By: Salil Saroj
Humans are social beings. From an evolutionary perspective, social relationships were essential for our early survival, and very much still are. Indeed, social connectedness is one of the most fundamental aspects of human life and is vital to our well-being. Feeling disconnected or uncared for by others will not only elicit painful emotional states but also thwarts a basic human need-a need for relatedness. However, just as thirst acts as a signal for us to drink water, painful emotional states can serve as a signal for us to seek greater connection to others.
Existing evidence indicates that social connectedness has a powerful influence on health and longevity. People who feel more connected to others, for instance, have lower rates of depression, and anxiety, and are at lower risk of suicide. However, the effects of social disconnection are not limited to mental health. Social disconnection also adversely impacts our physical health, including higher blood pressure, elevated stress hormones, and impaired immune function.
Social isolation in the elderly has been a growing concern, and many different studies have been conducted to determine its causes, risk factors, and how it affects seniors’ health. Most studies agree that loneliness and isolation can be as dangerous as smoking 15 cigarettes a day or being an alcoholic, and can increase the risk of dementia by 64 percent. Loneliness increases the likelihood of mortality by 26 percent. People who are lonely report 5 percent more severe symptoms of the common cold than those who are less lonely. Between 10 and 43 percent of community-dwelling seniors are socially isolated. Lonely seniors have a 59 percent higher risk of physical and mental health decline.
The loneliness and social isolation that seniors experience are usually caused by low-quality social relationships or a lack of these relationships entirely. However, many other things could cause these issues, such as being 80 or older, having chronic health problems, and changing family structures. Social contacts tend to decrease as we age due to retirement, the death of friends and family, and lack of mobility.
Other causes of elderly social isolation include:
- Living alone
- Limited finances
- Impaired mobility
- No family close by
- Never having married
- Transportation challenges
- Divorced, separated, or widowed
- Inability to remain physically and mentally active
- Lack of access and inequality due to rural living or being part of a marginalized group
- Poor health and well-being including untreated hearing loss, frailty, and poor mental health
- Societal barriers such as ageism and lack of opportunities for older adults to engage and contribute
Social isolation and loneliness will be reduced only if effective interventions and strategies are implemented at scale in a multi-stakeholder, multi-sectoral effort. This will require the identification of effective interventions and strategies (existing or new) and addressing all the factors required to scale them up to achieve an impact at the population level, including a cycle of continuous evaluation and optimization, estimation of intervention costs and benefits, adapting interventions for scale-up, determining their reach and acceptability, developing implementation infrastructure and a workforce and ensuring sustainability.
Social isolation and loneliness, which affect a considerable proportion of the population of older people globally, shorten their lives and take a heavy toll on their mental and physical health and their well-being. Covid-19 and the resulting lockdown and physical distancing measures have been a stark reminder of the importance of social connections in the lives of older people. The United Nations Decade of Healthy Ageing 2021–2030 offers a unique opportunity for United Nations agencies and stakeholders in all sectors to act together internationally, regionally, nationally, and locally to reduce social isolation and loneliness among older people.
The growth of the elderly population in the coming decades will bring with it unprecedented burdens of morbidity and mortality across the country. The key challenges to access to health for the Indian elderly include social barriers shaped by gender and other axes of social inequality (religion, caste, socioeconomic status, and stigma). Physical barriers include reduced mobility, declining social engagement, and the limited reach of the health system. Health affordability constraints include limitations in income, employment, and assets, as well as the limitations of financial protection offered for health expenditures in the Indian health system.
With the fast-increasing share of older people in the national population of India, older persons seem to struggle for their due share in the mainstream as well. They are raring to grab their share in the center stage and want to show their presence in the national arena. Unlike past decades, the profile of older people has changed significantly. They also comprise educated, active, able-bodied, experienced, well-informed, and well-placed senior citizens. With the dramatic change in their profile, their perceptions of needs and, therefore, their rights have also changed amazingly.
In India issues concerning old age are turning into bigger challenges due to the unprecedented rate of growth of this section of the population. There is a strong need for well-conceived policies and their implementation, backed by strong political and administrative willpower. Of late, the government has taken many steps and directed its stakeholders to include older people in its social agenda. Over the years several schemes and programs have been launched for the welfare and empowerment of older people.
It seems that there is mounting pressure on our governments to address the issues of 100+ million elderly people in the country. With fast-changing socio-economic conditions and redefined traditional value systems, most elderly are rendered without a social support base and the majority of older people are finding themselves at the receiving end.
The social security system, old age healthcare, empowerment of older people, and protection of human rights of older people are burning issues, which need to be addressed on a priority basis. There is an urgent need to devise such frameworks that could ensure an elderly-friendly environment in society, where people can lead a life with respect and grace in their old age. There is a need to create and spread awareness about the fast-changing needs & rights of older people, to educate and sensitize younger generations about issues concerning old age, and to empower older people through various media. All this will help society at large to understand the issues, learn from the past, and plan for the future as well.