Surveys show that people prefer to maintain their independence and continue to live in their own home rather than relocate as they age. Yet this needs to happen in a way that does not lead to isolation.
“Isolation is potentially dangerous because it separates us from a network of support, should difficulties occur,” said Dr. G. Allen Power, MD, FACP, and author of Dementia Beyond Disease: Enhancing Well-Being.
While independence seems like a positive, signaling one’s abilities and strength, it needs to be paired with some dependence or interdependence, Dr. Power explained. “Part of the problem leading to this is the very word independence, which leads us down a bad road,” he said. “No one is truly independent, but because this is held up as an ideal (and dependence is seen as bad and burdensome), people are unwilling to ask for assistance and support when they need it. And since they are unable to do for themselves, they become increasingly isolated in their homes, even from their close neighbors.”
The Isolation Problem
Isolation from others can lead to problems and Dr. Power calls it “potentially dangerous.”
“There are many studies that show that a lack of social capital is detrimental to physical, psychological, and cognitive health, even in healthy middle aged adults,” he said. “There are also a number of new studies that show the very real, negative health effects of loneliness.”
Even shy or introverted people may need to make an effort to socially engage to avoid becoming isolated. “It’s important to note that solitude and isolation are not the same things,” said Sophia Dembling, author of several books, including The Introvert’s Way: Living a Quiet Life in a Noisy World. “Solitude can be a very positive thing and it implies choice. Isolation happens when the solitude is no longer a choice.”
When that happens, Ms. Dembling said, isolation can lead to loneliness. “It can also mean you have no one to help you when you need it—whether it’s physical assistance or emotional support.”
Creating Interdependence
The goal with avoiding isolation is not to create dependent people, but rather support independence.
“One of our biggest blind spots is seeing older people only as recipients of "services," creating a one-way street that actually promotes excess disability and dependence,” he said.
In his book, Dr. Power cites examples of successful interdependence for elders who do and don’t have dementia:
--Homebound Japanese elders providing afterschool care for neighbors who are working parents in exchange for assistance with transportation or shopping.
--An “intergenerational charter school” in Ohio that includes elders who mentor children in activities such as reading and gardening. The creator of the school, a neurologist, believes that “volunteering can be more cognitively enhancing than any pill an older person can put in their body.”
--Creating volunteer opportunities for people with early-stage Alzheimer’s in Australia.
Ms. Dembling argues that in an effort to not become isolated, people will have to leave their comfort zones. “You don’t have to socialize a lot, but you do have to maintain some important connections in your life,” she said. “Even designating one day a week to make social contact—in person or on the telephone—can help keep the social cogs lubricated.”
And sometimes a change in environment can lead to an interdependent community. “People living with dementia may also become isolated in their homes because family members don't know how to continue to engage them socially, or assume they cannot,” said Dr. Power. “Also, poor community design for aging and dementia tend to isolate people; hence the movement to create more age-inclusive communities.”
The ideal, according to Dr. Power is to all live “within a network of contact and mutual support.”
“This takes the stigma away from asking for help and also opens our minds to see that even frail elders or those living with dementia also have gifts to offer in return,” he said.