Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Older adults and the epidemic of loneliness

John A. Dodson, MD
Conditions
May 25, 2019
782 Shares
Share
Tweet
Share

A recent New York Times article described a 77-year-old retired gardener in England who had not spoken with another human being in more than six weeks. He told the reporter through tears that he felt “very lonely, and bored.” Recent budget cuts prevented him from taking the bus to the grocery store. Younger people, including his own son, had left town for better jobs in larger cities.

I see this loneliness regularly in my geriatric cardiology practice in New York City. New York is the opposite of the sparsely populated English countryside; 1.6 million people live in the 23 square miles that make up the island of Manhattan, and another 2.3 million (like myself) commute there every day to work. While New Yorkers are not physically isolated, the city can still be an exceptionally lonely place — especially for the over 1 million older adults who live there.

During routine office encounters, many of my older patients tell me they have nobody in their daily lives: no spouse, no children, no close friends. They might be able to name an emergency contact — a neighbor whom they scarcely know, or a distant relative. But nobody checks in with them on a daily, or even a weekly, basis. From a basic human perspective, this loneliness matters: We are fundamentally social creatures. From a health perspective, emerging literature shows that loneliness carries an increased risk of many poor health outcomes, including coronary heart disease and stroke, independent of more traditional risk factors.

Many of my older patients lived through some the most iconic periods in American History–the Great Depression, World War II, Civil Rights — and through all of this they never planned on being alone. It just happened. The death of a spouse might have tipped the balance. Or sensory impairments prohibited regular conversations with friends (for example, think about how difficult it is as a physician to communicate with someone who’s hearing impaired).

Other physicians have written poignantly about loneliness and social isolation; Dr. Dhruv Kullar wrote an emotional piece in the New York Times in 2016 about “How Social Isolation is Killing Us.” He used the example of a hospital inpatient with a terminal illness, who had no immediate family or close friends to call at the end of his life. Dr. Kullar wrote, “A great paradox of our hyper-connected digital age is that we seem to be drifting apart.”

Most of cardiology is straightforward: aspirin and lipid-lowering therapy for coronary disease, diuretics for heart failure. Some decisions are nuanced–especially in geriatric patients — which keeps practice interesting. But cardiologists (and I would argue, most medical professionals) are ill-equipped to deal with the epidemic of loneliness among our older patients. This epidemic is likely to worsen in the next 20 years, driven by the confluence of an aging society, smaller families, and even the societal balkanization created by technology.

The crisis of loneliness calls out for solutions, but as with any complex problem there is no easy fix. Researchers have tried numerous interventions, including pairing lonely older people with volunteer companions, creating peer support groups, and animal therapy, with varied degrees of success. Technology companies are developing socially assistive robots (and even robot pets) that may have benefit in specific settings such as nursing homes. Forward-thinking cities are laying out ambitious plans for their older residents: for example, in 2017 the New York City comptroller issued a blueprint for “Aging with Dignity” that included investing in more senior centers and increasing the number of age-friendly neighborhoods (with tangible changes like more benches, safer street crossings, and buddy systems to help provide companionship for seniors).

In the meantime, I struggle with how to counsel my lonely patients. I ask about resuming an activity that may give them meaning. (I have found champion bridge players and professional singers among my patient panel.) Often I’ll put in a referral for a visiting nurse assessment; this identifies those who qualify for a home aide to assist with their daily activities and to provide companionship. Clinic itself provides some degree of socialization, and I so I try to ensure they have regular visits. I may call distant family members (if there are any) to let them know my concerns.

It’s been over 50 years since the Beatles’ “Eleonor Rigby” brought the plight of lonely older people to a popular audience of millions. The lyrics are heartbreaking, and the song is considered one of their best works. Since that time, the epidemic of loneliness among older adults has only increased. This problem will ultimately require system-wide solutions. But in the meantime, as physicians, we can recognize the problem, bear witness to others (including policymakers), and advocate for our lonely patients by taking small steps to improve their lives.

John A. Dodson is a cardiologist.

Image credit: Shutterstock.com

Prev

MKSAP: 60-year-old woman with persistent constipation

May 25, 2019 Kevin 0
…
Next

It's time for physicians to be less "productive"

May 25, 2019 Kevin 8
…

Tagged as: Geriatrics, Primary Care

Post navigation

< Previous Post
MKSAP: 60-year-old woman with persistent constipation
Next Post >
It's time for physicians to be less "productive"

More by John A. Dodson, MD

  • How minimizing treatment burden can help patients with chronic conditions

    John A. Dodson, MD
  • Letting go when people let go of their lives

    John A. Dodson, MD
  • Conversation with older patients is common sense

    John A. Dodson, MD

Related Posts

  • How hospitals can help with the opioid epidemic

    Richard Bottner, PA-C and Christopher Moriates, MD
  • Should adults receive another dose of MMR?

    Roy Benaroch, MD
  • The other opioid epidemic that we ignore

    Hans Duvefelt, MD
  • When should you prescribe statins for older adults?

    Kenneth Lin, MD
  • Approach the gun violence epidemic like we do with coronavirus

    Charles Nozicka, DO
  • Who’s really to blame for the obesity epidemic?

    Peter Ubel, MD

More in Conditions

  • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

    Harvey Max Chochinov, MD, PhD
  • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

    Hoag Memorial Hospital Presbyterian
  • The rising threat of lung cancer in Asian American female nonsmokers

    Alice S. Y. Lee, MD
  • Urgent innovation needed to address growing mental health crisis among children and families

    Monika Roots, MD
  • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

    Cheryl Lazarus
  • The unjust reality of racial disparities in pediatric kidney transplants

    Lien Morcate
  • Most Popular

  • Past Week

    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • New Data in NSCLC Bolster Support for Perioperative Immunotherapy
  • Breathing Support Type Matters for Preventing Extubation Failure in the PICU
  • Second-Line Axi-Cel Bests Standard in Relapsed/Refractory Large B-Cell Lymphoma
  • New Agents for Relapsed/Refractory Myeloma Impress in Early-Stage Clinical Trials
  • Kratom Linked to Outsized Proarrhythmic Risks

Meeting Coverage

  • New Data in NSCLC Bolster Support for Perioperative Immunotherapy
  • Second-Line Axi-Cel Bests Standard in Relapsed/Refractory Large B-Cell Lymphoma
  • New Agents for Relapsed/Refractory Myeloma Impress in Early-Stage Clinical Trials
  • CAR-T Tops Standard Care in Heavily Pretreated Lenalidomide-Refractory Myeloma
  • T-DXd Proves Mettle in Multiple Solid Tumors
  • Most Popular

  • Past Week

    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Older adults and the epidemic of loneliness
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...