existing social connections.
Loneliness and so¬cial isolation can co-occur, but recent research suggests they often occur separately.
A 2017 national study found that nearly two-thirds of individuals reporting significant loneli¬ness were married. On the other hand, people can live relatively solitary lives with no complaints of loneliness. Some research suggests that…we should focus on composite measures of social connection such as structural factors (eg., network size and marital status), functional factors (eg., perceived support) and relationship qual¬ity.
Despite variations in understanding and reporting of loneliness and isolation, there are significant data demonstrating persistent negative health consequences of loneliness and, conversely, protec¬tive effects of maintaining social connection. Prevalence rates of loneliness in the United States are reported to be as high as 43 percent in community-dwelling adults older than age 60, and are a significant risk factor for premature mortality, with health effects comparable to smoking.
…loneliness and isolation have demonstrated an association with worsened diabetes, increased risk of cardiovascular mortality, dementia prevalence and loss of independence…risk for elder abuse…
Loneliness and social isolation can occur throughout the life course…
…for older adults experiencing late-life disability, cognitive impairment and physical symptoms such as pain, they may be unable to recover lost connections and cope with loneliness. Sudden changes in physical function after a fall, for example, can lead to isolation in the home. Sensory changes such as visual impairment from macular degeneration or untreated cataracts, or undetected hearing loss may make getting out of the home difficult or reduce motivation to social¬ize or participate in community activities.
…older adults can experience fundamental changes in social roles due to a transition to widowhood or the loss of important family or friends, who are difficult to replace.
Retiring from a long-standing job can disrupt decades of routine, relationships with the community and feelings of self-worth and self-efficacy. Simply trying to “increase social contact” to address loneliness and social isolation among older adults, while compassionate, may lack the nuance required to manage complex and individual situations among older adults.
…there is increasing proof and concern that younger generations raised with a reliance on social media and technology are experiencing higher levels of loneliness and, potentially, isolation. This is thought to be related to how social media and technology are used, the quality of online relationships and interactions, and if these are replacing in-person relationships…
While the benefits of traditional medical care become increasingly limited (and sometimes harmful) as elders develop progressive physical and cognitive disability, social interventions fo¬cused on enhancing connectedness represent an area where we can positively impact well-being…
Solutions can include creating communities that value intergenerational living,…“structured” volunteering, which benefits both volunteers and people receiving the service; and, organizations, such as the Foundation for Art and Healing, are looking at how the arts can connect people…
https://www.asaging.org/blog/zeroing-isolation-and-loneliness-boosting-social-capital
Tackling the loneliness epidemic
ReplyDeleteAnalysis by Dr. Joseph Mercola
August 03, 2019
The loneliest are young adults between the ages of 18 and 22. This age group also rated their health the lowest, which correlates with science linking loneliness with a greater risk for obesity, heart disease, anxiety, dementia and reduced life span. In fact, maintaining strong and healthy social connections has been linked to a 50% reduced risk of early death. Similarly, emotional loneliness is linked with an increased risk of all-cause mortality…
Somewhat surprisingly, seniors over the age of 77 — an age group well-known for loneliness — had the lowest loneliness score in Cigna’s survey; 77% also rated their physical health as good, very good or excellent, compared to just 65% of younger Gen X’ers.
Loneliness translates into higher health care costs
…National Institute for Health Care Management — a nonprofit research firm for the health insurance industry — revealed social isolation among seniors is costing the federal government $6.7 billion each year in added health care spending, as “poor social relationships” are associated with a 29% higher risk of heart disease and a 32% increased risk of stroke.
…In its 2018 survey, “Loneliness and Social Connections,” the AARP reports that 35% of adults over 45 struggle with loneliness. Among those making less than $25,000 a year, the loneliness ratio is 1 in 2.
Aside from financial woes, a diagnosis of depression or anxiety, living in an urban community and the increased use of technology for communication are identified as factors that increase feelings of loneliness.
…Through interviews with leading experts around the world, author and investigative journalist Johann Hari…identified nine scientifically verified causes of depression — only two of which are biological. The remaining seven are all related to how we live…
Loss of tribal communities have taken a toll
In his book, Hari cites research looking at reported loneliness scales. One question in this study was, “How many close friends do you have that you can turn to in a crisis?”
The most common answer in the past used to be five. Today, the most common answer is “none.” Half of Americans also say that nobody really knows them well. Historically, mankind survived because we banded together and worked as a group. Our very survival often depended on being part of a tribe…
Recreating holistic communities
…Sir Sam Everington, a British doctor in East London, tackled the problem by inviting patients struggling with depression and anxiety to gather and do things together as a group…In learning about gardening, and meeting to share and implement their newfound knowledge, they formed a “tribe.”
And with that, “they did what people do when they are part of a tribe,” Hari says, “they began to care about each other … they began to solve each other’s problems.”
…similar program in Norway, which showed group gardening to be twice as effective as antidepressants. In his view, there are obvious reasons for this. Forming relationships addresses the reasons people feel bad in the first place.
The paradoxical role of technological hyperconnectedness
…Hari points out that when the internet, and social media in particular, arrived on the scene, the sense of community was already waning, and social media gave the appearance of giving back to us something of what we’d lost — friends and status being two examples.
But it’s not a proper replacement…
Is there a connection between materialism and happiness?
…professor Tim Kasser…research conclusively showed that the more you’re driven by money and status, the more likely you are to succumb to depression. Hari says:
“…You need to feel you belong … that your life has meaning and purpose, you need to feel that people see you and value you, you need to feel you’ve got a future that makes sense…”
https://articles.mercola.com/sites/articles/archive/2019/08/03/the-loneliness-epidemic.aspx
Once you hit this age, you’re far more likely to feel lonely
ReplyDeleteDec 10, 2019
By Catey Hill
You’re not alone if you’re feeling lonely.
Nearly half of Americans are lonely, according to a survey of 20,000 people across America by Cigna, which used the well-regarded UCLA Loneliness Scale to measure responses. Indeed 46% said they sometimes or always feel alone and 47% say they sometimes or always feel left out.
And that finding is mirrored by other studies, which reveal that anywhere from 20% to 43% of Americans feel lonely or socially isolated, NPR reports. And a study published last year in the journal International Psychogeriatrics found that as many as three in four people might be lonely.
Of course, levels of loneliness can fluctuate throughout your life, and there are certain factors that can help predict loneliness. Here are four:
Age. The oldest Americans are among the loneliest. Levels of loneliness begin to increase after about age 75, a study released Tuesday in the journal Psychology and Aging found. And a study released last year in the journal International Psychogeriatrics found that loneliness spiked for people in their 80s (though it also saw a spike when people were in their 20s and mid-50s).
Health. One reason older adults may feel lonely is due to poorer health, the Psychology and Aging study revealed. “Chronic conditions, functional limitations, cognitive decline, and sensory loss are examples of the types of health concerns that can affect people’s ability to remain socially active and to have good quality social interactions,” the study found. “In turn, social deficits increase risk for loneliness.”
Education. That B.A. degree may do more than up your earnings. “Education is believed to protect against loneliness because more education imparts individuals with greater resourcefulness in developing and accessing social supports that alleviate stress and thereby indirectly reduce risk for loneliness,” write the authors of the Psychology and Aging study entitled “Are U.S. Older Adults Getting Lonelier? Age, Period, and Cohort Differences.”
Relationship status. Do you have enough people — and the right kind of people — in your life? Married people (both those in their first and subsequent marriages) and those with larger social networks and closer relationships with family and friends tend to be less lonely. “The number and quality of people’s social relationships and activities play a prominent role in determining feelings of loneliness,” the study’s authors write.
One big issue with loneliness is that not only can it make us feel sad, it’s bad for our health. “Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death,” the National Institute on Aging reveals. Indeed, Steve Cole, the director of the Social Genomics Core Laboratory at the University of California, Los Angeles told the NIA that “loneliness acts as a fertilizer for other diseases.
https://www.marketwatch.com/story/once-you-hit-this-age-youre-far-more-likely-to-feel-lonely-2019-12-10
‘I’m Really Isolated Now’: When Elders Have to Fight Coronavirus Alone
ReplyDeleteThe shutdown of community centers means enforced solitude and a loss of structure.
By John Leland
March 19, 2020
…New York is an aging city, and in many ways, it’s a good place to be an older person: There is plenty of public transportation and ample medical care. But the city is unprepared for what it faces today. New York has 1.73 million residents over age 60, more than the total population of Boston and San Francisco combined, with a demographic profile that is getting poorer and older. The coronavirus pandemic stretches the gaps in a system already under pressure.
Shortages in supermarkets, closures in public facilities — all take an extra toll on elders, especially those with limited means: One in five New Yorkers over age 65 lives in poverty, twice the national average. The difficulties cascade: When schools close, home-care workers have to stay with their children, leaving frail elders isolated in homes they cannot manage.
All of it rests on an especially fragile work force of volunteers and low-wage workers who provide essential meals, home care, and social companionship to elders at home — exposed to long subway rides and managing their own child care. If they falter, there is often no net below for their clients.
For 30,000 elders each day, senior centers were an outlet from their homes. And now, by order of the mayor, all on-site activities are closed, though the centers can still provide meals to go.
…It is a terrible irony of the virus: that for older adults, steps to prevent the spread of Covid-19 increase the risks of social isolation, which carries its own devastating health effects. A study by the AARP compared the effects of prolonged isolation to those of smoking 15 cigarettes a day.
Normally programs for elders aim to increase human contact. Now that contact is potentially deadly.
Nursing homes and assisted-living buildings, by order of the city’s health department, banned visitors, including in many cases residents’ private aides. Public libraries, houses of worship, neighborhood cafes — all social spots for elders — are also closed, pushing older people back into what are often lonely apartments: 30 percent of New Yorkers over 65, and 43 percent of those over 85, live alone, according to the Department for the Aging.
…As much as the activities and the hot meals, senior centers provide structure in lives that may not otherwise have it, said Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College. “The way we remember to do something is that it’s tied to something else,” Ms. Finkelstein said. “When that gets disrupted, it disrupts when we eat, which disrupts our sleep, which disrupts whether we take our medications.
“We see this with the way older people experience delirium in the hospital after just a few days of disruption…”
…Stephanie Cacioppo, an assistant professor of psychiatry and behavioral neuroscience at the University of Chicago, who studies loneliness and social isolation, said that the sense of losing control in the pandemic was both harmful and treatable. Social distance need not lead to social isolation, she said.
…Caregivers and family members should try to help elders feel in control of the precautions they are being told to take, so that they feel involved rather than punished by the new rules, she said. She also recommended asking about public health crises they lived through in the past, including polio or tuberculosis, even SARS or the H1N1 flu.
Clear information helps; alarmist news programs, on the other hand, can make people feel helpless. In a nursing home or assisted-living building, rumors run wild. “Just having someone giving you an update every three hours, saying I’ll see you later, gives people a sense that there is a future,” Ms. Cacioppo said. “It makes seniors not feel abandoned. They see themselves not as objects, but as contributing.”
https://www.nytimes.com/2020/03/18/nyregion/coronavirus-elderly-nyc.html
In a Pandemic, Preventing Social Isolation Becomes A Personal Mission
ReplyDeleteposted 03.20.2020
AgeBlog recently reached out to Shireen McSpadden, the executive director of the City and County of San Francisco Department of Disability and Aging Services, to find out about plans the department has for preventing social isolation in elders…
On Monday, March 16, California Gov. Gavin Newsom announced an executive order that all people ages 65 and older and those with chronic conditions should shelter in place…
San Francisco Mayor London Breed issued an order…all San Francisco residents must shelter in place at home except to go out to provide essential work or to obtain essential items. Residents must practice “social distancing” (maintaining a 6-foot distance) from others at all times. All non-essential businesses were closed, including places of worship, gyms, hair salons, etc., leaving open only grocery stores, pharmacies and other essential businesses such as medical offices.
McSpadden emphasizes the importance…for people nationwide to respect public health officers’ decrees and remain at home, which in turn may prevent older adults and those with chronic conditions from getting the virus…
McSpadden is quite concerned that, as older adults shelter in place they are experiencing social isolation, a condition that can lead to higher risks for high blood pressure, heart disease, obesity, weakened immune systems, anxiety, depression, cognitive decline, Alzheimer’s disease and even death, according to the National Institute on Aging.
“We already know social isolation is a giant public health issue, and it will be exacerbated with the country shutting down,” said McSpadden. She’s particularly concerned about people with dementia and those who live alone during the shelter-in-place decree.
“As a network of area agencies on aging (AAA) and other programs that serve elders, we’re figuring out ways to engage older adults in community, whether it’s by phone or neighbors reaching out to neighbors. Programs are ramping up to do online social engagement, for example, Senior Centers Without Walls,”…Community Living Campaign works with a number of neighborhood networks… Community Music Center is finding ways to do video singing so members can still engage..
For ASA members not on the frontlines who are seeking ways to help older adults, McSpadden suggests picking up the phone and making calls…
“Neighbors need to reach out to neighbors. Leave a note. Knock on a door. Just stay 6 feet away, and ask if they need anything,” she said. “Let’s go back a bit to the old ways of doing things.”
Since the executive order, home-delivered meal requests to McSpadden’s department have increased three-fold, she said. They are working at the federal and state levels to clarify emergency funding packages in the hopes they can relax the rules of who qualifies for such meals during the shelter-in-place order. Her department also continues to provide congregate meal services, but on a take-out basis, which means someone needs to pick up the meals and/or deliver them.
…Businesses in San Francisco are branching out into meal and medication delivery services, which will enable them to hire more workers—a double benefit for the many people out of work. Groceries are offering early hours for older adults–only shopping, and the AAA network is scrambling to better support people staying at home. McSpadden’s department is mobilizing their staff disaster service workers who may be working from home.
https://www.asaging.org/blog/pandemic-preventing-social-isolation-becomes-personal-mission
Understanding the Three Types Of Loneliness
ReplyDeleteGerontologist Linda P. Fried discusses the unique mental stress of social isolation on the elderly.
By Rebecca Shapiro
Spring/Summer 2020
The COVID-19 pandemic has shut down society in an unprecedented way, but for the elderly, the consequences of both the disease and the social distancing required to curb its spread are sizable.
Gerontologist Linda P. Fried, dean of the Mailman School of Public Health, explains that adults sixty-five and older are at higher risk for severe illness and death from the virus because of their “decreased reserves.”
“There are changes in our physiology as we get older that make it harder for us to bounce back from any kind of illness. We call that frailty,” Fried says. “Older people are also more likely to have other long-term medical conditions. Because of that, the body is less able to handle a major stressor or infection.”
Such physiological vulnerability is exacerbated by the fact that nursing homes, assisted-living facilities, and hospitals have been breeding grounds for COVID-19. But Fried is also concerned about the well-being of seniors who live independently.
Fried, whose research focuses on healthy aging, says that older adults benefit tremendously by staying both mentally and physically active. Now, as people are encouraged — and in many states legally required — to stay at home, Fried worries about further isolating this population.
“As people get older, their life circumstances change. They lose their spouses to death or divorce, friends die, children move far away,” she says. “Obviously that now has bigger ramifications. There are deep mental tolls, and one of the most devastating is loneliness.”
Fried says that older adults are prone to three specific kinds of loneliness. The first is brought on by a lack of intergenerational contact. “We need all age groups to interact to create meaningful lives,” Fried says. Second, aging adults feel lonely when they aren’t able to contribute to society. While others might bond with colleagues or schoolmates as they work or attend class online, the elderly are not likely to have such outlets. And finally, aging adults are prone to what Fried calls an existential loneliness.
“People are wondering if their lives are going to end shortly for reasons out of their control. They’re wondering if they’ll be able to get the care they need,” she says. “And most profoundly, they’re wondering if they are going to be cast out of society. If their lives have value.”
The COVID-19 pandemic has brought that last question into startling reality as society has grappled with impossible dilemmas. In Italy, doctors working with limited resources were forced to prioritize the care of younger adults with a better chance of recovery. As the pandemic rages across the globe, other hospitals may be faced with the same impossible choices. In addition, decisions on how and when to relax social-distancing recommendations must factor in the value of society’s most vulnerable citizens.
“The ferocity of this particular virus has caught a lot of us by surprise,” Fried says. “We have a lot more questions than answers for the future.”
This article appears in the Spring/Summer 2020 print edition of Columbia Magazine as part of the cover story, "What We Have Learned From the Pandemic (So Far)."
https://magazine.columbia.edu/article/understanding-three-types-loneliness