Our number of friends tends to decrease as we get older, but this trend, which has many negative effects, can be actively combated even when old age has already set in.
“Thanks for coming over!” Four words I heard over and over again, and which hurt me as if someone had ripped off a row of skin when I found out that she was in hospital and that this would be, it seemed, her last admission. She was about two decades younger than my grandparents, had they lived, and about 20 years older than my parents; the last surviving member of the older generation of my childhood street.
I’d always known her—she was the neighbour my mother left us with when she went to the fields or to town. She had a large mulberry tree (to our childish delight, and to her dismay as the fruit stained her pathway) that we could climb to our heart’s content, just as we could climb all the cherry plum trees in her garden. We could also play freely in the front lawn without fear of reprimand if the ball hit the gates loudly or landed in the flower garden.
Time passed, as it does, and I saw her less frequently. We would meet by chance outside the gate, and she didn’t come by as often, afraid to interrupt our endless chores. We visited her only now and then, to talk to her and to give her gifts—a framed photograph of her grandchildren, a pot of hyacinths that would bloom on her windowsill in the spring. She told us to come and read more of the “Word of God” to her, because she didn’t know the alphabet and, as time went on, she became thirsty for good news from beyond the borders of our world. And somehow, towards the end, which we did not foresee, our meetings became even shorter, as we postponed them again and again, under the pressure of some unfinished, or even unstarted project.
“Come and see me again!” A request always preceded by a thank you: “Thank you for coming over!” It would be difficult to put into words all the heartbreaking, piercing pain that overwhelmed me when I realised that the time of visits—which I had considered eternal, judging by the long list of postponements—had come to an abrupt end, and that I had not known how to take stock of and cherish all those wasted opportunities. It’s been almost a year and a half since Aunt Adela could no longer invite us to visit her, and in all that time the void she left in the heart of the street has not been filled at all. In fact, it seems to be getting bigger and bigger, spreading over the grassy courtyard, over the cherry trees by the gate, over all the hyacinths that have stopped blooming, over all the good news that has stopped being shared.
Loneliness at the end of life
“Most of us have an hour a week to spare for someone who is ageing and alone,” writes Christian author Katy Morgan. We might even find two or three hours a week if we realised how bitter loneliness can be at an age when the best years and most joyful pleasures are far behind us—and also at an age when it is increasingly difficult to find someone to share your losses and worries about those already on the way.
By measuring perceived loneliness—the kind that hurts the most—researchers found a U-shaped curve. People feel lonelier in early adulthood and old age, and less lonely in middle age, with loneliness increasing after the age of 60 and being particularly pronounced around the age of 80, according to the Northwestern Medicine researchers.
Eileen Graham, a professor at Northwestern University, finds this increase in loneliness in old age striking. The researchers wanted to find out who is most vulnerable and why loneliness increases with old age. In midlife, Graham says, our social network is dense: we interact with our partners, children, colleagues, friends and others in the community. As we get older, these networks become sparser and people feel they have fewer close people around them.
Loneliness is associated with poorer health, the loss of a partner and fewer close family and friends, which explains why loneliness is more pronounced after the age of 75, according to a study published in 2019.
Most people benefit from having four to six close relationships, says Julianne Holt-Lunstad, professor of psychology and neuroscience, explaining the need to have different relationships that fulfil different types of needs.
Lack of social connections is a risk factor for cardiovascular disease, probably as significant as smoking or excessive alcohol consumption, and perhaps even more harmful than high blood pressure, obesity or a sedentary lifestyle, says Holt-Lunstad, listing a number of studies showing the link between loneliness and cardiovascular disease.
Poor social connections are associated with a 29% higher risk of coronary heart disease and a 32% higher risk of stroke, according to previous research. Other studies suggest that social isolation can increase inflammation in the body, blood pressure and stress, and prevent a person from being physically active and getting a good night’s sleep.
There is no “magic bullet” for healthy ageing, but strong social ties are probably close to the miracle food or medicine that all those who want to live a long and healthy life have been looking for, says geriatrician Amit Shah. After many years of caring for elderly patients, the doctor says that some of the overemphasised factors of successful ageing—such as longevity in old age or lack of physical illness—do not guarantee that we will have the old age we want, and on the other hand, relationships seem to tip the balance more in the direction of successful ageing.
As old age becomes a reality, forming new relationships becomes more difficult, and as loved ones die or become unavailable, forming a circle of close or at least new acquaintances remains a challenge.
Ageing and socialising
Despite the fact that it can be difficult and even intimidating to make new connections and socialise with people you don’t know, the effort should be seen as a workout for happiness and brain health, says Dr Shah, who has some recommendations for older people.
First, older people should get a hearing aid or use the one they already have, as hearing loss is a major cause of isolation: “When you can’t hear, your brain stops listening. There’s evidence that not correcting or addressing hearing issues leads to higher rates of cognitive decline.”
Studies suggest that the use of hearing aids is associated with longer life expectancy. It is a plausible link, the doctor says, because the inability to carry on a conversation leads older people to go out less; less physical activity can lead to loss of muscle mass, increasing the risk of falls and hip fractures.
Failure to correct hearing problems has been shown to lead to higher rates of cognitive decline.
The doctor’s second piece of advice concerns getting out of the house. Although older people tend to travel less due to common age-related difficulties (such as failing eyesight or lack of transport), overcoming these challenges pays dividends. Even in old age, getting out and about, learning things and building memories helps us process spatial information and exercise the brain’s executive functions and memory, says Dr Shah.
Third, seniors should actively seek out opportunities to build new relationships (talking to neighbours, being active in a religious community, finding people to share a hobby with, volunteering, etc.).
What lenses do we use to view old age? The impact of intergenerational programmes
Every Friday at 10 a.m., Zach Ahmes, a 19-year-old medical student, and Richard Bement, a 76-year-old retiree, begin their usual online conversation. Zach has enrolled in the Opening Minds Through Art programme, designed by the University of Miami to facilitate intergenerational activities. Initially, he may have done it to earn a few extra credits, but he really enjoys chatting with Mr Bement. The programme offers suggestions for discussion topics and activities (most of which focus on art), but the pair largely ignore them. Over the past year, they’ve talked about what interests them—topics ranging from bands and poetry to family and religion (Zach is Muslim and Mr Bement is Episcopalian).
Early retirement, multi-generational families no longer living together, and declining church membership are all contributing to reduced intergenerational interaction, says gerontologist Karl Pillemer. What’s more, he explains, there are whole industries—such as technology, advertising or entertainment—where the presence of older people is rather unusual. Most people have only people close to their own age (a decade older or younger at most) in the groups and networks with whom they frequently interact, Pillemer notes, pointing out that one damaging effect of this is ageism—the devaluation of older people.
Intergenerational programmes work, with positive effects for both young and old, studies show. The first meta-analysis to look at the outcomes of non-family intergenerational programmes showed a change for the better in young people’s attitudes towards older people. Positive changes were also seen in older adults —increased quality of life, improved physical health, reduced depressive symptoms and increased generativity (a willingness to engage in acts that promote the wellbeing and success of future generations).
Education and intergenerational interaction are very powerful tools for changing negative attitudes towards the elderly, with the most visible effects among women, adolescents and young adults, concludes another meta-analysis.
Professor Karl Pillemer developed a programme in which high school students interview older people, and at the end of a study examining the impact of the programme, the professor found significant benefits for young people—improved attitudes towards old age and older people, increased confidence and interest in interacting with older people, and a clarification of their purpose in life.
It’s barely a century-and-a-half since people used to consult the oldest person in the community for advice on choosing a mate or which crops would grow better in times of drought, says Pillemer. The age segregation that is now taking place in society is damaging the generations, says the professor, stressing the need to find and implement solutions to counteract this “dangerous experiment, in which youth have almost no interactions with older individuals other than their own family members.”
Carmen Lăiu is an editor at the Signs of Times Romania and ST Network.
