“My shadow’s the only one that walks beside me.” – Green Day, “Boulevard of Broken Dreams”
I am surrounded by people, I am loved and respected, and yet I often feel lonely. I am now 61, on the younger side of older adulthood, but I’ve experienced many of the things that make older people feel loneliness – loss of close family and friends, grief, the empty nest.
My wife died while we were on vacation in Australia from another pandemic – the swine flu of 2009. I came home from that trip a single father of my 8-year-old daughter. I was not good at asking for help. I was not good at connecting with others outside work back then. I realised that I needed to connect with others, ask for support, be a part of our community, a part of her school. I had to help my daughter with grief while balancing my career and my own feelings of loss and loneliness. When she left for college, I wasn’t sure I would survive the empty nest.
Flash forward to 2022, at the tail end of what we all hope has been a turbulent few years for all of us: a new global pandemic, racial inequality and strife, seemingly unfixable political divides, and overwhelming economic isolation. Going through this, older adults have faced two pandemics. The most obvious has been the coronavirus, which has caused the need to physically distance from one another to keep each other safe. The second pandemic is the spread of social isolation and loneliness among our elders.Unfortunately, physical distancing to protect ourselves against the spread of COVID-19 exacerbates isolation in older people, creating a perfect storm where one pandemic makes the other much harder to bear.
According to the Centers for Disease Control and Prevention, eight out of ten deaths in the US during the pandemic have been among seniors. And while seniors were among the first in line for the vaccine, other safety nets in place to catch the elderly unravelled quickly.
The Federal Cigarette Labeling and Advertising Act of 1965 required that packages of cigarettes display the warning “Caution: Cigarette Smoking May Be Hazardous to Your Health.” I wish the Surgeon General would issue this warning: “Caution: Loneliness and Social Isolation May Be Just as Hazardous to Your Health.”
Yes, just like smoking, loneliness and social isolation are deadly. And just like smoking in the 1960s, our society is just beginning to understand the perils of loneliness and social isolation today. A 2015 study published in the journal Perspectives on Psychological Science shows that lacking social connections is as damaging to our health as smoking 15 cigarettes a day.
The New York Times recently ran a story with the headline “Social Isolation Is Killing Us.” The risks of social isolation and loneliness have also been compared with alcohol consumption and exceed those associated with physical inactivity and obesity.
This is not news to me, because I have worked in senior housing for 24 years. We see it every day. Loneliness can kill you — period — and there is no medical intervention that can cure it. But it can be cured in other ways through social interventions.
There are proven ways to combat isolation and loneliness for older adults.
The Arts and Health Journal recently published a study from the Institute for Health and Aging at the University of California, San Francisco, “Effects of Visual & Literary Arts Interventions on Well-Being of Older Adults.” Findings suggest that participation in a 12-week visual or literary arts programme has multiple benefits for diverse older adults. From interacting with new people and developing meaningful relationships to facilitated happiness and laughter, participants overwhelmingly reported an improved sense of emotional well-being. The study evaluated classes led by artists in affordable senior housing communities.
Social isolation and loneliness are not the same thing.
About 28 per cent of older adults in the United States, or 13.8 million people, live alone, according to a report by the U.S. Department of Health and Human Services, but many of them are not lonely or socially isolated. At the same time, some people feel lonely despite being surrounded by family and friends. Loneliness is a subjective perception stemming from a disparity between people’s actual social relationships and the ones they desire. 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. Two in five Americans report that they sometimes or always feel their social relationships are not meaningful, and one in five say they feel lonely or socially isolated.
Isolation and loneliness are also costly.
An estimated US$6.7 billion in annual federal spending is attributable to social isolation among older adults. Poor social relationships were associated with a 29 per cent increase in risk of coronary heart disease and a 32 per cent rise in the risk of stroke. Authorities expect the financial and public health impact of loneliness to increase as the nation’s population ages.
In 1999, I founded an organisation called EngAGE, which currently provides life enhancing classes, programmes and events in 55 affordable senior and multigenerational housing communities in California, Oregon and Minnesota, serving more than 5,500 seniors and hundreds of families with children. Residents attend classes in the arts, lifelong learning, well-being and community building and civic engagement. We connect elders to the younger generations through intergenerational programmes like arts, gardening, cooking and mentoring.
We have found that there are sure-fire ways to combat loneliness and isolation by helping people change isolating behaviors and create lasting social connections, replacing loneliness with feelings of belonging, purpose and community.
I started looking for a model of how to change the “box” of senior housing 20 years ago, but I had to look elsewhere. I found that model in college. College and retirement — similar times in life if you look at them through the right set of goggles. They are both new phases of life, where we can use our free time to better ourselves, continue to grow and become something new each day if we choose. But unlike college students, the people who enter the doors of our senior housing communities often come down a path of grief.
A common tale goes like this: Mom and Dad live in their town where they have made a life together. Dad dies. The family is worried about Mom, so they move her closer to them to be near family, far from her social network. But the family, the adult children of Mom, often have jobs, soccer practices and a full plate of caring for their own children. Mom becomes depressed and isolated.
The EngAGE model inserts into this mix an instruction manual, a cadre of classes and events, and a pathway to social connection right where Mom lives. When Mom walks downstairs, someone from EngAGE is standing there with a ‘college catalogue’ giving her ideas about what she might do with the rest of her life — daily programmes that draw people together, where they create lasting relationships and a sense of community and purpose.
EngAGE contracts with affordable housing developers to provide required services programmes onsite, but instead of just checking the boxes on subsidy applications, delivering the minimum, EngAGE delivers a package that is proven to create healthy outcomes and extended independence.
How do you get someone who is lonely and isolated to re-enter the world? EngAGE programmes do that every day by creating an environment where they live
that is filled with arts, wellness, lifelong learning, a sense of community and purpose, connectivity to all ages and a place in the community elevated by people seeing how great this time of life can be instead of being afraid of it.
In a short film, called A Dose of Creativity, a few of our residents talk about what it’s like, living like this as we grow older. I invite you to watch the film, listen to them and try to envision what it would be like if everyone grew older like they do. It’s possible. We see it every day where we work.
In collaboration with one of our key development partners, Meta Housing, we co-created a community model known as The Arts Colony, which features arts spaces and classes for people who want to create later in life. The Burbank, North Hollywood, and Long Beach Senior Arts Colonies are open and consistently leased to capacity. The success of these senior developments has now been replicated in multigenerational communities at the Pacific Avenue Arts Colony and the Glendale Arts Colony, ACE/121.
Suzanne Knode, 67, was surviving on social security income, well below the poverty level, before she moved to the Burbank Senior Artists Colony. She was depressed, had suffered a traumatic accident and was in chronic pain.
At Burbank, she attended an EngAGE writing class. Suzanne wrote a screenplay as a class assignment, and her project, Bandida, was made into a short film. The film won the audience award at the NOHO Film Festival, where she watched her film for the first time in a vintage theater and stood onstage, tearing up to a standing ovation for her accomplishment. The making of her film, and her story of reinvention, was profiled on national television. Suzanne is now working on several new film and stage projects and has also taken up painting in an EngAGE art class. She has returned to full health with a new lease on life.
I often say that I want to be Suzanne Knode when I grow up. But I also want to be Sally Connors, a neighbor of Suzanne’s at BSAC, who didn’t think she was an artist, but then achieved dream after dream of becoming a writer, actor, director, painter and a singer who performed with a jazz band live onstage in front of hundreds. I want to be Walter Hurlburt, who, simply because he can, spends every waking moment painting, showing his work and attending any class of any medium available to him, continuing to learn and grow. Walter mentored at-risk teens at a nearby transitional school and helped Angel, one of his arts mentees, to get back into school, graduate and become an artist. Angel taught Walter graffiti and Walter taught Angel to paint. I want to be Dolly Brittan, who moved to BSAC from South Africa after her husband died, and discovered she could be a sculptor, painter, poet and actor in her later years. Then she fell in love again, marrying the man who taught the sculpture class, and no one was more surprised and filled with wonder than Dolly.
Arts programmes – proven effective in the UCSF study – in addition to others like wellness, lifelong learning and intergenerational civic engagement, can be delivered at low cost in every affordable housing community in the country. By making these programmes a requirement and providing some additional funding for them, this would create an effective social intervention to combat the isolation and loneliness pandemic.
My own experience with loneliness has helped me understand much better what older adults face in the other “pandemic” of isolation. If there has been a gift in the coronavirus pandemic, it has surely shone a light on just how alone older people feel in our society and that we really need to look for solutions to create connectivity for all ages.