A third of U.S. adults are lonely - here's how we can help
'Relationship-based home care' is designed to promote independence and, ultimately, emotional well-being in old people. Image: Lisa Bussell
“The most terrible poverty is loneliness, and the feeling of being unloved.” – Mother Teresa
One of the most urgent, expensive and fast-growing epidemics today remains largely invisible: loneliness among seniors. Millions of older adults around the world are struggling with painful, prolonged isolation – leading to poor mental health, deteriorating quality of life and unsustainable healthcare costs. As global population ageing accelerates, these impacts threaten to reach catastrophic levels.
However, a new model of elder care offers a potential – and scalable – solution. Called relationship-based home care, this approach could be the key to keeping seniors healthy, active and socially engaged.
The world’s population is ageing on an unprecedented scale, with the number of people 60+ set to double to more than 2 billion by 2050. While this widespread longevity is miraculous, too many seniors are lonely and isolated. More than one-third of older Americans say they’re lonely, while the number of lonely older people in the UK is projected to increase 49% by 2025. In China, if current rates continue, there will be more than 90 million lonely older people by 2050. The story is the same in countries around the world.
This is a public health crisis. Loneliness takes a serious toll on older adults’ mental and physical well-being – the equivalent of smoking 15 cigarettes a day. It often leads to unrecognized, misunderstood and unaddressed mental-health challenges, as well as increasing the risk for obesity, heart disease and other chronic, life-threatening conditions. These health effects also generate increasingly unsustainable costs for families, health systems and governments. For example, in the US, Medicare already spends nearly $7 billion each year in additional direct costs for socially isolated older adults.
We urgently need new solutions to keep older adults socially engaged. There are a number of promising efforts in progress, including the UK’s Campaign to End Loneliness, the WHO’s Decade of Healthy Ageing, and WEF’s work on mental health. However, the scale of the crisis demands greater focus and action, building on existing efforts to find and implement new solutions.
To address this global epidemic, we need solutions that can be scaled for the vast number of older adults today and in the future. More and more, relationship-based home care is being recognized as a solution to an ageing demographic.
In this model, a professional, trained caregiver provides highly personalized care and companionship in the senior’s home, with activities organized around the senior’s needs and interests, as well as incorporating the needs of the care recipient’s family. Instead of having a carer focus on one specific task, relationship-based care focuses on broader benefits. Specifically, it promotes independence, ensuring physical and emotional well-being and supporting the continuous monitoring and evaluation of an individual’s needs. Not only does this care model support the senior, but it also provides support to family caregivers. These advantages make home care an effective, scalable and cost-efficient approach to fighting and preventing loneliness and supporting mental health among seniors.
As the CEO of Home Instead Senior Care, I see the power of this model in action every day. Paul and Lori Hogan founded Home Instead in 1994, after a transformative experience caring for Paul’s grandmother. At the time, Grandma Manhart was lonely and isolated, and her doctors gave her only months to live. But then her family rallied around her, providing love, companionship and connection. She lived for more than a decade – demonstrating how human relationships can drive health and wellness.
Outside of relationship-based care, stakeholders around the globe are beginning to see the need for innovative approaches to fight loneliness in seniors. The government of Singapore uses gardening and has since 2017 when it rolled out an allotment garden scheme, with the intent that these shared plots of land will foster closer social bonds. Kay Pungkothai, head of the community gardening at the government’s National Parks Board, believes that the gardens are “a modern ‘kampung’ where people come together, they have a communal space they can go to and look forward coming to … it really tackles the issue of isolation and depression.”
Humanitas Retirement Village, located in the Netherlands, uses intergenerational living to address loneliness among seniors. This programme provides free room and board to university-aged students in exchange for 30 hours of their time each month, which are spent interacting with and providing companionship to its senior residents.
The global community needs to continue to innovate around and create a more significant focus on the senior loneliness epidemic as a key element of mental health. As we begin this conversation, there are a number of complex questions:
• What can the experiences of elder-care workers tell us about the best ways to fight loneliness?
• How can technology be used to support social engagement, rather than undermine it?
• What are the unique risks and effects of loneliness for LGBTQ seniors?
• What are the connections between loneliness and elder financial abuse?
• How will these challenges evolve in the future, as technological, demographic and societal changes unfold?
Leaders from around the world and all stakeholders involved in senior care must begin to scale effective solutions to end the loneliness epidemic. Together, we can seize the opportunity for human connection to improve seniors’ health outcomes, extend lives, lower costs and ultimately address one of the foremost mental-health challenges of the 21st century.
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