The winter holidays are a time to celebrate family, friends, and community. But for the millions of older adults worldwide who have no family, few friends nearby, or are lonely and socially isolated, December is far from the most wonderful time of the year. A survey carried out by AARP in 2017 found that 28 percent of U.S. adults ages 50 and older report that they’ve felt lonely during a holiday season over the past five years, and nearly half (43%) have worried about a friend or family member who was lonely during the holidays.
Christmas season may sharpen the dull pains of loneliness, as older adults yearn for their loved ones who have died, or reminisce about happy celebrations in their family home that they have since abandoned for residence in a long-term care facility. Yet social isolation among older adults is a sweeping social problem whose impact extends beyond the family-centric weeks between Thanksgiving and New Year’s. Rising numbers of older adults worldwide have no living or nearby kin. In the United States, nearly 7% of adults ages 55 and older have neither a living spouse nor biological children and 1% have no partner/spouse, children, biological siblings, or biological parents – with these rates rising across successive cohorts. Worldwide rates of kinlessness, or having neither a spouse nor children, range from a low of just 2% in China and Korea, to more than 10% in wealthy western nations including Canada, Ireland, the Netherlands, and Switzerland.
Rising numbers of kinless older adults are a result of demographic trends over the past century. Declining birth rates mean that older adults today have fewer children than in the past, especially in societies that have maintained restrictive population policies, and where childlessness rates are high. Due to processes of urbanization and globalization, adult children may migrate far distances from their aging parents to pursue rewarding economic opportunities. Moving from the countryside to the city, or from one’s hometown to more lucrative opportunities overseas are especially common among young adults in Asia and the global south. Rising rates of divorce worldwide mean that older adults may no longer live with a spouse. Women are especially likely to grow old alone, both because they tend to outlive their husbands and because they are less likely to find another partner after being divorced or widowed.
Being kinless isn’t the same thing as being lonely, however. Unmarried and childless adults tend to have larger networks of friends, compared to their peers with spouses and children. Friends can be an essential source of practical support and emotional uplift for older adults, especially in countries where non-family ties are valued as highly as familial ties. And even older adults with family by their side are not necessarily spared of emotional loneliness, or a lack of intimacy and closeness in one’s relationships. An older adult who has a stale marriage or chilly relationship with her adult children might feel a sense of aloneness and alienation even when surrounded by others at a lively family dinner. One in four married older adults reports feelings of emotional loneliness, and these rates are even higher for those whose spouses are chronically ill, who have a dissatisfying (or non-existent) sexual relationship, and for whom communication is silent, stilted, or combative.
An absence or shortage of satisfying social and emotional ties can be harmful and even deadly to older adults. Loneliness and social isolation are serious public health concerns because they are linked to far-ranging health problems including difficulty sleeping, poor cardiovascular health, high blood pressure, depressive symptoms, compromised immune function, and dementia, each of which is linked with mortality risk. The societal problem of loneliness and the health toll it exacts on older adults is so profound that in early 2018, the United Kingdom appointed its first-ever Minister for Loneliness, alongside the launch of a national charitable Campaign to End Loneliness.
Old age need not be a time of loneliness and isolation, however. Innovative clinical practices, public policies, and community programs can help mitigate against loneliness and its personal toll. Health care providers can screen older adults for loneliness as part of their usual geriatric assessment, identifying and providing supports for those at particular risk. Meal delivery programs like Meals on Wheels provide not only nutrition to older adults, but are effective in reducing their feelings of loneliness. Publicly-funded volunteering programs like Senior Corps that provide older adults an opportunity to learn new skills, interact with others, and give back to their communities help to reduce loneliness and provide the physical and emotional health boosts that come from meaningful social engagement. Continued investments in programs that enhance older adults’ social integration will have payoffs that linger long after the holiday season has passed.
Featured image credits: Tejas Prajapati via Pexels