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Early in the coronavirus pandemic, the Centers for Disease Control and Prevention urged older adults — the group at highest risk for severe illness with COVID-19 — to stay home with few, if any, visitors. Many of those restrictions were lifted with the approval of coronavirus vaccines and booster shots in 2021 and 2022, and while the country has reached a “new normal” in many ways, increased social isolation and loneliness in older adults persists.

“My mother has lived alone several hours away from family for years,” said Imani, 53, a nurse practitioner in Atlanta. “She had a booming social life before the pandemic hit — garden club, yoga classes, and a church group. She was always busy. But partway through 2020, the lack of activity started to show. Her decline was shocking, even over FaceTime calls.”

It’s undeniable that social restrictions have helped physically protect people throughout the pandemic, but those same precautions have also limited seniors’ interactions with friends and family, leading to a stark increase in reported elderly isolation. In fact, 56% of older adults said they felt isolated in June 2020, according to a University of Michigan poll on healthy aging. That’s more than double the number of seniors who reported feeling isolated in 2018’s healthy aging poll.

This upward trend is worth noting because senior isolation can lead to depression, weight loss, cognitive decline, and other medical complications, research suggests.

“Mom was losing weight — you could see it in her face — and she would often tell the same stories as she had the last week,” Imani said. “At some point, she admitted she was only eating once or twice a day, without lunch dates with friends.”

Read on to learn the major mental and physical effects of elderly loneliness and how senior isolation has been complicated by the coronavirus pandemic. Plus, get tips on how to connect with and support seniors who are lonely or living alone.

Living at home and staying in a familiar community may offer benefits to seniors’ emotional well-being — but research indicates that a staggering number of seniors who should be receiving assisted living care are still living at home. And in many cases, they live alone.

Loneliness can be as deadly as smoking or obesity, according to a study published in the journal of Perspectives on Psychological Science. Senior isolation may complicate existing conditions, encourage an unhealthy lifestyle, and affect cognition.

• Unhealthy habits increase when seniors are isolated. Social isolation often leads to bad health habits, according to the American Psychological Association. Lonely seniors are more likely to smoke, drink in excess, and neglect the need for physical activity. Conversely, social support can encourage seniors to eat well, exercise, and live healthy lifestyles. “Mom had gone to do exercise classes at the Macon senior center every week and went walking on Sundays after church,” Imani said. “For a few months, she did one of those programs at home. Then she started feeling lonely just doing it along with the TV.”
• Balanced diets are more difficult for lonely seniors. Because of decreased appetites, medication side effects, and physical changes, seniors may be less likely to eat healthy, balanced meals.
• Loneliness increases the risk of Alzheimer’s disease. Loneliness is a risk factor for cognitive decline, according to a study conducted by the Rush Institute for Healthy Aging. In the study, the risk of Alzheimer’s nearly doubled in lonely seniors, and mental decline was faster. This could be because isolated older people have less stimulation or because their symptoms are less likely to be reported before the disease has progressed, the study suggested.
• Stress follows loneliness. Researchers at the University of Chicago note blood pressure and stress levels are “significantly higher” in lonely people, especially seniors. “I felt like I couldn’t get out of bed some mornings,” said Anne, 78, of Elizabethtown, Kentucky. “My stress was through the roof, and when I went to the doctor in 2021 my blood pressure was way up.”
• Isolation leads to higher instances of elder abuse. Isolated seniors are more likely to fall prey to scammers and financial mistreatment. Neglect, one of the lesser-known types of elder abuse, is more likely to go unnoticed. Seniors themselves are less likely to report physical abuse without a trusted family member, and they may protect abusers if they don’t have other caregiving resources.
• Lonely seniors assume the worst. Socially isolated seniors are 60% more likely to predict their quality of life decreasing over the next 10 years. They’re also more concerned about needing help from community programs as they get older, and they’re more likely to express concerns about aging in place, according to the National Council on Aging (NCOA). “Mom always said she’d stay in that house until she died. She was stubborn. But she started getting concerned. ‘What if I can’t stay here anymore? What if I have to go to a home?’ She kept bringing these things up,” Imani said.

The “double pandemic:” Coronavirus and senior isolation health risks

Senior isolation has been a core concern during the coronavirus pandemic, according to a University of Washington study of social services and health care organizations across the state. Organization leaders expected the impact of social isolation in seniors to persist well after restrictions have been lifted, according to the study, leading to “exacerbated problems of dementia, depression, suicide risk, and disrupted care.”

They were right.

“Even after I started being able to see family again — after we were all vaccinated — I felt this pressing sense of depression,” Anne said. “I felt like I’d missed a year of my life, isolated from grandbabies and my son.”

Family caregivers agree social distancing and the stress of the pandemic have affected their aging loved ones. Sixty-two percent of adult children caring for their parents or elderly relatives say their loved one has suffered physically or mentally from senior isolation during the pandemic, according to a December 2020 survey from A Place for Mom. Some groups particularly affected by pandemic isolation include the following:

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• Seniors in need of preventive healthcare who may postpone regular appointments, tests, and elective surgeries
• Older adults with impaired mobility who may lose the benefits of regular physical therapy or suffer bedsores from decreased movement
• Seniors with lower incomes who may rely on public transportation or may be essential workers
• Older adults with depression, anxiety, or other mental illnesses that may go untreated without access to a therapist
• Unpaid spousal caregivers who have limited respite from their duties and are more likely to experience caregiver stress and health problems
  
• Seniors with chronic conditions who may have less support for disease management and postpone medical visits to avoid exposure to COVID-19
• People living with dementia who require cognitive and sensory stimulation and benefit from seeing relatives and familiar faces

Elderly isolation remains a struggle, even without pandemic-related social distancing. As far back as the 1950s, psychiatrist Frieda Fromm-Reichmann raised awareness about the dangers of loneliness, which she defined as the difference between someone’s “preferred and actual social relations.”

For many seniors, that gap has been caused by situations that will persist once the pandemic subsides.

“Even before the pandemic, I was living alone, and I did feel lonely sometimes because I was very social when I was younger,” Anne said. “Since my husband passed in 2014, it just hasn’t been the same.”

Here are seven contributing factors to senior isolation.

1. Family dynamics have changed. Divorce rates have nearly doubled over the past 40 years, and the number of adults who never married is at an all-time high, according to the most recent U.S. Census. National birth rates also plummeted after the baby boomer generation, meaning more seniors are childless. These factors lead to a decrease in family social ties that often preclude intergenerational caregiving.
2. Women are more likely to live alone than men. Higher percentages of older women never married or are either widowed or divorced. The median income of women older than 65 is $18,380 — that’s roughly half of men’s $32,000 average, according to a study conducted by the Administration on Aging branch of the Administration for Community Living. This financial discrepancy makes it more difficult for single women to afford home health care or assisted living later in life. Interestingly, more men report being lonely in old age, while women are more content to age alone.
3. Neighborhoods evolve. Many seniors choose to stay home as long as possible, often citing their community as the main reason to age in place. However, community dynamics change over time: Gentrification, new job opportunities, and an increase in urban living can bring in younger neighbors, which can isolate seniors. 55+ communities can be a good option for seniors who want to maintain a neighborly environment as they age.
4. LGBTQ+ seniors are more likely to be socially isolated. LGBTQ+ seniors are twice as likely to live alone, according to SAGE, an organization that advocates for LGBT+ elders. This is because they’re less likely to have children and are more commonly single or estranged from their biological families.
5. Transportation challenges lead to social isolation. Forty-one percent of seniors believe that transportation in their communities is inaccessible or inadequate, according to the National Council on Aging (NCOA). Since many people lose their ability to drive as they age, they’re likely to be isolated without available transit.
6. Married couples can be lonely, too. Seniors don’t have to live alone to be lonely. Older adults who are married are just as likely to report feeling isolated as those who aren’t married. This is partially because couples who focused on children for years aren’t used to living without them. Spouses who act as caregivers for their partners are at risk of emotional isolation since they often don’t have time for activities or social outings.
7. Seniors may feel they’re being left behind. New technologies and lifestyles can be overwhelming for seniors. The first generation to experience color TV and the personal computer is inundated with new, seemingly inaccessible tech without proper instruction.

Before the pandemic, many seniors living alone maintained active social lives, regularly visiting community centers and friends. Additionally, routine interactions like checking out at the grocery store or chatting with the mail carrier offered much-needed socialization. Now that most older adults can participate in safe or socially distanced activities with family and friends, there are several ways to help your loved one feel more active and engaged.

• Learn how to combat senior loneliness and isolation. Review these nine key tips from a top Cleveland Clinic physician to understand the importance of socialization, plus how you can help your loved one remain engaged.
• Consider these activities for seniors social distancing. Families and friends can stay connected with these unique takes on classic activities — no matter their level of comfort regarding pandemic regulations. From virtual movie nights to socially distanced crafting, there’s something for everyone.
• Explore intergenerational programs to build relationships. Intergenerational programs can offer aging loved ones a sense of purpose, as well as a much-needed social outlet.
• Find social engagement in senior living. It’s hard to be lonely when you have friends and neighbors nearby for activities, meals, and conversation. Moving to senior living can be a difficult decision, particularly if your loved one is not keen on moving, but the regular engagement communities offer can improve health and wellness in older adults.

How senior living can help your loved one beat loneliness

“In October of 2021, we realized something had to change,” Imani said. “Mom didn’t want to go to senior living, but she also really didn’t know what it was all about.”

Imani’s mother ended up choosing an independent living community just a few blocks from her old home.

“I think she still drives past that house to check up on it,” Imani laughed. “She got to keep her friends and also made new ones. She’s started eating again, loves that there’s a beauty shop there, and has joined another Bible study in addition to the one at her church. It’s been a lifesaver for all of us.”

If you think senior living could help your loved one remain social and avoid senior isolation, reach out to one of our 400 free, local senior living experts. They can guide you through the process of finding the right fit for your family.

Sources:

Administration on Aging. (2021, May). 2020 profile of older Americans. Administration for Community Living.

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American Psychological Association. (2020, October). Stress in America 2020: A national mental health crisis. 

Bennett, D.A., Schneider, J.A., Buchman, A.S., Barnes, L.L., Boyle, P.A., & Wilson, R.S. (2012). Overview and findings from the Rush Memory and Aging Project. Current Alzheimer Research, 9(6), 646-663.

Berridge, C., Parsey, C.M., Ramirez, M., Freitag, C., Johnson, I.M., & Allard, S.W. (2020). Caring for Washington’s older adults in the COVID-19 pandemic: Interviews with organization leaders about the state of social and healthcare services. University of Washington. 

Cacioppo, S., Grippo, A., London, S., Goossens, L., & Cacioppo, J. (2015). Loneliness: Clinical import and interventions. Perspectives on Psychological Science, 10(2), 238-249. 

Eckhart, K. (2020, October 21). Pandemic further isolating older adults, as senior services struggle to adapt. UW News. 

Holt-Lunstead, J., Smith, T.B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227-237. 

National Institute on Aging. (2019, April 23). Social isolation, loneliness in older people pose health risks. 

Piette, J. (2020, September 14). Loneliness among older adults before and during the COVID-19 pandemic. University of Michigan. 

Real World Health Care Editorial Staff. (2021, March 31). COVID-driven isolation can be dangerous for older adults. National Council on Aging. 

SAGE. (2020, August 31). Startling mental health statistics among LGBTQ+ are a wake-up call. 

United States Census Bureau. (2021, November 30). 2020 ACS 1-year experimental data tables.