Fighting loneliness among older adults
Loneliness, with its associated stigma of personal failure, is difficult to discuss and too often ignored or accepted as the price of aging.
But we can't ignore it. Studies indicate that one out of two residents in residential care homes are lonely. A 2013 study of one care home, for example, revealed that more than half (55%) of its 296 residents experienced loneliness.
And loneliness is much more than a distressing feeling. Its health effects are severe, according to research that links it with increased depression, dementia, heart disease and even increased falls and emergency department visits.
Effects are not just personal, either. Residents with a diagnosis of or signs of depression are more likely to exhibit severe aggressive behavior and conflict with staff members. The resulting challenging environment leads to high staff turnover in an industry already desperately in need of qualified help. And things will get worse.
No way exists to balance an equation that has increasing demands on one side and decreasing resources on the other. We are in a crisis, and a radical shift must occur.
Giving life meaning
Social identity theory suggests that as human beings evolved, they developed a sense of responsibility and caring for the well-being of others.
In a healthy community, we help our families, our neighbors and those less fortunate. We build bridges, cities and entire countries together. The very fabric of society depends on our helping one another. Without this type of engagement, our lives lack meaning, and we become socially isolated and lonely.
As a researcher, I've been investigating loneliness and social isolation for more than 15 years, and the stories I continue to hear from residents fill me with sadness.
I've come to believe that an urgent need exists for a social revolution in residential care — an overturning of the entrenched medical and hospitality models to individual social and emotional well-being. A move from what we can do to and for residents, to what they can do for one another.
The answer? Peer support — residents helping each other.
A new peer support approach
Over the past five years, I have developed and piloted a peer support approach called the Java Mentorship Program. In this program, community volunteers and residents meet weekly as a team. They call themselves mentors.
Each week at the team meetings, mentors check in, receive education on how to be a mentor and talk about who is struggling with loneliness, who just moved in or is just back from the hospital, who used to come to things but has stopped and similar matters.
Participants then pair up to visit socially isolated residents. They develop bonds with and engage residents who typically are difficult to engage and who seldom attend programs.
As a Ph.D. candidate at the University of British Columbia, Vancouver, I partnered with the Schlegel-UW Institute for Aging and Schlegel Villages in Ontario in 2016 to conduct a six-month trial of this mentoring program involving more than 200 participants.
Mentors said they derived personal benefits from participating in team meetings and mentoring, and they expressed an increasing sense of empathy and connection with those they visited.
After they had been in the program for six months, we found a statistically significant drop in visitee loneliness and depression and a 60% increase in the number of other monthly programs attended. Findings from this research were presented in July at the 21st IAGG World Congress of Gerontology and Geriatrics in San Francisco and also will be discussed Oct. 17 at the American Health Care Association / National Center for Assisted Living 68th Annual Convention.
Let me share a story with you.
Lillian (not her real name) is a retired school teacher who lives in a large care home surrounded by 240 residents and more than 400 staff members. When I walked into her community, it looked like a bustling, happening place. One of the first things I saw was a busy social calendar tacked on the wall near the entrance.
When I visited Lillian in her room and asked her how she was doing, however, she talked about feeling empty and profoundly lonely. She had no interest in the activities offered in her home.
“I'm lost here and depressed,” she said. “No one knows, because I suffer in silence. My room is at the end of the world.”
After the mentorship program was implemented in her community, Lillian received visits from two mentors, and over a few months, things began to change — really change.
She loved the visits and, in fact, ended up asking whether she could become a mentor, too. She joined the mentorship team and began visiting those struggling with loneliness and depression as she was.
When I returned several months later and asked how mentoring was going, she said: “I'm 95 — it gives me a new lease on life. It makes my life worthwhile!”
Peer support is practical, cost effective, transformative and revolutionary.
Kristine Theurer is founder and president of Java Group Programs. She holds a master's degree in gerontology and is a Ph.D. candidate at the University of British Columbia, Vancouver. Theurer is a member of the Canadian Association on Gerontology, the Gerontological Society of America and the Canadian Association of Music Therapy. She may be reached at firstname.lastname@example.org.
Theurer discussed her research with LeadingAge's Robyn Stone, DrPH, at the 2017 American Health Care Association / National Center for Assisted Living and LeadingAge annual conferences.
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