(soft piano music) - [Narrator] Coming
up on Aging Matters, loneliness and isolation. - I wanna have a
say in what goes on and so, I want a
sense of autonomy but I also don't wanna
be lonesome doing it. - [Narrator] We have a natural
need to connect with others, to find happiness in
relationships with
family and friends but keeping social connections is difficult as we grow older. - How am I going to live
the rest of my life? What do I want? You drive into a community and
never connect with anybody, you can drive into your garage,
the garage door goes down. Totally isolated, everything's built for isolation
and loneliness, really. (relaxing music) - [Narrator] Many
Tennessee adults 65 years and older
experience social isolation. According to the Tennessee Commission on
Aging and Disability, 28% live alone. That's almost three
hundred thousand people. 14% report rarely
or never receiving social and emotional support. 48% of older adults experience
loneliness and isolation. - This is a substantial
number of people. We need to address that. - One never thinks about
isolation and loneliness until you find
yourself by yourself. - [Narrator] Researchers
say loneliness is hazardous to physical
and mental health, and can even lead
to early death. - Loneliness is more
important than diet. It's as damaging as
cigarette smoking. 15 cigarettes a day is the
equivalent of loneliness, in terms of the medical risk
that you put yourself through. - [Narrator] Studies show that feelings of loneliness increase the risk of death by 26% and
not always by natural causes. - On an annual
basis in the U.S., we lose close to seven thousand
older adults to suicide. With the baby
boomers moving older, our numbers are gonna increase. - [Narrator] There is an urgent push to find new, reliable ways to measure loneliness
and isolation, and to intervene before
the damage is done. - We saw big differences
in depression, anxiety, better sleep, so what we wanna do is actually correct those things, so that if we can actually reach out to people, maybe we can actually
prevent some of those things. (clapping) ♪ I love you ♪ (laughing) (calming music) - [Narrator] Major
funding for Npt Reports, Aging Matters, is provided by: The West End Home Foundation, improving the quality of life of seniors through the support of nonprofit organizations
in Middle, Tennessee, the HCA Foundation, on
behalf of TriStar Health, the Jeanette Travis Foundation, dedicated to improving the
health and well-being of the Middle, Tennessee community,
and Cigna HealthSpring. Additional support provided by: Jackson National Life
Insurance Company, The Community Foundation
of Middle, Tennessee, and by members of
Npt, thank you. - Growing older can be
an isolating experience. Retirement, the passing
of loved ones and friends, a change in health
or functional ability all can limit one's
engagement with the world. The problem is that
social isolation has grave consequences
for health. Studies show it can be just as bad for you as
smoking and nearly twice as dangerous as obesity. Hi, I'm Kathy Mattea. The likelihood of living
alone increases with age but is living alone inevitable? Is physical isolation as bad
as feeling isolated or lonely? What can we do to
prevent ourselves and our loved ones from becoming
withdrawn from community? As our population ages, we need to think about the
kind of community we want to live in and what
it will take to create it. Join me as we explore the role of isolation and
community in our health. Stay tuned. (emotional music) - This is our
anniversary in 2010. We used to do a lot of things but after her illness, we had to curtail some of those things. That's the one reason I
decided to go ahead and retire. - [Narrator] James Trent retired after a 35 year career in
the automotive industry. He didn't have a plan but
he did have a mission, to be primary caregiver
for his wife, Carolyn. - My number one focus
was to take care of her. It just wasn't feasible
for me to try to work and take care of her because we didn't have family members here. That's what I enjoyed
doing, taking care of this woman who had been in
my life for the last 50 years and she had stuck beside
me when I was down. (emotional music) - [Narrator]
Carolyn died in 2017 and James suddenly found himself with no mission, no plan,
and few relationships. - When she passed,
she had friends and families that come around, and they support you, and as the days go by and the
weeks, after a while you find yourself alone and that's when the reality sets in. She's not coming back. You're alone. That's when you find
yourself understanding what loneliness is
and what isolation is. - [Narrator] Loneliness
and isolation are powerful words in
our western lexicon. They are the
subjects of countless works of art, from
popular music, ♪ Would shake me
from my slumber. ♪ (western music) ♪ Lonely to the grave. ♪ - [Narrator] To the visual. To the written and spoken. - [Male Narrator] When,
in disgrace with fortune and men's eyes, I, all alone,
beweep my outcast state. - [Narrator] But
isolation and loneliness are often misunderstood
and misconstrued when it comes to social
and clinical purposes. Experts are working
to find the risk and identify the consequences of what is now considered
a public health threat. (western music) - Western countries,
in particular, have been looking
at this, you know, for several decades as
the older population becomes more isolated from
the general population. For example, retirement. A lot of times, that really
reduces one's social circle. Of course, the death of a spouse or family members,
other friends. Of course, we have
environmental factors, which may be living
in remote areas, or we don't have
adequate transportation, or maybe disability,
or health issues. - Loneliness is more
of a subjective feeling and it has a lot to
do with a person's perceived social
contacts and connections compared with what they
would want and desire, so that if a person
wants social contacts but doesn't really have them, that is understood
as loneliness. - [Narrator] Dr. William Petrie is professor of
clinical psychiatry at Vanderbilt Medical Center. His patients are
mostly older adults. While anyone at
any age is at risk for loneliness, Petrie suggests we should pay extra
attention to older adults. - The older population is
more vulnerable to this. There's less they
can do about it but the fact is, loneliness is a problem even in
younger people. - [Narrator] Simply
put, social isolation can lead to
loneliness, which can lead to health problems,
both physical and mental. - If you are lonely,
you will have an increased incidence
of heart disease, you will have an
increased risk of stroke, increased risk of
premature death, and increases dementia, also
reduces your cognitive ability. - [Narrator] The root cause
is not simply living alone, although that can
be a risk factor for social isolation
and loneliness, but many older adults
live by themselves, aging in place, whether
by choice or circumstance. - A lot of older
individuals will fight tooth and nail not to
come and live with family, or to go into assisted living, or any other sheltered housing. Also, we have families that
live miles and miles apart now. In some cases, that
ends up creating isolation or at least a
physical separation from family. - [Narrator] Dr. Ronald Aday,
professor of sociology at Middle, Tennessee
State University specializes in geratology. Studies show that
while living alone might put older
adults more at risk for fall-related injuries,
household accidents, medical mistakes, and
other safety concerns, their risk for loneliness is
much more complex to determine, and not simply related
to living alone. - For some individuals,
they may have a real small social
network but they may not necessarily feel lonely. They may enjoy being and
living in a remote area. A lot of people do like to live
a very private kind of life. We know, also, that
we may be isolated even though we
live around people. In today's society,
we have, you know, neighbors but we
may not necessarily know who those neighbors are. It's not necessarily sometimes the number of
people that we have but the meaningful
relationships that we have. - [Narrator] In
other words, someone can be lonely but not isolated,
or isolated but not lonely. (relaxing music) So how prevalent is
social isolation? The AARP Foundation
has an isolation team whose focus is to investigate, analyze, and make
recommendations
related to isolation and loneliness among
adults ages 62 to 91. - And we wanted to
get some sense of what that really looks like, how many people are
we talking about? And so, this survey
indicates that most people over
50 don't experience loneliness or isolation,
but almost 30% do occasionally feel isolated and experience
loneliness, and 20% say that they do that
on a regular basis. This is a substantial
number of people. We need to address that. - [Narrator] The
study found that certain characteristics are
linked to social isolation. They include physical
impairments like hearing loss and lack of mobility,
psychological problems like depression and addiction, and a number of
social challenges. - A couple of population factors contribute to the
feeling of isolation and literally being isolated, and that is non-English
speaking groups, and we have literally hundreds of those, right here in
the Middle, Tennessee area. The LGBTQ community. Women, single women,
multicultural folks. Any people who may
find themselves in a vulnerable
situation or not have other people like them
around in larger numbers can definitely feel
lonely and isolated. (soft piano music) - [Narrator] Being vulnerable
to social isolation often leads to
feelings of loneliness. Researchers say men exhibit more characteristics of loneliness but women are more likely to
describe themselves as lonely. For example, 80 year
old Essie Sappenfield discovered that
retirement and relocation were isolating experiences,
despite her best efforts. - I moved here from Kansas
because of granddaughters and I found this little house, and it was really cute,
and I fixed it up, and I took ballroom
dancing, and I tried to find a church that I liked. It just felt like there
wasn't a place for me. I have a spiritual
advisor and so, I was talking to
her, and I said, you know, I've got
my house all fixed up just like I like it
and I'm still lonesome. - [Narrator] Sappenfield
also encountered an unexpected cultural barrier to making social connections. - There are career women but
they're doing their career, and there are married women who are busy with their families, and then, there
are married women who don't want you anywhere
around their husband. (laughing) - [Narrator] Sappenfield's humor hints at an
important trend among older Americans that impacts
isolation and loneliness. Older women outnumber older men by a ratio of five
to two by age 85 and most older men are married, but most older women are not. - As we have people
living longer and longer, they're
more vulnerable to medical illnesses which limit their ability to
connect with people and ability to get
about their communities. People over 85,
which is the largest growing segment of
our entire population, and especially the women,
they outlive the men, they are the ones that end up with this problem of loneliness. - The link between
loneliness and poor health is well established but how
it occurs is less clear. - We think that
there are mechanisms that operate through
the endocrine and other systems,
and particularly stress hormones play a factor. Cortisol, epinephrin,
norepinephrine. We think that
loneliness increases stress-activated
feelings and there are other inflammatory factors that have been studied,
so what you've got is this subjective
symptom of loneliness which causes medical
illness and death. - The risk extends to those who take care of older
adults, caregivers. - A lot of times,
people don't realize that they are
isolating themselves because they figure, I've
got somebody in the home, I'm talking to them, but if they look at their lives before they were in the caregiving situation and think about all the times they went out of the house
for lunch with friends and activities with
their faith community, being able to go to
the grocery store and not have to be
home within an hour. - Whatever she needs to
do, if she can just come. I have a big meeting that
morning I have to go to. - [Narrator] An
untimely phone call puts Cindy Lumpkin
in a tailspin. - I just got a telephone call that I won't have somebody
to stay with Mom tomorrow. It's like, oh no,
what am I gonna do? I've got these meetings
I've gotta go to. Now I've gotta figure out how we're gonna handle all of that. - [Narrator] Lumpkin is primary caregiver for her
mother, Lorene. - So, she's been living with me since she was 78
and she's 101, now, and it's her body that's going, not her brain at
this point in time. She gets worried when she can't remember somebody's
name and I'm thinking, oh Mom, that's a daily
occurrence with me. - [Narrator] A
couple of years ago, Lorene's body started to decline and both women are feeling
the impact of that change. - When she first
moved in with me, it wasn't about
being a caregiver. She did a lot of things
like the laundry, a lot of the cooking, even
though I cooked some, too, so it was kind of a great,
mutual relationship. - We've had lots of laughs
and tears. (laughing) She has taken such
good care of me. - I do, sometimes, feel isolated because you don't get to go out and do things with
friends and now, I've become a homebody
just like her. - I sometimes feel
like I'm an old burden because I always
have to have somebody with me and it
sorta ties her down. - The guilt that
caregivers can feel because they're leaving that
person is, it's enormous. - I get so concerned
for her health, I don't think about my own. I don't sleep as well
and so, therefore, my body gets run down,
and then I get sick, and I can't take
care of her like I need to take care of her
because I'm not feeling well. I have thought, well
what if something happens and I have
to have surgery, and I'm laid up for two months? Who's gonna take care
of either one of us? - [Narrator]
Researchers say between 40 and 70% of family
caregivers experience symptoms of
depression, which can be linked to isolation
and loneliness. (soft piano music) - Caregivers don't realize they were socially
isolated until they're not in that caregiving
situation anymore, ready to go back into the world, and their friends
may have moved away, the groups they
participate in change. (soft piano music) - [Narrator] There
is growing interest and necessity for
tools to identify and measure loneliness
in older adults. One of the most
common and widely used is the UCLA Loneliness Scale, a 20 item test that
asks participants to rate statements like,
there is no one I can turn to, my interests and ideas are
not shared by those around me, I can find companionship
when I want it, people are around
me but not with me. - These are the scales that have helped us understand the strong relationship between loneliness and these medical outcomes like premature death, heart disease, stroke, Alzheimer's
disease, and memory loss. - If the loneliness
creates, especially, a mental health reaction
in terms of depression, in many cases, they may not eat, they may not go out socially, and that sort of
thing, so it reduces their overall quality of life. If it's severe
enough, of course, they may even
contemplate suicide. (dark piano music) - The one thing
that happens when anyone passes
away, when it's not a sickness or
something like that, everybody asks, what happened? And I'm trying to figure
out, in my own mind, what could be so
devastating that you would take your
life like this? (emotional music) - [Narrator] Annette
Lake believes her father ended his life after retiring from a 40 year
career as a truck driver. His health began to decline,
he lost independence, and he had to stop
driving, which meant he couldn't go to
church, the one social connection he maintained. - That was what I observed,
him becoming more isolated. (emotional music) Anytime you have a major
change in your life, the older you get, the more
difficult it is to manage. - [Narrator] According to the Centers for Disease
Control and Prevention, suicide rates increase with age. In 2013, 7215 Americans over the age of 65
died by suicide. 84% were men. The Tennessee Older Adult
Suicide Prevention Plan now labels suicide as
a public health threat. That designation is
reinforced by this fact. Many older adults
who die by suicide have recently visited a
primary care physician. 20% on the same day,
40% within one week, and 70% within one
month of the suicide. - When we think about
our older adults, they're more likely to visit
a primary care physician than going to see a
mental health physician. We've got to be able to educate the community of
the warning signs. Common suicide
warning signs are: Withdrawing from friends,
hobbies, social activities. Talking about suicide,
death, or being a burden. Preparing a will or
final arrangements. Giving away prized possessions. - I believe that primary care, just as, you know,
behavioral healthcare folks should start asking
the question: Have you thought about suicide in the last two
weeks or have you thought about suicide
in the last month or so? Just as we stand on the
scale to find out our weight, our height, it's
okay to maybe ask those two questions
and see what happens. (emotional music) - What I found in the pockets of the cover of his
Bible, I felt like he was reconciling himself
to what he felt the Word was saying
about committing suicide. - [Narrator] Annette
Lake is determined to be better
prepared as she ages for the possibility
of loneliness. - It's very important
to understand that the mind is part
of your physical being, just like your heart,
your lungs, your liver. It's the central system for everything that
moves within you. If there is something wrong within your mind,
it's treatable. - When physicians and hospitals look at illness, are you lonely is more important than what is your cholesterol and how
much are you walking? I think we have to
begin understanding and attending to those
factors in medical care. - The impact of
social connections in
preventing early death is documented in
a massive research project at Brigham
Young University. It found that being
socially connected reduces the risk of
early death by 50% and simply thinking
about a supportive person lowers stress responses. Social contacts also can
reduce healthcare costs, according to AARP
Public Policy Institute. It estimates that
Medicare spends $134 more, monthly, for each
socially isolated older adult than it does for those who
have typical social contacts. (emotional piano music) - If people are
already isolated, how do you connect
with the people who are going to understand you, who are going to be
connected with you? - One solution might be using digital technology to
reduce social isolation. - [Muffled Voice] They say, I'm
gonna talk to somebody else. That kinda made
me angry and mad. - [Narrator] At
Vanderbilt Kennedy Center, researchers are testing
a social media platform with people who have
developmental disabilities, another high risk population
for social isolation. - Our folks already
have a greater risk for depression, anxiety,
health problems, so what we wanna do is actually correct those things so that if we can actually
reach out to people, maybe we can actually
prevent some of those things. The other thing is parents
are taking care of these kids. They don't move away,
they live at home, so parents are also
incredibly isolated, so we think that
if we can actually help get the kid more
connected socially and reach out, then maybe the
parents won't be so stressed. The two-year isolation
study was conducted in ten week intervals
with small groups of young adults
with disabilities, helping them to
learn social skills and build social connections. - So, using some of
those de-escalation terms and techniques would
probably be really helpful. - Right. - [Narrator] Early
results indicate that participants are
more socially engaged and Ruth says, this
type of intervention could help other populations. - How much can we really
move the needle, here? So, for people who are older, I think the idea that
if you could connect, and I think things like
FaceTime and Skype, and we already
know that for some of our older adults, if they can find those ways
to connect, maybe there's not somebody
face to face. A lot of our folks
only have family and paid staff members
as their kind of friends but if we can find
them to kind of outside of that comfort
zone and hook up, and connect with other people, then really we could
do those things. (emotional music) - [Narrator] A
recent study found that internet use was associated with lower levels of loneliness among residents of assisted
and independent living centers, and encouraging older adults
to begin using the internet to communicate with others
could help to enhance social contact and
decrease loneliness. (soft piano music) - You got it looking easy. Six. - The more we're learning about isolation, we are realizing that we can do something about it and the quantifiable
aspects are things like, are you engaged with a social
group at least once a week? Do you have more than
three or four friends? Are you continuing to be
active in your community? Are you going to the library
and the senior center? Are you staying as involved
as you possibly can be? And if not, then we can change that at any point in our life. (cheerful music) - [Narrator] For
some aging adults, the first step in
preventing isolation is choosing to
live in a community designed and built for
bringing people together. It's called
co-housing, a concept based on the Roseto
Effect, named after a town in Pennsylvania of Italian immigrants whose
close-knit lifestyle resulted in lower heart disease
and longer lifespans. - There were three
generations in a household. The homes were all
along the sidewalk. There were big
porches out front. Just highly structured
for social connection. Think about that
just for a moment. All of our social
ills, addictions, crime, and disease,
could be eliminated by the way we build
our environment. - [Narrator] Diana Sullivan,
a Nashville realtor, wanted to live and grow
older in such a community. She joined with a small group of like-minded residents to create a co-housing community
in Germantown, the first in Tennessee, and one of fewer than two
hundred in the country. - Well, there are 25 homes
and then the common house. That size community
really builds empathy, as opposed to a much
larger group of people, and co-housing is built
both for connection and for privacy, so,
yes, there are times when you don't wanna
connect with people and you don't have to
come to all the dinners. It's returning back
to the natural state of who we are that
we need one another. - [Narrator] Those needs are why this community attracted
Essie Sappenfield. - Old age isn't a problem. It's a stage of
life and I didn't have any idea that it could
be as joyful as it is. I'm happier now
than I've ever been. I live in a pretty
house and I have a community that
supports me and cares. - Friends. Really, really
important and a huge factor in protection
from the problems of medical illnesses
with lonely people. Now, we can hire people
but they aren't friends. I mean, it may help to
have a visiting nurse, a visiting social
worker, whatever, but there's nothing
like a good friend who comes to see you, and so, how do we create
communities where friends can connect, stop by, go to the grocery for
them, how are you doing? - Hey you. (laughing) - How you feel? - Rubbery. (trainer laughing) (cheerful piano music) - When you stop communicating, when you're lying in bed
and not getting out of bed, then you know if you're
gonna have to do something. The company that I'm
keeping, you know. All the people around you. You just don't come in
here and sit, you know. You interact, you're
moving, you're doing activities all the time. (emotional music) - You need some sort
of outlet for yourself. Both emotionally, something
physically that you can do. - Seeking new environments where we can meet other
friends and replace the old ones is a
very important part of what we're looking
at in the future as people live longer and so, creating those
environments where they can come, meet,
and experience this
is very important. (soft music) - As Americans live
longer, we will need to find new
ways to mitigate the pressures of isolation
that occur naturally as we age. We all have a role to play
in ensuring that no one lives alone or faces
loneliness without support. Community is the antidote
to social isolation and we all benefit
from a community where everyone at every
age is included and valued. For more information and to see all of Nashville
Public Television's
Aging Matters series, visit our website at
WNPT.org/AgingMatters. Thanks for watching. ♪ ♪ - [Narrator] Major
funding for Npt Reports, Aging Matters, is provided by: The West End Home Foundation, improving the quality of life of seniors through the support of nonprofit organizations
in Middle, Tennessee, the HCA Foundation, on
behalf of TriStar Health, the Jeanette Travis Foundation, dedicated to improving the
health and well-being of the Middle, Tennessee community,
and Cigna HealthSpring. Additional support provided by: Jackson National Life
Insurance Company, The Community Foundation
of Middle, Tennessee, and by members of
Npt, thank you.
