(Editor's note: This story is part of a special report for The John A. Hartford Foundation.)
While aging often presents physical challenges, mental health can also suffer. Social isolation is rampant among older adults who lose mobility, lack transportation options or live alone or away from family. The impact of isolation is severe. Don’t underestimate it.
Mental and Physical Health Affected
Humans have a fundamental need for socialization and inclusion. Without it, they can suffer from high levels of stress, depression and even death. Loneliness may be as significant a health factor as smoking; it is said to have the same impact of smoking 15 cigarettes a day.
Research from the Journal of the American Medical Association (JAMA) found that 43 percent of older adults report feelings of loneliness. A 2013 study in the Proceedings of the National Academy of Sciences even found that social isolation and loneliness are associated with a higher risk of mortality.
Feelings of isolation can impact mental health and cognitive abilities. Depression later in life has been associated with cognitive impairment and dementia. Those experiencing cognitive limitations could become depressed as a reaction, or depression could be a risk factor for the development of dementia. Research also reveals that depression is more common in those with other illnesses. Since approximately 80 percent of older adults have at least one chronic health condition and 50 percent have two or more, being aware of these risks and taking steps to encourage social activities is essential.
Prevention needs to start early by understanding the serious — and widespread — problem of social isolation. In tandem with care providers, older adults and family members should research resources and understand which services are available locally.
How to Promote Social Interactions
Local senior programs and virtual centers  To reduce isolation and improve emotional health, social interaction has to be a priority. Many communities have services and programs so older adults can engage with others and take up new activities and hobbies (gardening, board games, exercise, painting, volunteerism). Some may involve spending time with young children or teens. When researching what your community offers, reach out to municipal community groups, your senior center, local Area Agency on Aging, and your church, temple or mosque. They often offer weekly or monthly activities and get-togethers.
Virtual senior centers are on the rise, too. These may take the form of organized video chats like Selfhelp Virtual Senior Centers (VSC). For those without friends or family nearby, technology can supplement social interactions. Although there’s nothing like a face-to-face conversation, video-chatting is a good option. Those who participate in VSCs report an 85 percent decrease in feelings of isolation since joining the program.
Don’t forget Internet forums or Facebook groups. People “meet” to talk about a common interest in such places as AARP’s community forum. For those without access to programs in their area, it’s an alternative. A VSC may offer online classes led by instructors on a variety of topics, from travel to current events to art to technology instruction.
Technology  There are a host of different types of technology that can keep older adults engaged — and give those worried adult children peace of mind. It might be a gadget to remind Mom or Dad to take medications, a personal emergency response system around their neck or on their wrist, a smartphone that summons help at the push of a button or a simplified, older-adult-friendly, pre-programmed device. On it, you can talk instantly to a friend or relative, listen to their favorite music, watch a grandchild’s soccer game in real time, find a new recipe,or gain knowledge via the web.
Telemedicine offerings, such as wellness calls, can also help alleviate feelings of loneliness. The Silver Line, a UK-based charity, offers a helpline that older adults in England can ring up when they are feeling lonely and want to talk to someone. A similar service, the Friendship Line, is provided in the U.S. by the Institute on Aging. It describes itself as "the only program nationwide that reaches out to lonely, depressed, isolated, frail and/or suicidal older adults."
These phone and app-based services provide an outlet for older adults who may not be close to family or have friends, or who live in rural areas or suburbia where community programs are scant, if they exist at all.
Brain fitness apps that improve focus and memory, as well as speed up visual processing, can keep older adults engaged, learning and sharp.
Some older adults may avoid social situations because they lack confidence due to vision, hearing or cognitive decline. Technology can be a great way to keep them in the world!
Transportation options  Today’s older adults can take part in activities and visit loved ones without having to depend on friends or family for a ride. Ride-sharing services are an excellent option, particularly for those living at home. Lyft, for instance, has several partnerships with health care companies, including care communities and providers, to make ride-sharing more accessible. With these services, older adults can schedule a ride through a brief phone call instead of through the app, eliminating technology barriers.
There are a variety of other transportation options, public and private, to consider as well. Los Angeles, for example, offers door-to-door rides for those over 65 at a reduced price. Most senior living communities also have shuttle services for residents.
Isolation Is Preventable
No question it is challenging, but social isolation is preventable. Knowing where the resources are, and using technology to supplement in-person contact, can mitigate loneliness and depression. Making social engagement a priority early on will have a long-term impact on mental health and happiness.
See this new white paper on isolation by my company, GreatCall, and Aging in Place Technology Watch. 


How to Combat Loneliness and Isolation as We Age

David Inns

For many years, Erin Loughran lived independently: she owned a home and car, worked as an adult English language learner instructor, even dabbled in online dating. She now lives with a disability.
Three years ago, Loughran suffered a bleed in her brainstem caused by an inoperable cavernous angioma. She has six such angiomas in her brain. Damage from the bleed has produced symptoms including right-sided ataxia (lack of muscle control and coordination of voluntary movements) which impairs her walking and right-handed fine motor control and has left her with throat tremors; visual deficits; head and nerve pain and nausea.
"Loneliness is a subjective experience - how you feel on the inside - whereas social isolation is an objective measured of your social supports and networks - you can see it on the outside."
Craig Peterson also lives — for over 40 years, now — with a disability. In 1974, when he was 15, a diving accident resulted in an incomplete spinal cord injury at the mid-neck level, leaving him quadriplegic, with degrees of weakness and loss of sensation in all four limbs and trunk.
Hearing and vision loss influence Margaret Pols' daily life; she is also limited in physical activity like walking and climbing stairs due to compromised lung function. Pols (the author's aunt) contends that "when people talk about older adults, one of the first things you have to recognize is that a seventy-five-year-old is not the same as an eighty-five-year-old. Age, in and of itself, is the issue."
Loughran is 33, Peterson is 60, and Pols, 87. They all live with a disability. And yet, in this admittedly very small sample population, their stories are not stories of social isolation and loneliness, but of resilience, optimism, creativity and pragmatism. How is each of their lives impacted by social connectedness or its two opposites, social isolation and loneliness?
Defining the Terms

There is a clear, definitional distinction between loneliness and social isolation. Dr. Nauzley Abedini, who has worked on the ongoing AARP-sponsored University of Michigan National Poll on Healthy Aging, says: "Loneliness is a subjective experience — how you feel on the inside — whereas social isolation is an objective measured of your social supports and networks — you can see it on the outside."
While the loneliness/socially isolated distinction is widely written about in the literature, a clear definition of what it means to be disabled is a little harder to come by. In a 2015 University of Oregon study, professor Gloria Krahn (and others) align themselves with Affordable Care Act guidelines which define disability as serious difficulty with any of the following: hearing; seeing; concentrating, remembering, or making decisions; walking and/or climbing stairs; dressing or bathing; and doing errands alone. According to the study, 13% of the American population age 45 to 54 is disabled; 23% of those age 55 to 64 and 45% of those 75 to 84. By age 85 or older, 68% of people in the U.S. live with a disability.
The Krahn study also highlights different models of disability.
Krahn explains that the World Health Organization model of disability is a social model, holding "that much of the disabling aspect of having a functional limitation is due to expectations, restrictions, and discrimination that society displays toward people with disabilities — in essence, it is physical (e.g., stairs, not ramps/elevators), attitudinal (e.g., lowered expectations, discomfort with disability), and eligibility barriers (e.g., employment opportunities) that create much of the disability experience. The solution is social policies that eliminate discrimination and promote inclusion."
The American model, by contrast, is a medical one, "based on diagnoses, and holds that disability resides within the individual — that it is the way their body works or does not work that creates the disability. The solution is 'curing' the disability or ameliorating it to the extent possible."
“The Invisible Enemy”
There is little research on the relationships between disability, isolation and loneliness, though, especially in the United States.
A 2018 U.K. study, "'The invisible enemy:' disability, loneliness and isolation," by Stephen J. Macdonald and others explained the impact of disabling barriers that seem to result in disabled people being overrepresented in the population who are lonely and isolated.
[Loughran] admits to occasionally feeling lonely and speaks periodically to a therapist, but "most of the time, it's less loneliness and more frustration," she says, with her lack of independence.
When examining risk factors such as spending long periods of time alone [61% disabled, 28% nondisabled]; not cohabiting with a partner [28% of disabled were single vs. 13% nondisabled];  limited contact with family and friends [21% disabled, only 5% nondisabled] and substantial periods of unemployment, [34% unemployment among disabled vs. 6% nondisabled], the disabled group was most likely to report these experiences.
Erin Loughran: Valuing Herself for Who She Is
Loughran, who lives in Minnesota, uses social media, among other methods, to maintain connections with family and friends. She regularly contributes to her blog, "My Invisible BFF,"  because, she says, "it helps me deal."
Loughran insists on the "best friend forever" status of her illness as a guarantee she will value herself for who she is, disability and all.
Erin LoughranIn addition to social media, Loughran has a large and close cadre of family members, personal care assistants and friends who accompany her most of the day, every day. Her biggest barrier, she says, is personal mobility. She admits to occasionally feeling lonely and speaks periodically to a therapist, but says most of the time her lack of independence is "less loneliness and more frustration."
Craig Peterson: Connected to a Core of Friends
Peterson has been married for 20+ years and has three stepchildren. He is retired from his position as an executive in financial services after selling his business a few years ago. He lives most of the year in Florida, making Minnesota his home "for Twins season." He uses an electric wheelchair for mobility and hand controls to fly planes and drive cars.
Peterson says isolation and loneliness have never been issues for him, even as a newly injured 15-year-old. What has been most valuable to him then and now, he says, is an almost hard-wired optimism and acceptance that has made it easier for him to deal with his limitations.
He also attributes his connectedness to "a large core of friends. I've always been lucky to carry friendships wherever I go." Peterson is in contact with most of these friends several times a month, he says. He is not a big fan of social media.
"I believe in giving back," Peterson tells me, and often counsels people who have recently suffered an injury like his own. "You can look at the glass as half full or half empty," he says. "I remind them they have that choice."
Margaret Pols: Joy in Creativity and Collaboration 
Pols is a retired Christian educator and church executive and lives in a life-plan community in New York, where she edits the bi-monthly resident newsletter. She says: "The major change in my social connectedness occurred when I gave up my car. Depending on others, or even a bus, makes for immediate changes in your social interaction."
Pols feels it is a necessary change, however. She thinks leadership to find resources to compensate for the loss of driving is lacking, even in a living facility like hers, where "far more people are driving than should."
She says she doesn't generally consider herself disabled because she has glasses, hearing aids and places to rest along the way of the long walk from her apartment to the dining room. "My new, young pulmonologist recently told me not to forget I'm eighty-seven-years-old," she laughs.
Even so, she takes clear joy in the creative and collaborative experience of editing her community's newsletter. "Our imaginations are alive and well," she says.


Facing Loneliness and Isolation While Living With a Disability

Donna Pols Trump

Rita Scott and Denise Goerke met at a senior day facility in Atlanta, GA. Scott worked as a program director at the facility, and Goerke was one of 30 people Scott looked after. Despite their different roles, they shared a love of gardening, dogs, sewing, cooking, and reminiscing about their families.
Having strong relationships and a social network can help those living with Alzheimer's or dementia have a better quality of life and may reduce agitation.Goerke's husband, Dan, noticed their friendship and asked Scott to care for his wife a few days a week. In 2014, Goerke was 56 and recently diagnosed with Alzheimer's. Scott interviewed Denise, Dan, and their son. 
"I was welcomed into their home," she says. "She was diagnosed with Alzheimer's and could mostly take care of herself. So I started two days a week, helping with light housework and shopping, but mostly spending time engaging with Denise. Dan thought it was important for me to keep her mind active." 
"While more research is needed, some evidence shows social isolation may harm those living with Alzheimer's or dementia. 
Staying Socially Active 
Monica Moreno, senior director of Care and Support for the Alzheimer's Association, sees the benefit of spending time with people. "During the pandemic, we heard from some dementia caregivers that they noticed an accelerated disease-related decline with their loved ones," she says. "While more research is needed, some evidence shows social isolation may harm those living with Alzheimer's or dementia. 
But, on the other hand, strong relationships with others and having a social network can help those living with the disease have a better quality of life and may reduce agitation." Further, the National Institute on Aging found social isolation in older adults can pose health risks. 
Part of the Family 
"Dan read a lot about Alzheimer's and shared a lot of the materials with me," Scott says. "His main concern was for me to keep Denise's mind as alert as possible. They had a loving relationship, and I felt like I was part of the family; we worked in her garden, took long walks, and talked." 
Scott's son, who was in high school then, stopped by a few times a week to spend time with Denise and her dog. "We all loved Denise and her dog," Scott says. "I loved her whole family like they were mine." As Goerke's Alzheimer's progressed, Scott spent more time with her until she was moved into a memory care facility (memory care is for older adults struggling with memory loss due to Alzheimer's, dementia or other cognitive impairments.) 
Scott kept in touch and visited often. "I felt the loss," she says. "I thought of Denise as my older sister." Goerke passed away from Alzheimer's at the age of 65.
A Friend to Count On 
Esther Nunez looks forward to Wednesdays ─ that's when Annagrette Oberholtzer visits. Oberholtzer is a caregiver at Papa, a service that connects older adults with caregivers. Papa calls their caregivers pals. "Annagrette and I have gotten close," Nunez says. "I would say we are friends. It's socialization for me, myself, and I. I have a special needs son, Leland, who is 32. So since Leland is not here when she comes on Wednesdays, it's just her and I time.  
When Annagrette comes, we start with her asking what I need to do. First, she helps change the sheets because I have bad knees. Next, she checks things around my house to ensure I stay safe. She does some light cleaning or reaches for things that are up high because I'm short. Then we sit around and chit-chat." 
"It feels like I'm spending time with a good friend rather than going to work," Oberholtzer says.  
One common bond is foster care. "Esther and I have similar backgrounds in different parts of the child welfare system," Oberholtzer says. "I was a case worker, and Esther was a foster parent a couple of decades before I graduated from college. We share stories about our experiences and discuss how times have changed. In addition, she updates her previous foster children with whom she maintains regular contact and sometimes shows me pictures of them." 
She cares for her family, extended family, and foster family. When I first started, I would help with chores around the house, such as dusting. I still do these things, but a year later, we make sure we have lots of time during visits to sit and chat.
Oberholtzer is supposed to spend 10 hours a month with Nunez. She has learned to set the alarm before the visit ends. This gives Oberholtzer enough time to change the bedding or do chores before the break.  She also helps remind Nunez about upcoming doctor appointments. 
The Rockford, Ill., resident has diabetes and has family members with dementia. It's something she worries about. "I write everything down, and I have Annagrette here to remind me of appointments," she says. But, over the past year, their friendship grew. "It feels like I'm spending time with a good friend rather than going to work," Oberholtzer says.  
Friendly Supports  
In addition to in-person visits, people who use Papa can connect with caregivers via an app or the telephone. Papa partners with approximately 70 Medicare Advantage health plans.  
"I believe we've entered a new era of healthcare," says Andrew Parker, CEO and founder of Papa. "Social needs are seen as health needs. Increasingly, the healthcare industry recognizes the value of nontraditional, yet impactful approaches like Papa to enhance member experience and improve outcomes." 
Monica Vermani, a clinical psychologist, also believes social connections provide a sense of belonging. "Close contact with people enhances mood and reduces stress and anxiety," she says. "Further, a healthy social life lowers our risk of dementia." 


The Changing Role of the Caregiver

Michele C. Hollow

Sing holiday songs with a friend or friends virtually via Zoom or over the speakerphone. Arrange to have a Zoom date — or an in-person meal — the day before the holiday or the weekend after with a friend, who'll be observing the holiday alone. Make your get-together a "holiday celebration." 
Screenshare a movie or football game on the holiday via Zoom with someone who is alone … or view the football game or movie separately and text or talk about what you watched by phone afterward.
These are just a few of the many ideas compiled in holiday lists by Make Room @ The Table, a Milwaukee and Chicago-based affinity group, founded in 2020, which counts among its members health care professionals, social workers, community organizers, philanthropists and those who have worked in the aging space.
Make Room @ The Table belongs to the national Coalition to End Social Isolation and Loneliness, participates in the international Togetherness Hub and is a partner on the Far From Alone website.
"In the past, when loneliness and isolation were talked about, the onus was always on the lonely person to get out and do things."
For the second year in a row, members of the group brainstormed a list of simple, fun and kind suggestions to help combat loneliness and isolation during the holiday season — with an understanding this is an issue prevalent throughout the year, and affecting not just older adults but younger people as well.
There are actually two lists; one is for people who will be spending the holidays alone and the other is for people who may be looking for ways to engage friends, neighbors and others seeking companionship. (Full versions of the lists are found at the end of this story.)
A Conversation on Loneliness and Isolation 
Marcia Johnston, a founding member and convener of Make Room @ The Table, said she and other members of the group, numbering about a dozen, had all been talking about the issues of social isolation and loneliness in the aging space in their various capacities and that "it wasn't a new area, but the pandemic moved the topic to the front burner" in terms of awareness.
However, it was at a local symposium in June 2020 that she and future members of the group attended, with a focus on loneliness and isolation, which provoked something of an "aha moment." 

"In the past, when loneliness and isolation was talked about, the onus was always on the lonely person to get out and do things, to not just stay in their house," Johnston explained. "But in the presentation we heard, not once did that come up. It was about how the community should support people in the community who are isolated and alone." 
"Many of us were kind of blown away by that and wanted to get together to keep the conversation going," she continued. 
In July 2020, Johnston, who served for more than 25 years as an adviser to the Harry G. and Charlotte H. Slater Family Foundation, which supports programs for older adults in the Greater Milwaukee area, gathered (virtually) a group of others interested in determining some next steps.
Participants included Karen Graham, manager of community relations at Rush Medical Center Alzheimer's Disease Center in Chicago; Lucas Livingston, a member of the steering committee of the Arts and Brain Health Coalition in Chicago and Ruth Ann Watkins, a member of the Village Chicago social network for people 50+ and board chair for the Retirement Research Foundation. 
"Loneliness and isolation is a universal issue," said Watkins. "It's not just an issue facing older adults; intergenerational connections are so necessary." 
Accessibility of resources, and truly finding ways to bring everyone to the table, is a part of the issue that's important to Graham and one that was particularly magnified during the beginning of the pandemic. 
"One of the things I was finding with communities of color was that many people living in senior buildings and nursing homes were not able to get out and their loved ones weren't able to see them," she said, adding that once the vaccine became available, many were challenged to find ways to sign up that didn't require computer access.
"The pandemic has just brought to the forefront so many issues, especially among members of marginalized communities." 
And at her Chicago church, services pivoted online, but once it became clear that many members of the church community didn't have computer or internet access, a phone line was established so isolated individuals could call in and hear the services. 
Livingston, former assistant director of Accessibility and Lifelong Learning at the Art Institute of Chicago working with volunteers to bring art programs to older adults in the community, agrees with Graham.
"Loneliness and isolation have always existed. The pandemic has just brought to the forefront so many issues, especially among members of marginalized communities," he said. 
How the Holiday Lists Were Created 
One of the first projects of Make Room @ The Table was to create holiday lists with suggestions on how to make the holidays brighter and more inclusive for everyone. Johnston solicited input and suggestions from not only members of the affinity group, but several others as well. Last year, the list focused solely on Thanksgiving; this year, it includes Hanukkah, Kwanzaa, Christmas and New Year's Eve. 
"We had a wide range of intergenerational input — all of the ideas were really good," said Johnston, who compiled the lists for those celebrating alone and those looking for ideas on ways to engage with others. 
The lists are distributed via Make Room @ The Table's Facebook page and sent to more than two dozen organizations in the Chicago area that serve older adults as well as to the group's partner organizations across the country.
Feedback on last year's lists was very positive.
"Many of the organizations who received a copy really took it to heart," said Johnston. "They were holding virtual open houses and drop-ins, inviting community members to participate. We heard from them that the lists were very helpful and very impactful." 
Raising awareness about how loneliness and isolation impacts people of all ages is essential, according to Graham, who would like to see more research on the topic by the health care community, as well as the development of interventions.
Watkins agrees: "There is a need for all of us to make human connections, and five or ten years down the road, I'd like that idea to be accepted and valued, so that people wouldn't even have to give thought to reaching out to others — they would just do it."
The suggestions on these holiday lists, provided courtesy of Make Room @ The Table, seem like a good place to start: 
22 Tips for Spending the Holidays on Your Own 
Invite someone you know will also be alone to share a holiday meal via Zoom or in person. Talk about the dishes you’ve made for each course and why you included them on your menu.Bake some goodies to share with friends during the holidays. Experiment with new recipes. If they are a success — or a spectacular failure — display them on social media.Settle back in your favorite chair and become absorbed in a book you’ve been wanting to read.Stream a film. Fix a snack that carries out the theme of the movie — an ice cream soda if watching Judy Garland and Mickey Rooney or some warm croissants if catching a French film with subtitles.Dive into a project — like cleaning your closets — that you’ve been meaning to do but haven’t had time to tackle.Go through photo albums, diaries and calendars and relive holidays past when you celebrated with friends and family and were not alone.Take a walk by yourself or go for a ride. Or ask a friend or neighbor to join you on a stroll, staying socially distant and masked, if that seems prudent.Write a note to people you are thankful are in your life and mail it so your greeting arrives on the holiday. Or reach out to them by phone, e-mail or text and wish them a “lovely day.”Sign up to participate in the Audubon Christmas Bird Count that takes place from December 14, 2021 to January 5, 2022. The bird count is free, but you need to register in advance. Begin a journal or add to one you’ve already begun. Consider starting work on a memoir. Emphasize gratitude and the things in your life for which you are thankful.Attend a religious service online or in person.Get tickets to a virtual or in-person play, musical, jazz performance, dance recital or concert during the holidays.Offer to take care of a pet for a friend or neighbor who will be spending the holidays out of town. If feasible, volunteer at an animal shelter on the holiday.Plan a micro “adventure” — take a bus or cab or drive to a different neighborhood and view the holiday decorations outside the homes and in the stores. Sample hot chocolate and a pastry — or a holiday treat — in a local café you’ve never been to before.Check to see whether Mather Telephone Topics or Well Connected or other learning or social programs designed for older people are available via Zoom — either by phone or online — on the holidays.Write a story… create a poem… or make up a song. Begin knitting a sweater or scarf. Engage in a craft to make special presents for those on your gift list.Invite friends and neighbors to your home — or to Zoom — early on New Year’s Eve. Share champagne or wine and snacks to launch a New Year’s celebration. If you’re going to be home alone at midnight, arrange to call a friend or family member who is also alone as the clock strikes 12 to usher in the new year.Offer to fill in for a volunteer, so that person can celebrate with family. If it’s feasible to volunteer in person, you can do so. If not, see if there is a way you can volunteer online or by phone.If you are spending the holiday on your own as the caregiver for an older loved one who is physically challenged or cognitively impaired, try brightening up your festivities by singing familiar seasonal songs, listening to holiday music together or collaborating on simple projects like stringing popcorn garlands, decorating wreaths or wrapping presents.Contact a local university alumni relations office or community liaison department and ask if there are foreign students or faculty members who won’t be traveling to their home country for the holidays. You could offer to host an informal get together with them, such as a virtual or in- person caroling party on Christmas Eve or a Christmas or New Year’s Day virtual — or real life — open house.Plan ahead to cook a special holiday dish or entire meal for yourself. Or place an order for a holiday banquet from a restaurant or grocery store. Set the table with your favorite china and glassware. Make a centerpiece of brightly colored gourds, a Christmas poinsettia or Kwanzaa Kinara with Mishumaa Saba candles. Dress in your holiday best.Ignore the holiday and view it as just another day. Stick to your usual routine, take something out of the freezer and savor the gift of quiet time alone.14 Tips for Reaching Out to Those You Know Will Be Alone 
Call a friend or family member who will be alone on the holiday. Perhaps you can coordinate with others who know the person to space out calls throughout the day.E-mail someone who’s alone on a holiday. Send a video greeting from you and, if appropriate, members of your family.Arrange an in-person or virtual caroling party on Christmas Eve that includes friends and family members who will be alone.Enlist young folks to become pen pals, sending cards and letters — or poems, drawings, and stories — to older people who are alone on the holiday.Send a beautiful, animated e-card to be delivered on the holiday to a person alone. Have the message on the card reflect your gratitude that the person is in your life.Make time on the holiday to set up a Zoom date with someone who is alone. If feasible, include family members or mutual friends. During the virtual visit, you could light the candles together in a Kwanzaa Kinara or trim Christmas trees.Set aside a portion of your holiday dinner for a friend who is observing the holiday alone and deliver it to their door.Send or lend a book you enjoyed or found meaningful to a friend, who will be alone on the holiday and then plan to discuss it with the person by phone or Zoom on the holiday or shortly thereafter.Cook with friends who will be alone. Whip up innovative holiday delicacies, concoct tempting Yule logs or elaborately decorated Christmas cookies. Then sample some of your culinary creations together and comment on how they turned out.Write “letters of gratitude” to friends you know will be alone. Mail them so they will arrive the day before the holiday, but write “Do Not Open Until” — whatever holiday it is — on the envelopes.Invite a friend or neighbor who is alone to go for a walk — masked and socially distanced, if prudent — on the holiday.If someone you know lives alone but has holiday plans, check in at the end of the day to make sure those plans came to pass. If the plans fell through, the person will be disappointed and lonely and will be pleased to have the human contact. If the holiday get-together took place as scheduled, the person will be delighted to have the chance to share details with a friend.See if your senior center, house of worship or older adult social organization can arrange a virtual dinner or open house on the holiday to provide social connectivity for folks who’ll be by themselves.Make room at your table virtually…or in real life. Add a person who is alone to your guest list to dine with you and your family on the holiday. If it’s too much of a hassle to include someone who’s alone for an entire holiday meal, ask them to share dessert with you and your other guests. Or invite someone who is alone to dine with your family the night after the holiday and join you in a traditional holiday feast of leftovers.

Make Room @ The Table Offers Ideas To Ease Holiday Loneliness and Isolation

Julie Pfitzinger

In the short film "Elgin Park," Michael Paul Smith, an older gay man who was living a reclusive life in Pennsylvania, found joy in creating his fictitious town populated with models he crafted of old-fashioned cars, houses and storefronts.
Jeffrey Wall, right, and his grandmother in "Golden Age Karate" Smith inhabited that place, as surely as he inhabited the world. "Elgin Park is a dream-like recreation of my past. It's never a lonely place for me," he said in the film. After he shares some photos of Elgin Park on the internet, a British magazine picks up a few images of the cars, leading to opportunities for Smith to connect with other creative people around the world, something which delights, but occasionally overwhelms, him.
"Film is our country's storytelling modality." 
This poignant film, by award-winning filmmaker Danny Yourd, is just one of many short-narrative documentaries and animated films that are part of The UnLonely Film Festival archives, a curated selection of films specifically intended to reveal common ground and build connection for those who are feeling lonely or isolated. In short, all of us at different points in our lives.
On June 6, the collection will grow by 40 new films with the celebration of the fifth anniversary of the UnLonely Film Festival at 8 p.m. ET.  Unlike other film festivals which take place over several days, the UnLonely Film Festival will feature a brief welcoming event and then all of the films will be available for viewing, and remain on unlonelyfilms.org. The films are free to watch. Participants are encouraged to RSVP in advance of the event. 
The UnLonely Film Festival is part of The UnLonely Project, an initiative of The Foundation for Art and Healing, a nonprofit with a goal "to promote creative expression as an approach to improve public health" through community and individual partnerships.
Dr. Jeremy Nobel, a 2020 Next Avenue Influencer in Aging and founder of The Foundation for Art and Healing, said The UnLonely Project was launched in 2016 "in response to what I saw as a public health crisis around loneliness."
According to Nobel, the three original goals of the initiative were to increase awareness of loneliness and its toxicity; to reduce the stigma that surrounds it and to develop or partner to get programs that could foster a sense of connection.
The UnLonely Film Festival was born a year later. "We had the idea to curate a series of films that would bring people together to see that loneliness is fundamental to the human condition across a broad range of scenarios," said Nobel.
I asked what it is about film that can help foster connection.
"Film is our country's storytelling modality," he explained. "People aren't intimidated by it, but rather, they engage with it."
The Personal Journey of Film
On the website, each of the films is tagged with one or more descriptions of the subject matter, and includes topics ranging from mental health, addiction and everyday life to older adults, LGBTQ+, healing after loneliness and more.
"Some of our films are tough films," said Nobel. "They are darker, they unpack and reveal human circumstances that for many people are difficult to watch."
Not wanting to leave viewers struggling with their emotions, each selection is followed by a short orientation to the film, with an on-screen moderator offering questions and topics for reflection to help viewers better process their reactions.
"This gives people the opportunity to take their own personal journey on the film. They can explore their own relationship to loneliness, and maybe find resources for creative expression around loneliness," said Nobel.
'Golden Age Karate' 
Natalie Gee, the curator for the UnLonely Film Festival, said that even within the topic of loneliness, the theme of connection is an important one.
"We also have a lot of uplifting films," she said. "And by watching any of these films, we want people to see where they can connect to the subject."
Jeffrey Wall from the film "Golden Age Karate"One prime example of an uplifting film is "Golden Age Karate," which the UnLonely Film Festival has selected as its Staff Pick this year.
Directed by Sindha Agha, "Golden Age Karate" tells the story of Jeffrey Wall, 16, of Dayton, Ohio, who has put his advanced karate skills (he's a first-degree black belt and in the Martial Arts Hall of Fame) to inspirational use. 
After successfully teaching karate to his grandmother, Wall takes it one step further by offering a karate class to older adults in a local senior residence. As the film shows, the "students" reap both physical and emotional benefits. And so does their teacher.
In a phone interview after his high school football practice, Wall said how surprised he has been by the enthusiasm of the older adults.
"We were careful not to have COVID as a big focus, but to have the festival offer a sense of hope." 
"When I was younger, I thought that people who were older really couldn't do much. But now I know that some of them can do more than the younger kids," he said. "Every time I come to teach class (he's there once a month due to his school schedule), they are all just really energetic and ready to get right into it."
Wall said the experience of working with older adults, and seeing the confidence they gain by doing karate, has "inspired me to keep having an impact on the world."
Showing Stories of the Pandemic 
Staff members watched close to 80 films this year before making the difficult decision to pare the list down to about 40. "It was the most submissions we ever had, and we had trouble tossing some of them out," said Nobel.
A film festival in 2021 is most certain to contain stories addressing COVID-19, and there are two among this year's collection:
"Meet Me at the Stairs" is a 5-minute short film about an essential worker whose husband has an autoimmune disease and shows how they must remain separated in their home.
"This is The Closest to How the End of March Felt Like" is about a college student struggling with loneliness on an empty campus.
"We were careful not to have COVID as a big focus, but to have the festival offer a sense of hope," said Gee. "We've gone through [COVID] and come out on the other side. But for a lot of people, even though COVID will go away, they will still have the same challenges [of loneliness and isolation] whether due to health or age-related circumstances."
She points to the beautiful film, "Keep Calling," which is the story of Lilian, a woman with Parkinson's disease, and Michael, a young volunteer with mental health issues, and the connection they make when they sing to each other over the phone. (It is uplifting, but keep a tissue handy.)
For newcomers to the UnLonely Film Festival, there is a "Best of the Fest" section, which includes a selection of 20+ of the most popular films since the event first launched, including "Drawings for My Grandchildren," a film from the Festival's first year, about Grandpa Chan and Grandma Marina, who like Nobel, were 2020 Next Avenue Influencers in Aging.
This was the pair's first introduction to a broader audience, in a film made by their son Ji Lee, detailing their adoption of Instagram as a way to build relationships with their grandsons. It's a fun film, filled with lots of emojis and graphics.
A Return to 'Elgin Park' 
In a conversation about "Elgin Park," which Yourd made in 2015, he revealed there was more to the story.
Like others, Yourd found Smith's Elgin Park photos online. As a filmmaker very interested in character-driven storytelling, he decided to call Smith with the idea for a film.
"He was very interested, and within a month, we traveled to his home and spent four days with him," said Yourd. "We hit it off, and he really started to open up to us." 
So Yourd and his team returned to film more footage, which included Smith's revelations about being bullied as a young child and being closeted when he was young, in scenes which make up the emotional core of the movie.
According to Yourd, Smith was "ecstatic" about the final product, and he and Yourd stayed in touch. When Smith was dying and in home hospice a few years ago, Yourd returned to visit, and fondly recalls their final conversations.
"I know the film gave his art a breath of fresh life. He had thrived on the fact that people were connecting to him," said Yourd. 


The UnLonely Film Festival Celebrates Five Years

Last time you visited your doctor, did he or she ask if you felt lonely? Did your doctor inquire about how many friendships you have or ask about how many community groups you are involved with?
There's a growing body of research showing that extended loneliness and isolation are detrimental to health, and can even shorten people's lives. One example is an analysis of about 70 studies conducted between 1980 and 2014 looking into loneliness and social isolation as risk factors for mortality. It found a 26% increased likelihood of death for reported loneliness, a 29% increase for social isolation and a 32% increase for living alone.
In the report of that research, the author, Julianne Holt-Lunstad, a psychologist and professor at Brigham Young University, warned that loneliness could reach epidemic proportions by 2030.
The prevalence of loneliness and isolation may already be fairly widespread; a 2018 AARP study found that one-third of people over age 45 experienced loneliness.
According to the National Institute for Health Care Management (NIHCM), loneliness raises the risk of premature death as much as smoking or obesity. An estimated $6.7 billion in annual federal spending is attributable to social isolation among older adults, NIHCM says.
This phenomenon is not limited to the United States. Many studies include other countries, and the World Health Organization recognizes the importance of social connections. Researchers worry that we are facing a loneliness epidemic, which can have serious health effects.
Defining and Measuring Loneliness and Isolation
While research reveals that strong social connections are protective to your health, experts caution that we should not conflate the feeling of loneliness with social isolation.
"We focus so much on traditional risk factors. 'Do you smoke? Are you overweight?' But we do not ask about loneliness and isolation, which have huge health effects."
As Louise Hawkley, a psychologist and senior research scientist at the University of Chicago, explains, social isolation is an objective, quantitative measure. You can determine how many friends people have and how often they interact with them as well as whether people participate in civic engagements, volunteer, have religious affiliations and other aspects of their social life.
On the other hand, loneliness is more subjective. Someone may be surrounded by people but feel quite lonely due to not feeling like they’re part of the group or that they have any close relationships. And when it comes to loneliness, the quality of the relationship matters.
"Because of the importance of the quality of the relationship, you can't just put a bunch of lonely people in a room and expect them to make friends," Hawkley says.
How Loneliness and Isolation Affect Health
Research has shown that loneliness can lead to depression, which, untreated, can eventually lead to serious physical health issues, Hawkley says.
When a person experiences loneliness, the level of the stress hormone "cortisol" increases, which can compromise the immune system and lead to inflammation in the body. This can increase the risk of many health issues, including heart disease, high blood pressure, diabetes and dementia, according to the Cleveland Clinic.
Some researchers have suggested that anti-inflammatory medications could help. However, Dr. Carla Perissinotto, a geriatrician who researches loneliness at the University of California San Francisco (UCSF), points out complications.
"There is very good research [showing that] some anti-inflammatory medications actually worsen cardiovascular disease and worsen kidney disease,” she says. “The thing is, you’re not reducing loneliness, you're reducing the physiological effects of loneliness. So, it’s really more of secondary prevention or tertiary prevention, not primary prevention.”
Here is a sample what research has found regarding some of these conditions and loneliness and isolation:
Cardiovascular disease: So far, the research about the effects of loneliness and isolation on the cardiovascular system has been among the most robust. According to a study published in 2015 by Nicole Valtorta, doctoral fellow at the University of York in the U.K., feeling lonely or being socially isolated is associated with defective immune functioning and higher blood pressure.
In her data review, Valtorta found that poor social relationships were associated with a 29% increase in coronary heart disease and a 32% increase in risk of stroke. Further, cardiovascular disease prognosis is worse among people with poorer social relationships.
Stroke: Loneliness has been associated with increased prevalence of stroke and increased mortality, disability and poor recovery following stroke, according to research published in 2015 and conducted by Trisha Petitte, an assistant professor at the West Virginia University School of Nursing.
Stroke is linked to an increased risk of post-stroke depression, Petitte wrote. Factors that influence and predict the degree of loneliness and depression among stroke survivors include the presence of loneliness and depression prior to the stroke, stroke severity and whether the patient went to a nursing or rehabilitation facility.
Dementia and Alzheimer’s disease: In a 2007 study led by Robert Wilson,  a professor in the department of Neurological Sciences at Rush Medical College, a cohort of about 820 older adults without dementia were checked on annually for up to four years. The study found that lonely individuals were more than twice as likely to develop dementia than those who were not lonely.
How Loneliness Can Impact Sleep and Health
One of the most fascinating connections between loneliness and health is poor sleep quality. There is an evolutionary basis for this thinking, which was pioneered by the late researcher John Cacioppo, a psychologist at the University of Chicago and founder of the field of social neuroscience.
Hawkley, who authored articles with Cacioppo, explains that lonely people can feel the hypervigilance a primitive hunter might have felt without others around to guard against predatory animals. Hawkley says this feeling is still wired into our brains and does not necessarily go away at night.
“It encroaches on your sleep, your most vulnerable time,” Hawkley says. “How can you sleep soundly if your brain is hyperalert for a threat?”
Even if lonely people are not waking to the point of consciousness, they are not getting enough restful sleep. And this, in turn, can significantly contribute to poor health, Hawkley adds.
Asking the Right Questions
Many researchers and organizations are alarmed enough about the health effects of loneliness and isolation to call for more attention and study in this field. Many questions remain unanswered — especially in terms of how to address this issue.
Perissinotto, at UCSF, spends a lot of time thinking about loneliness because she sees it in her practice.
“We focus so much on traditional risk factors. 'Do you smoke? Are you overweight?' But we do not ask about loneliness and isolation, which have huge health effects. So, part of it is asking the right questions,” she says.
Perissinotto also is interested in anthropology — she has a bachelor's in it — and wonders about the causes of loneliness and isolation in the U.S.
“As an anthropologist and a geriatrician, I'm very interested in understanding, why are we seeing so much loneliness and isolation?" she asks.
"And why is it that our older adults don't feel valued?" she continues. "Why is it that solutions we are proposing are not really aimed at human connection and what binds us to each other, and how we form societies? That is more interesting to me and that is where I think we need a lot of work — but that's a lot harder.”


How Chronic Loneliness Can Trigger Health Problems

Deborah Quilter

One thing the pandemic has taught us: intergenerational connections can be extraordinarily powerful for older and younger people when they're required to practice social distancing. During my recent fellowship in Columbia University's virtual 2021 Age Boom Academy for journalists covering aging, I learned about a few successful intergenerational strategies that have valued older adults during COVID-19 times.
At Columbia U.'s Age Boom Academy, experts spoke about intergenerational connections in the pandemicThe theme of this year's Age Boom Academy: "Combating Loneliness in Aging: Toward a 21st Century Blueprint for Societal Connectedness."
Here are highlights:
Why We Need Intergenerational Connections
Setting the stage for the need for intergenerational connections in America, Dr. Linda Fried, director of Age Boom Academy, dean of Columbia's Mailman School of Public Health and a Next Avenue Influencer in Aging, noted that the United States has a serious age-segregation problem.
In a recent article for the American Society on Aging's Generations magazine, she wrote: "Societal ageism, which makes older individuals invisible and devalued in society, and age segregation in housing and in work and volunteer roles have resulted in the United States being the most age-segregated society in the history of the world, with loss of intergenerational contact and solidarity."
"There is now a potential opportunity to build on the greater empathy, compassion, caring and concern that have been shown towards those experiencing loneliness and social isolation."
But Roger O'Sullivan, director of ageing research and development at the Institute of Public Health in Ireland spoke, noted that the pandemic has actually opened the door for more intergenerational connections. 
"There is now a potential opportunity to build on the greater empathy, compassion, caring and concern that have been shown towards those experiencing loneliness and social isolation," he said, "and to set in place policies and structures to address root causes and to support healthy choices."
Reducing loneliness and isolation, noted Dr. Carla Perissinotto, a geriatrician and palliative medicine physician at the University of California, San Francisco, can improve health in numerous ways. That's because loneliness and isolation can cause or increase health problems including dementia, cardiovascular issues, diabetes, stress and other mental health woes, Perissinotto said.
Intergenerational Connections in Action
Throughout the uncertainty, anxiety, loneliness and isolation felt during COVID-19, social entrepreneurs, nonprofits, researchers and other organizations have been researching the benefits of intergenerational technologies, helping realize the potential for connection, compassion and kindness.
When Joy Zhang, CEO and co-founder of the social engagement startup Mon Ami launched her business in 2016, she told the Age Boom Academy Fellows, she couldn't know how impactful her technology would become years later addressing social isolation and loneliness. But during the pandemic, when many older adults and college students couldn't see their families, Mon Ami has provided them with unexpected joys of connections.
Its technology lets older adults connect with younger ones who can address their basic needs, such as food, medications and companionship. Mon Ami now partners with over 20 agencies across nine states, such as the federal AmeriCorps Seniors program and Sage USA (which offers advocacy and services for LGBT elders).
Dana Griffin, co-founder and CEO of the intergenerational startup Eldera, said she's seen the impact her global online community has had, leveraging the wisdom of older adults as an asset for the next generation. 
Chapman University's Julianne O'Brian connected dance students with a senior centerGriffin's mission stems from being raised by her grandmother. She explained how valuing older adults as social capital lets Eldera connect the wisdom and experiences of "vetted mentors [with at least six decades of life experience] with kids for story time, help with homework or just a friendly conversation…a virtual village with a real soul that activates our elders as assets to society and their wisdom as a service to humanity." 
Making Intergenerational Connections Through Dance
Chapman University's Julianne O'Brian, chair of the school's dance department, shared the success of her intergenerational dance program during the pandemic, connecting dance students with a local senior center.
Students connected by phone with the older adults and listened to their poignant stories, ranging from being a Holocaust survivor to struggling with depression. The students then worked with their instructors and choreographed dance performances, capturing those older adults' lives in dance. 
O'Brian said, "As people age, they don't feel valued, they don't feel that their stories mean much. Seeing their lives in dance was tremendously meaningful and formed an emotional connection with the students reenacting moments in their lives."

She noted that the experience was also a lesson for all participants in listening, being present and connecting. O'Brian also learned that the older adults weren't the only ones who were lonely. "I didn't realize how lonely the students were," she said.
Judi, one of the senior center residents participating in the program, loved seeing how a Chapman dance student named Rosemary, reenacted her life. Their relationship has since blossomed with phone calls and visits.
"I thought, 'Why can't we have more young people coming to visit us old people?'"
"Rosemary and I are still friends. We talk once a week or once every other week. And her parents invited me for dinner. She is so sweet," said Judi.
Another resident, Theresia, shared the special feeling of seeing dance student, Megan, create a dance reflecting her life living through WWII. "When Megan danced, I could feel somehow a connection with that dance because I went through a hard life," Theresia recalled. "I felt like I was reliving my life when I saw her dancing." 
Lessons From Age Boom Academy
Theresia said she felt isolated and lonely during the pandemic and has struggled recovering from COVID-19. Getting to spend time with Meghan and seeing her perform gave her a lift. "I thought, 'Why can't we have more young people coming to visit us old people?' Old people can tell their stories and we learn from the young generation and you can learn from us, and that is my philosophy."
I came away from Age Boom Academy seeing how the pandemic has reinforced the necessity to value intergenerational connections, to focus on being present in conversations and how loneliness and social isolation impact mental, physical and emotional health at any age.
We must ask ourselves, "What role will I play in deconstructing ageism, reducing loneliness and isolation and connecting generations? "
There is a lot of work to be done, but the outcomes will be beneficial for all ages.


The Power of Intergenerational Connections to Reduce Loneliness

Janeane Bernstein

(Editor’s Note: This is part of our Loneliness + Isolation series brought to you by Consumer Cellular.)
Various surveys of older Americans have found that between 33% and 43% of them are lonely. But we wanted to find out how lonely, what makes them feel lonely, when they feel lonely and, most important, what they do to feel less lonely. So, we surveyed our readers to find out.
In our online survey on loneliness and isolation, we heard from over 5,600 Next Avenue readers, virtually all over 55, mostly women (81%) and across the income spectrum. (Loneliness is typically about a lack of time spent with friends and family; isolation is more about living alone and not having close relatives.)
A striking 82% say engaging in the arts — either as an audience member or as a creator — can play a key role in helping a person fight loneliness and isolation.
Here are our survey’s chief findings, along with quotes from our readers about loneliness and isolation.
75% of readers say they feel lonely either occasionally, frequently or always. But most — 55% of respondents — feel lonely only occasionally. This echoes loneliness surveys from AARP and the University of Michigan that found the number of older people in the highest risk category for loneliness to be small.Roughly 55% say loneliness isn’t negatively affecting their quality of life: only 29% say it is; 16% are undecided.A striking 82% say engaging in the arts — either as an audience member or as a creator — can play a key role in helping a person fight loneliness and isolation.And a full 72% say technology can play a key role in helping a person mitigate loneliness and isolation. Cellphones, computers and tablets are the technology most use to stay connected with family and friends to help mitigate loneliness.Now, let’s dive into those findings to hear from the voices of the readers.
What Makes Readers Feel Lonely — and When
When we asked if they feel lonely at certain times or certain situations, a few themes emerged.
Many readers say they feel lonely during winter months or during the early darkness of night. “Ice and snow make it almost impossible to get outside,” says one reader. Seasonal Affective Disorder — when people feel depressed during the winter — was mentioned numerous times.
And quite a few say they feel lonely after a visit from their grown children and other family members, especially around holidays like Thanksgiving and Christmas.
Another holiday that sparks loneliness for some readers: Valentine’s Day.
The death of a spouse, parent or other family member has also triggered loneliness among Next Avenue readers. “After losing my best friend, Mom — every day when I would pick up the phone to call… no one to call anymore,” one reader says. From another: “Alone in my house where my wife and I lived a magical life of 40 of our sweet 53 years before she passed away here peacefully.”
Going to parties or seeing couples together makes some feel lonely. “When I see people my age paired up in relationships,” says one reader.
Others also feel lonely at work, or because they’re out of work. “I’ve been unemployed and job searching for 4 ½ months; it’s such an isolating situation,” says one.
Poor health makes some feel lonely, too. We heard this from readers with chronic insomnia, chronic migraines and cyclic depression.
But, notes one reader, “For those with depression and/or dysfunctional family situations, loneliness’ impact is different. We often seek out aloneness, hoping to avoid social contact and discussion of our situations. In this context, loneliness has fewer negative connotations and is often a desirable state.”
And others feel lonely because their partner or spouse has Alzheimer’s or Parkinson’s disease.
Social media makes some readers lonely, too, even though its name includes the word social. “After looking at Facebook and seeing what other friends and family are doing and I’m not there,” says one. Another notes: “I think many people mistake social media ‘friends’ with real connections.”
Sadly, some readers say they feel lonely when they are with their spouse.
“Sometimes I am lonely when I am with my husband of 30 years, he does not pay very much attention to me,” says one. Another tells us: “Anytime I’m around my husband. He is 68 and I am 10 years younger. Our last child left a year ago so we are empty nesters for the first time in 21 years. I thought we’d have lots of fun together but I find we have very little in common and that makes me feel lonely.”
And some say they are lonely daily because they feel alone and stigmatized because they’re older. “I ponder why I no longer have a place in society and why — although I am educated and knowledgeable and have much to offer — I am no longer valued. All because of my age,” says one reader. Notes another: “As I age, I feel more invisible. People look right past me and ignore me.”
What Makes Readers Less Lonely and Isolated
When we asked which activities help them feel most connected to the world around them, readers offered a wide variety of answers. But volunteering came up time and again — ranging from hospice volunteer to tutoring to political volunteering to pet rescues to being a docent.
“Volunteering gets me out of my head and helps me see the struggles of others,” says one reader. “And the connection I’ve made to the other volunteers is priceless.”
Frequently, poll respondents provided details about how engagement in the arts helps them feel less lonely. “Art is my savior,” says one. Some paint or take art classes; others act or sing (sometimes in church choirs) or dance or attend theater or concerts or museums.
Getting outdoors and getting exercise also provides relief for many. Birdwatching and enjoying nature. Gardening. Going to the gym or the Y. Taking a hike. Camping. Swimming. Yoga. Bicycling. Golf. Playing basketball. Just walking in the neighborhood.
But sometimes it’s just about getting out: going shopping, hearing a lecture, stopping by the public library, taking a class, attending a discussion group or running errands.
Doing hobbies with others came up a lot. Book clubs and playing cards are popular. One reader is in a fountain pen club. Another is in a knitting group. Sewing and quilting were mentioned, too.
Being with family and friends or just talking to them by phone, text or online is also a big help. One reader hosts occasional pizza parties for neighbors. Helping grandchildren and babysitting them makes others less lonely.
Religion plays a large role in helping many readers feel less lonely. Many say they participate in worship services at their church or synagogue or attend Bible study. “Having a relationship with God can help the loneliness feeling,” says one reader. Notes another: “A church family can always be there for you especially when your blood family does not live near.”
For some, technology reduces loneliness. That could be texting; Instant Messaging; talking on the phone; email; Facetime; Instagram; Skype; Zoom; webcam or conversing with an electronic personal assistant like Alexa or Google Nest — all were mentioned.
“Being on social media connects me to oldest friends who aren’t nearby anymore,” says one reader. “Twitter helps me seek out those who have same interests and beliefs that I do,” says another. And a reader calls technology “a nice complement to my in-person, face-to-face activities.”
Facebook is quite popular. But, notes one reader, “Facebook can be a blessing and a curse; it’s nice to see what friends are up to, but I miss actual contact.”
Spending time with pets also helps readers feel connected. Notes one: “Animal friends frequently fill any gaps I might feel in not having people around much.” Quite a few who are cheered by meeting other dog owners during walks or at dog parks. One pet-sits and house-sits: “Knowing there is a level of trust that people place in me to care for their homes and treasured furry friends,” says this reader.
A number of readers go to 12-Step or Alcoholics Anonymous meetings.
And one reader says: “Hugs.”
Readers' Quotes on Loneliness and Isolation
Finally, a few notable quotes from readers on the subjects of loneliness and isolation — some poignant, some funny, some thoughtful and some grateful for time alone.
“A certain degree of loneliness helps me reflect and connect with the person I am.”
“At times I appreciate just being alone with no constant expectations of having to do something.”
“Being a caregiver is a lonely life.”
“LGBTQ people like me are particularly vulnerable to loneliness as we may be isolated from family and from the youth-focused community.”
“I love my alone time. Solitude is critical to live a meaningful life, to have time to think about who and how we want to be in this life.”
“Intergeneration solidarity! Seniors need the energy of youth, and youth for experiences that have not yet passed.”
“After 2.5 years of retirement, I’m overwhelmed by loneliness.”
“After a recent bout with loneliness, I’ve come to realize that I placed responsibility of my happiness on others or even situations but I have realized that happiness is a state of mind only I can control.”
“After being around people for 45 years due to work commitments, being home alone is currently a gift!”
And two readers turned to quotes from notables in the arts. “If you have an imagination, you’ll never be alone,” says one, quoting author Roald Dahl. “As Mary Chapin Carpenter says…’I’m alone, but not lonely,’” says another.


What You Do to Reduce Loneliness

Richard Eisenberg

Does the outline of this scenario seem familiar?
Paige Wilson, age 60, had a long career in finance with her last position as managing director at an investment bank. She and her family lived in Richmond, Va. not far from her 78-year-old mother. Her mother was vital and energetic, but she needed help with some everyday tasks, such as going to the grocery store. Wilson found herself juggling her own family and her job (which involved travel), as well as visiting her mother.
"I needed another me," she laughs.
Dede and Connie, who connected through NaborforceSo many people these days are struggling to take care of aging parents and relatives while also juggling work and family responsibilities. A surprising number of them have taken their caregiving experience to start a business or social enterprise that addresses the problem they faced. 
Among them is Wilson (since cloning wasn't an option). In 2018, she launched Richmond-based Naborforce, a company designed to address the kind of everyday non-medical needs her aging mother dealt with.
"I knew it wasn't going to be easy," she says. "I didn't know how hard it was going to be." 
"I thought of Naborforce because it solved a problem I had," she says. "When I started digging into it, I believed I had to do this."
The tech platform (think Uber and Airbnb) connects older people in the community with a network of helpers called "Nabors." The Nabors are carefully vetted, and they deal with all kinds of routine tasks, such as housework, transportation, and companionship. The job is on-demand gig work and participants average four to six hours a week. The pay is $15 an hour, plus an additional $5 for evening and weekend work. The average age of a Nabor is 56 years old and 85% are women. The job is designed for people looking to supplement their income rather needing full-time employment.
Converging Trends in Longevity Economy 
Naborforce is now in eight markets on the East Coast, including Raleigh, N.C. and Bethesda, Md. with Atlanta next. Naborforce currently has 11 employees and approximately 1,000 Nabors. Wilson largely self-funded the company in its early years, but a recent financing attracted some $2.5 million. (Among her early backers was an 84-year-old who went into the office every day, she says.)
"I knew it wasn't going to be easy," she says. "I didn't know how hard it was going to be."  
Wilson's entrepreneurial story is intriguing on its own. But her journey illuminates two trends in the rapidly evolving longevity economy that are feeding off and reinforcing each other.
Sarah and Phyllis also met through NaborforceFirst is the striking rise of entrepreneurs in the second half of life. Second, entrepreneurs of all ages are increasingly turning to advanced technology to not only support independent living among older people but to foster human connections and combat loneliness and social isolation. Many of these businesses and social enterprises have a mission of promoting intergenerational relations.
I'm always struck when giving talks about the economics of an aging population, at how surprised people are when I emphasize the swelling number of people in the second half of life starting their own businesses.
Popular culture still equates entrepreneurship with fleece-wearing young adults even though the ranks of those 50 years and over opening new businesses have been on the rise over the past quarter century. 
Some of these businesses have intriguing growth prospects with employees on payroll and the backing of professional investors (mostly angel investors and venture capital). Many more encore entrepreneurs form a microbusiness, perhaps an artisan operation, a lifestyle business, or a sole practitioner enterprise.
New Entrepreneurs Addressing Loneliness and Isolation 
Whatever the nature of the startup, older adults are embracing the startup culture. For instance, 14.8% of entrepreneurs were 55-64 years old in 1996 and by 2020 that figure had swelled to 24.5%, according to the Kauffman Foundation, an organization focused on small business creation.
Guidant Financial and the Small Business Trends Alliance in its 2021 Small Business Trends, a survey of over 2,400 current and aspiring small business owners nationwide, report that boomers account for 41% of small business owners (currently between ages 57 and 75) and Generation X for 46% (41 to 56 years old).
Hiscox, the global specialist insurance company, for its Hiscox Encore Entrepreneur Report surveyed 400 small business owners who opened their first business at age 50 and over. The survey "found that many encore entrepreneurs are starting businesses because they want to pursue a personal passion (24%)."
"After the pandemic, everyone knows the problem of loneliness and social isolation." 
The other trend is entrepreneurs of all ages creating services that are designed to create better human connections to an aging generation. The reality of loneliness and social isolation among many older people was deeply troubling before the pandemic, which only heightened the risk.
"In the beginning I thought we were supporting independent living and aging in place. I knew loneliness was an issue," says Wilson. "After the pandemic, everyone knows the problem of loneliness and social isolation."
For example, Papa is a Miami-based company that, like Naborforce, uses digital tools to offer non-medical care and companionship to elders with its "Papa Pals." A much larger company than Naborforce, Papa's business puts an emphasis on offering services through Medicare Advantage plans.
Chef for Seniors, founded in 2013 by the father-son team of Barrett and Nathan Allman, provides personal chefs that prepare meals in the homes of elderly customers. Mon Ami is a San Francisco-based tech platform that pairs college students with older adults for companionship and is now working with several service organizations nationwide, and Albuquerque-based Teeniors has teens and young adults teach older adults to use technology. Joy Zhang and Madeline Dangerfield-Cha, the founders of Mon Ami, and Trisha Lopez, founder of Teeniors, were among Next Avenue's 2021 Influencers in Aging. 
The late business philosopher and management consultant Peter Drucker remarked: "Entrepreneurship is neither a science nor an art. It is a practice." Like Wilson, odds are many more older Americans will tap into their experience dealing with America's oldest adults and turn to the practice of entrepreneurship to improve their quality of life.


Entrepreneurs Are Creating Services to Better Connect the Aging Population

Chris Farrell

You may have heard that loneliness is hazardous to your health — and can even lead to an early death. Now, an analysis of 23 scientific studies gives us numbers that reveal just how sick it can really make you.
People with “poor social relationships” had a 29 percent higher risk of newly diagnosed heart disease and a 32 percent higher risk of stroke, according to the study, published July 1 in the British journal Heart.
That puts loneliness and social isolation on par with other known risk factors for cardiovascular disease, such as anxiety and job strain, the researchers said. And it exceeds the risk posed by physical inactivity and obesity, said lead researcher Nicole Valtorta, of the Department of Health Sciences, University of York, England.
Given the results of the study, Valtorta said, “interventions to prevent coronary heart disease and stroke should take loneliness and social isolation into consideration.”
Such interventions could be relatively inexpensive, she added, especially given the fact that cardiovascular disease remains the most costly disease in the United States. It accounted for direct medical costs totaling $193 billion, according to a 2015 study from GoBankingRates.com. 
There’s a Difference
Loneliness and social isolation do not necessarily go hand in hand. You can be lonely in a crowd, or you can be by yourself and feel perfectly content. But when your experience is negative — you are not happy with the quality of your social interactions, or you’re grieving a loss — that “can be really disastrous for well-being,” Valtorta said.
Unlike other studies, Valtorta’s (which was published online in April) was the first to focus on whether people experiencing loneliness and isolation were at greater risk of developing cardiovascular disease. It excluded people who were lonely but already had the disease. 
Studies involving 181,000 people living mainly in the U.S., Europe and Japan were examined as a part of the meta-analysis, and they were tracked for a range of time — between three and 21 years. Among those people, there were 4,628 heart attacks or related events and 3,002 strokes.   
The age of the subjects varied, and it wasn’t possible given the data to conclude whether a 75-year-old lonely person was more likely to have a heart attack than a 50-year-old, Valtorta said. The researchers did not find evidence of a difference between men and women.
Other Research on Isolation and Health

A separate 2015 meta-analysis by Brigham Young University researchers concluded that both actual and perceived isolation were associated with early death.
Social isolation corresponded with a 29 percent greater risk of premature death; loneliness corresponded with a 26 percent greater risk and living alone corresponded with a 32 percent greater likelihood, according to the study, published in Perspectives on Psychological Science. Social isolation and loneliness threatened longevity as much as obesity did, the study said.
Two of the Brigham Young researchers were also involved in a 2010 study that found loneliness is as bad for your health as smoking 15 cigarettes a day. The problem is only getting worse, the scientists said.
“Humans are naturally social. Yet, the modern way of life in industrialized countries is greatly reducing the quantity and quality of social relationships ... over the past two decades there has been a three-fold increase in the number of Americans who say they have no close confidants," the study said. 
All of the studies reinforce the growing recognition of loneliness as a public health issue. 
A nonprofit coalition in Britain has responded by initiating the Campaign to End Loneliness, which among other things aims to broaden the services and activities available to those who may be lonely.
What We Should Be Doing
Brigham Young researcher Julianne Holt-Lunstad told Time magazine that nurturing close relationships as well as a “diverse set of social connections” is key. She said that policies to alleviate loneliness may be difficult to imagine but could include encouraging doctors to identify at-risk patients and rethink the way neighborhoods are designed, the magazine said.
“People’s response is oftentimes to say, ‘What are you going to do, tell everybody to give someone a hug?'” Time quoted Holt-Lunstad as saying. “But there are many potential ways in which this could be implemented.”


What Loneliness Is Doing to Your Heart

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