It’s not unusual to experience an increased desire to curl up on the sofa and “hibernate” when the weather turns cold. But for older folks with chronic illness like asthma, COPD, diabetes, dementia or heart disease, retreating to the indoors can lead to social isolation and sometimes trigger serious health problems.
This time of year especially, isolation can be particularly sharp for people who live alone or who are uncomfortable talking about changes they’re experiencing as they age.
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Moving Out, Getting Around
One of the women I coordinate care for drew strength and joy from attending church services in her neighborhood. But when her illness started slowing her down, she felt she couldn’t keep up with the ladies she’d attended services with for several years. She eventually stopped going.
Mobility is a real problem for many older folks. Even in a city like New York, where public transportation is a priority and many public places are reasonably accessible, lack of transportation can cause social isolation.
When people stay engaged and feel a sense of purpose, they’re usually able to take responsibility for their own well-being.
I spoke with her primary care physician. He agreed a wheelchair might be a great help to her for navigating longer distances. Now, she joins her friends for services at least once a week, and sometimes even takes in a movie. She’s gone from sitting alone and feeling sad to feeling much more a part of life. When people are at risk for social isolation, it can also be helpful to encourage them to take advantage of senior centers and other community organizations that may offer meals and a safe place to visit and socialize with others on a regular basis.
Body Image, Social Comfort
Older adults also routinely and deliberately avoid social interaction because they may not feel well, or are self-conscious about the changes in their body. Even seniors with mild hearing or vision loss may avoid social gatherings as communication becomes difficult.
If this sounds like someone in your family, or one of your neighbors, it may be helpful to gently inquire if they are struggling with one of these common issues and encourage them to seek medical help. Offer to accompany them to an appointment or refer them to local resources that can support them and help them regain confidence and self-esteem.
Weathering the Storm
Shorter days, cold weather, rain and ice — and the opposite, extreme heat — can be a deterrent for socializing, too. Arthritis can cause aches and limited mobility, and fear of falling is a serious concern for many older people who do not feel as sturdy on their feet as they once did. In the winter months, many people suffer from Seasonal Affective Disorder (SAD) or Sundowning, a term used to describe the agitation, irritability, confusion, and disorientation that as many as 20 percent of all people with dementia experience in the late afternoon and evenings. Both conditions can trigger depression and social isolation.
Keeping active indoors may take a little extra creativity, but it can be done.
It is sometimes challenging to remember that “change is the only constant” — aging certainly involves a lot of change. When people stay engaged with the things and people they love most in life, and when they feel a sense of purpose, they are usually more independent and able to take responsibility for their own well being. In my work, helping older New Yorkers avoid the chill of social isolation is key to ensuring they are living their best life possible.
Alicia Schwartz is the RN coordinator for Visiting Nurse Service of New York.