tag:theconversation.com,2011:/africa/topics/loneliness-among-elderly-37841/articlesLoneliness among elderly – The Conversation2023-04-06T12:06:48Ztag:theconversation.com,2011:article/1968622023-04-06T12:06:48Z2023-04-06T12:06:48ZMacaque monkeys shrink their social networks as they age – research suggests evolutionary roots of a pattern seen in elderly people, too<figure><img src="https://images.theconversation.com/files/517325/original/file-20230324-22-v5nrpg.JPG?ixlib=rb-1.1.0&rect=157%2C0%2C2994%2C2087&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Older monkeys still hang out, just with a smaller circle of intimates.</span> <span class="attribution"><span class="source">Lauren Brent</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>There are many changes that can come with old age – hair turns gray, eyesight isn’t quite what it used to be, mobility often becomes limited. But beyond these physiological changes, people also experience changes to their social world. As we age, <a href="https://doi.org/10.1037/a0028601">our social circles tend to get smaller</a>.</p>
<p>Such declines in social networks have raised concern among scientists who are aware of just how <a href="https://doi.org/10.1126/science.aax9553">important social relationships are to health and well-being</a>. Being socially isolated can harm health as much as <a href="https://doi.org/10.1371/journal.pmed.1000316">obesity, alcoholism or sedentary living</a>.</p>
<p>In the past decade, however, scientists have started to think that the shrinking of social networks with age might not be all bad.</p>
<p>Rather than social declines being driven exclusively by the death of friends or deteriorating health, people might become more selective in their social interactions as they age. After all, many older adults tend to <a href="https://doi.org/10.1037/0882-7974.9.2.315">focus their social effort on family and close friends</a>. This change in social focus might result from older adults’ being <a href="https://doi.org/10.1037/0003-066X.54.3.165">aware of the limited time they have left</a> and prioritizing their most important relationships.</p>
<p>As a <a href="https://erinsiracusa.weebly.com/">behavioral ecologist</a> and <a href="https://smack-lab.com/team/noah-snyder-mackler/">a molecular ecologist</a>, we were interested in understanding the evolutionary roots of these age-based changes in social focus.</p>
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<a href="https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Lone monkey sits on some branches" src="https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505683/original/file-20230121-20-idfswj.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">An older female macaque sits alone on Cayo Santiago, Puerto Rico.</span>
<span class="attribution"><span class="source">Noah Snyder-Mackler</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>To investigate whether other animals share these patterns of social selectivity with age, we turned to a free-roaming population of over 200 macaques on the island of <a href="https://www.youtube.com/watch?v=5j1ezxH0hAQ">Cayo Santiago</a> in Puerto Rico. In collaboration <a href="http://www.laurenbrent.com/">with</a> <a href="https://www.nyuprimatology.com/">our</a> <a href="https://plattlabs.rocks/our-team/michael-platt">colleagues</a>, we collected eight years of data about how these monkeys interacted with one another as they got older.</p>
<p>We found striking parallels to the patterns of social aging seen in humans, and <a href="https://doi.org/10.1073/pnas.2209180119">our study sheds light on the causes and potential consequences</a> of shrinking social networks with age.</p>
<h2>Picky partner choice</h2>
<p>We focused specifically on female macaques, because they have the most stable long-term relationships in this population. With the help of several dedicated research technicians, we followed these females for up to seven hours a day over the course of eight years. </p>
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<a href="https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="dozens of monkeys scattered around a rocky beach with one person standing there" src="https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505684/original/file-20230121-14-iddflb.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Daniel Phillips, a research technician, collects data on macaque social relationships on Cayo Santiago, Puerto Rico.</span>
<span class="attribution"><span class="source">Erin Siracusa</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>First, we found that female macaques did indeed spend time with fewer social partners as they got older. Aging macaques sat near fewer partners and also groomed fewer partners. Grooming is an <a href="https://doi.org/10.1007/BF02557701">important bonding behavior</a> in macaques that females do only with their besties. </p>
<p>Importantly, this reduction in females’ social circles was not precipitated by their partners dying or by older monkeys being seen as somehow undesirable and therefore to be avoided. We observed that how often other monkeys sought out older females as social partners did not change with age.</p>
<p>Instead, there seemed to be clear evidence that females were actively reducing the size of their social networks over time. Specifically, as females got older, they initiated interactions with fewer group mates. We observed these declines beginning in females who were in their prime years (around 10 years old) all the way through those who were near the end of their lives (around 28 years old).</p>
<h2>A family matter</h2>
<p>Of course, an important piece of this puzzle is who these female macaques did choose to interact with as they got older. </p>
<p>We found that, similar to humans, aging female macaques focused their time and effort on family members and “friends” with whom they shared a particularly strong and stable bond.</p>
<p>While this narrowing of networks and focus on kith and kin does not necessarily result from macaques’ being aware they are nearing death – scientists aren’t sure if nonhuman animals have an <a href="https://doi.org/10.1098/rstb.2013.0486">awareness of their own mortality</a> – it does suggest that there may be a shared evolutionary reason for social selectivity in humans and other primates.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="two monkeys pick through the fur of a third lying on the ground" src="https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505685/original/file-20230121-31602-irg6sz.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A female macaque grooms her offspring on Cayo Santiagio, Puerto Rico.</span>
<span class="attribution"><span class="source">Lauren Brent</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<p>Why might this be? </p>
<p>One possibility stems from the fact that as humans and other mammals get older they experience <a href="https://doi.org/10.1111/ele.13343">declines in their immune system</a>. We get sick more easily and have a harder time recovering when we do come down with something.</p>
<p>Reducing one’s social circle with age may be an important way to <a href="https://doi.org/10.1016/j.tree.2020.07.004">avoid acquiring a disease or other illness</a>. Such a decrease need not be a deliberate strategy, but could be an unconscious tendency that was selected for over evolutionary time because it enhanced biological fitness in our primate ancestors. As a result, this pattern might persist today, even in humans well beyond their reproductive years. </p>
<h2>A hopeful outlook</h2>
<p>So, what does this all mean? Understanding how people can <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">live longer and healthier lives is a central priority</a> for health organizations worldwide. Figuring out how to maintain valuable social relationships into old age is likely to play a key role in that endeavor.</p>
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<a href="https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="five monkeys relax together; two small ones are nursing" src="https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505686/original/file-20230121-8189-crf3zj.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An older female macaque spends time with her family on Cayo Santiago, Puerto Rico.</span>
<span class="attribution"><span class="source">Lauren Brent</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>The results from this study indicate that the shrinking of networks across the life span is an aging pattern that is not unique to humans but may be present in other primates. </p>
<p>While <a href="https://www.pnas.org/doi/10.1073/pnas.1219686110">loneliness in the elderly</a> is a health concern that should not be ignored, there may be important distinctions between those who are unwillingly isolated as they get older and those who choose to stick to a smaller social circle. In the latter cases, shrinking networks with age may not be all bad.</p>
<p>Instead, there may be important benefits to be gained from being selective in our socializing as we get older, which has allowed this pattern to persist for millennia.</p><img src="https://counter.theconversation.com/content/196862/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erin Siracusa has received or currently receives funding from the American Society of Mammalogists, the Arctic Institute of North America, the Natural Sciences and Engineering Research Council of Canada, the National Institute of Health, and the European Research Council.</span></em></p><p class="fine-print"><em><span>Noah Snyder-Mackler has received or currently receives funding from the National Science Foundation, the National Institutes of Health, the Leakey Foundation, Arizona State University, and the University of Washington.</span></em></p>Many older people tend to trim their social circles and focus their social efforts on family and close friends. New research on our close primate relatives may help explain why.Erin Siracusa, Postdoctoral Research Fellow in Animal Behaviour, University of ExeterNoah Snyder-Mackler, Assistant Professor of Evolution and Medicine, Arizona State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1263142019-11-13T11:21:13Z2019-11-13T11:21:13ZHow simple policy changes can help us age better and prevent cognitive decline<figure><img src="https://images.theconversation.com/files/301373/original/file-20191112-178511-r00zvz.jpg?ixlib=rb-1.1.0&rect=0%2C6%2C4193%2C2785&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Ensuring older people can continue to socialise is important for preventing loneliness and cognitive decline. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-senior-friends-chatting-416231764?src=750ff30e-cf7f-44e0-9e41-3d5b64188ddb-1-2">Pressmaster/ Shutterstock</a></span></figcaption></figure><p>Many people experience a decline in cognitive function with age, such as a worsening memory and trouble processing information. In most cases, this is perfectly normal. In some cases, however, age-related cognitive decline may affect a person’s ability to carry out complex tasks, such as managing finances or preparing a meal. At times, it may even make it difficult for a person to perform daily tasks, such as dressing and feeding. </p>
<p>Around 18% of the UK’s population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/july2017">aged 65 and older</a>. By 2030, it’s estimated that <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/later_life_uk_factsheet.pdf">one in five UK people</a> will be aged over 65. </p>
<p>But this doesn’t account for the number of people who will experience cognitive decline and dementia as they age. Incidence of dementia sharply rises at the age of 75 – and it is expected that the number of people in the UK living with dementia <a href="https://www.ncbi.nlm.nih.gov/books/NBK513075/">could triple by 2050</a>. Cognitive function is very important to older people’s well-being. It influences <a href="https://www.ncbi.nlm.nih.gov/books/NBK513075/">everything they do</a>, including working and socialising, and has a huge social and economic impact on families. Finding ways to prevent cognitive decline is increasingly important.</p>
<p>We’re often told that the solution to cognitive decline lies in <a href="https://www.alz.co.uk/news/biogen-and-eisai-announce-plans-to-file-for-market-approval-of-alzheimers-drug">new medicines or therapies</a> that can reduce symptoms, or by following a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32350-9/fulltext">healthy lifestyle</a>. </p>
<p>But recent research by our team found that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950961/">social and emotional well-being</a> – meaning our feelings of being connected to family and the community, and our subjective experience of positive or negative emotions – may be just as important as therapy and lifestyle for maintaining good cognitive function in older age. <a href="https://g2aging.org/">Numerous studies</a> from around the world have found that social connectedness and loneliness influence older people’s cognitive function, including their memory. </p>
<p>Loneliness affects <a href="https://www.tandfonline.com/doi/abs/10.1080/00223980.2011.609572">approximately 9% of people</a> over 65 in the UK. It’s a complex emotional state where people perceive their social interactions and individual relationships to be inadequate. </p>
<p><a href="https://www.elsa-project.ac.uk/">One major study on ageing</a> – which collects data from more than 18,000 UK over-50s about physical and mental health, well-being, finances and attitudes towards ageing – found that isolation and loneliness were associated with poorer memory, especially among those with lower levels of education. In addition, loneliness in older age was associated with a <a href="https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyz085/5485775">steeper decline in cognitive function</a>. This included worse memory and verbal fluency. </p>
<h2>Cognitive decline and loneliness</h2>
<p>Although these findings are staggering, they also show us how difficult it is to establish if loneliness causes cognitive decline, or if cognitive decline causes loneliness. One way to find out is by looking at whether interventions to reduce loneliness also inadvertently affect older people’s cognitive health too. </p>
<p>We addressed this question in a series of studies looking at the impact that free bus travel had on over-60s. When the UK government gave free bus travel to people over 60 in 2006, it was thought that the measure may reduce loneliness and increase social engagement as it enables older people to remain connected to their social environments. </p>
<p><a href="https://academic.oup.com/aje/article/188/10/1774/5525029">We found</a> that free bus travel significantly increased public transportation use but, in addition, it led to improvements in cognitive function – particularly, improved memory. </p>
<p><a href="https://jech.bmj.com/content/72/5/361">In another study</a>, we found that increased public transportation use also reduced depression and feelings of loneliness. It increased participation in volunteering activities and contact with older people’s adult children and friends. These findings show how a simple policy has had unintended positive consequences. It led to significant improvements in older people’s cognitive function and mental health – potentially by influencing social well-being. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=418&fit=crop&dpr=1 600w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=418&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=418&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=525&fit=crop&dpr=1 754w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=525&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=525&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Public transport increased community participation, which improved cognitive function and well-being.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/nottingham-nottinghamshire-uk-05282017-three-old-1092811700?src=39224da0-c962-4edc-840b-0128cd0be1dd-1-18&studio=1">Simon Annable/ Shutterstock</a></span>
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<p>This isn’t the first time we’ve found how social policy changes can help protecting older people against cognitive decline. For example, <a href="https://jech.bmj.com/content/73/4/370">we examined the impact</a> of a French law that increased the minimum legal school leaving age by 2 years in 1959, from 14 to 16 years of age.</p>
<p>This law effectively increased the years of schooling for French adults presently reaching old age. We found that even decades after leaving school, a longer period in education helped older adults maintain cognitive function – particularly memory – and postponed cognitive decline. </p>
<p>Even policies that affect the whole economy have been found to be an important factor in health and memory. We found that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018975/">older people exposed to an economic recession</a> in the years leading up to their retirement experience faster cognitive decline in their post-retirement years. This suggests that policies that protect older people from the impact of economic decline might help them to maintain good cognitive function in older age. </p>
<p>Long-term care policies that enable older people to maintain independence and continue to socialise may also be important. “<a href="https://www.nia.nih.gov/health/aging-place-growing-older-home">Ageing in place</a>”, an approach that emphasises the importance of supporting older people to continue living in their home and community, has led many governments to offer care for older people with limitations in their own home. </p>
<p><a href="https://www.palgrave.com/gp/book/9783319689685">Our research suggests</a> that only a small fraction of older Europeans that have difficulty performing daily activities (such as dressing, walking or washing) are actually eligible to receive home care through the government. </p>
<p>But we also found that an increase in the amount of care that people receive at home through government-sponsored programmes, paradoxically, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3665">increases the amount of assistance they receive</a> from friends and family. This suggests that a long-term policy that expands access to home care may help older people maintain social ties, mental well-being, and cognitive function well into older age.</p>
<p>While prospects such as new drugs that protect against cognitive ageing are exciting, research shows that many simple policy changes can also promote social and emotional well-being – which may be just as important for maintaining brain function in later life. Even in the face of declining physical ability, programmes that provide long-term care at home may be critical for maintaining cognitive function and leading a <a href="https://www.pnas.org/content/116/4/1207">meaningful life at older age</a>.</p><img src="https://counter.theconversation.com/content/126314/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mauricio Avendano (<a href="mailto:mauricio.avendano_pabon@kcl.ac.uk">mauricio.avendano_pabon@kcl.ac.uk</a>) receives funding from the Economic and Social Research Council (ESRC), the National Institute for Health Research (NIHR) and the European Commission Horizon2020 Programme. </span></em></p><p class="fine-print"><em><span>Ludovico Carrino is research fellow at the Department of Global Health & Social Medicine at King's College London. He receives funding from the Economic and Social Research Council and the European Commission Horizon 2020 Programme. He is affiliated with the Department of Economics at the Ca' Foscari University of Venezia.</span></em></p>Simple policies, such as the free bus pass for older adults, not only reduce loneliness but also help older people maintain cognitive function.Mauricio Avendano Pabon, Professor of Public Policy & Global Health, King's College LondonLudovico Carrino, Research fellow, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1180462019-06-11T20:13:24Z2019-06-11T20:13:24Z‘I really have thought this can’t go on’: loneliness looms for rising numbers of older private renters<figure><img src="https://images.theconversation.com/files/278797/original/file-20190611-52776-m2eyee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People living in private rental housing were much more likely than social housing residents to say they felt lonely.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-sad-lonely-pensive-old-senior-45607705">Dundanim/Shutterstock</a></span></figcaption></figure><p>Loneliness is increasingly recognised worldwide as a critical social issue and one of the <a href="https://www.ncbi.nlm.nih.gov/pubmed/25910392">major health hazards of our time</a>. Our <a href="https://www.publish.csiro.au/book/7269/">research</a> shows older private renters are at high risk of loneliness and anxiety. This is a growing concern as <a href="https://theconversation.com/why-secure-and-affordable-housing-is-an-increasing-worry-for-age-pensioners-69350">more Australians are renting housing later in life</a>. By contrast, only a small proportion of the <a href="https://housing.vic.gov.au/social-housing">social housing</a> tenants we interviewed said they were lonely.</p>
<p>The links between housing arrangements and loneliness could have profound <a href="https://www.psychology.org.au/for-members/publications/inpsych/2018/December-Issue-6/The-impact-of-loneliness-on-the-health-and-wellbei">implications for our health</a>. As former US surgeon general Vivek H. Murthy <a href="https://www.washingtonpost.com/news/on-leadership/wp/2017/10/04/this-former-surgeon-general-says-theres-a-loneliness-epidemic-and-work-is-partly-to-blame">said</a>:</p>
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<p>The reduction in life span [for people experiencing loneliness] is similar to that caused by smoking 15 cigarettes a day, and it’s greater than the impact on life span of obesity … Look even deeper, and you’ll find loneliness is associated with a greater risk of heart disease, depression, anxiety and dementia.</p>
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Read more:
<a href="https://theconversation.com/why-secure-and-affordable-housing-is-an-increasing-worry-for-age-pensioners-69350">Why secure and affordable housing is an increasing worry for age pensioners</a>
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<h2>What causes loneliness?</h2>
<p>The causes of loneliness are multifaceted and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167494305000361">complex</a>. The <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2071.0%7E2016%7EMain%20Features%7ESnapshot%20of%20Australia,%202016%7E2">number of people living alone</a> in Australia is <a href="https://www.ahuri.edu.au/__data/assets/pdf_file/0016/2095/AHURI_Final_Report_No164_Housing,_loneliness_and_health.pdf">clearly a factor</a>. In 2016, just under one in four households (24.4%) were single-person households. That’s up from one in five in 1991. </p>
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Read more:
<a href="https://theconversation.com/one-in-four-australians-are-lonely-which-affects-their-physical-and-mental-health-106231">One in four Australians are lonely, which affects their physical and mental health</a>
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<p><a href="https://www.kff.org/other/report/loneliness-and-social-isolation-in-the-united-states-the-united-kingdom-and-japan-an-international-survey/">Research</a> suggests low-income individuals are more likely to experience loneliness. So, too, are people who have a serious mental or physical health condition or have had a serious disruptive event (financial or job loss, illness or injury, or relationship breakdown) in the last couple of years.</p>
<p>The <a href="https://www.ahuri.edu.au/__data/assets/pdf_file/0016/2095/AHURI_Final_Report_No164_Housing,_loneliness_and_health.pdf">impact of housing tenure on loneliness</a> has received little attention. While recognising that there are no definite associations, we interviewed about 80 older (65-plus) private renters and social housing tenants who depended on the <a href="https://www.humanservices.gov.au/individuals/services/centrelink/age-pension">Age Pension</a> for their income. These in-depth interviews indicated that their housing tenure was a critical factor in their risk of experiencing loneliness.</p>
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Read more:
<a href="https://theconversation.com/when-falling-home-ownership-and-ageing-baby-boomers-collide-102846">When falling home ownership and ageing baby boomers collide</a>
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<h2>Many older private renters are lonely</h2>
<p>Many older private renters have little disposal <a href="https://www.publish.csiro.au/book/7269/">income</a>, because the cost of housing uses up much of their income. They also live with the constant possibility that they may be asked to vacate their <a href="https://journals.sagepub.com/doi/10.1177/1440783317707833">accommodation</a>. Their limited budgets mean they often end up living in a poorly located property. These features, individually or in combination, create fertile ground for anxiety and loneliness.</p>
<p>Their dire financial situation was often an obstacle to social activities. One interviewee told of how she had to choose between food or breaking her isolation by using public transport.</p>
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<p>Well, you sort of think what you can do with $2.50. That’s a loaf of bread type of thing. <strong>– Beverley</strong> *</p>
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<p>A 72-year-old woman living by herself said she could not afford the outings organised by her church.</p>
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<p>There’s quite an active social club at the church for over-55s but I can’t go to any of those … Sometimes I think it would be nice to go on something that appeals to me, yes. And they might have an afternoon at somebody’s home and you’re asked to bring a plate [of food]. You see, I couldn’t afford to do that.</p>
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<p>Peter, 67 and divorced, had left the workforce prematurely due to ill-health.</p>
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<p>I’ve become very isolated. I used to, before I had the hip operation, I used to play tennis and I loved to play tennis … but I really can’t afford it. I’ve found a few clubs that I could go and play in. I’d like to get back to it, but they say, ‘Ah, the fees are this and you pay it annually,’ and I can’t come up with $150 or $200 or whatever.</p>
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<p>Lack of money and insecure tenure were sources of enormous distress and anxiety, which further discouraged social contact. Brigette (67) was brutally honest:</p>
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<p>You do get depressed and I believe that’s why people suicide … And there have been times when I’ve thought, what is the point to life? I really have thought this can’t go on, you know … I feel sorry for people because it is hard, and once you stay in it’s like crawling out of a slime pit … I have to say, ‘Get up and go out, go up the shops … Pretend you need potatoes or something.’</p>
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<p>Not all of the private renters interviewed experienced loneliness. These interviewees usually had strong family ties or had managed to find affordable and secure accommodation.</p>
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<strong>
Read more:
<a href="https://theconversation.com/many-people-feel-lonely-in-the-city-but-perhaps-third-places-can-help-with-that-92847">Many people feel lonely in the city, but perhaps 'third places' can help with that</a>
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<h2>Social housing tenants feel less isolated</h2>
<p>In sharp contrast, only a small proportion of the social housing tenants interviewed said they were lonely. Almost all were adamant they did not experience loneliness and felt they had strong social ties. Their affordable rent, security of tenure, long-term residence and having neighbours in a similar position meant they could socialise and were not beset by anxiety. </p>
<p>An 85-year-old long-established social housing tenant’s response to the question about loneliness and isolation was typical:</p>
<blockquote>
<p>I do like it around here. I know where everything is and I know all the people, especially around these units you know. I know everyone and they know me. I like it around here. This is my home, you know. This is a community, I think. Like I know all the people and we’ve become really good friends. I couldn’t think of being anywhere else. <strong>– Kay</strong></p>
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<p>Pam, who had been a private renter before being allocated social housing, reflected on how her life had changed:</p>
<blockquote>
<p>Well, it is changed because I’m happier and I think I’m healthier and I have a lot of new friends. I also have a lot more people around me for support if anything does happen. If I get sick and if they don’t see me for a few days someone will come and say, ‘Pam, are you OK?’ In private housing there was nobody.</p>
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<p>The <a href="https://journals.sagepub.com/doi/abs/10.1177/1440783313500856?journalCode=josb">residualisation</a> of social housing meant some tenants were living in what they perceived to be unbearable conditions. However, they generally were able to deal with their situation. Patricia coped with her very challenging neighbours by going to the local community centre.</p>
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<p>No, I hate it [public housing]. I live here [at the community centre] every day. Yes, I’m on the committee here and I do things every day. This is my home, my family. Everybody is friendly with everybody. We have outings and things.</p>
</blockquote>
<p>What the interviews indicate is that the housing tenure of age pensioners often plays a fundamental role in whether they are able to escape the experience of loneliness. Older private renters are far more likely to experience loneliness than their counterparts in social housing and that loneliness can be acute.</p>
<p><em>* All the names used are pseudonyms.</em></p>
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<strong>
Read more:
<a href="https://theconversation.com/designing-cities-to-counter-loneliness-lets-explore-the-possibilities-104853">Designing cities to counter loneliness? Let's explore the possibilities</a>
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<img src="https://counter.theconversation.com/content/118046/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alan Morris does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p><p class="fine-print"><em><span>Andrea Verdasco does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Increasing numbers of older Australians don’t own their homes. Whether they are private renters or live in social housing can make a big difference to their risk of loneliness and anxiety.Alan Morris, Research Professor, University of Technology SydneyAndrea Verdasco, Research Associate, University of Technology SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1061812018-11-23T12:05:03Z2018-11-23T12:05:03ZRobot carers could help lonely seniors — they’re cheering humans up already<figure><img src="https://images.theconversation.com/files/246841/original/file-20181122-182040-1ehikcv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Social robots are one way to provide lonely seniors with companionship.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/robot-friend-learning-teaching-mentally-disabled-1113194150?src=AFuOGtVppkajFdkMK1OEpQ-1-6">Miriam Doerr Martin Frommherz/ Shutterstock</a></span></figcaption></figure><p>The film <a href="https://www.imdb.com/title/tt1990314/">Robot and Frank</a> imagined a near-future where robots could do almost everything humans could. The elderly title character was given a “robot butler” to help him continue living on his own. The robot was capable of everything from cooking and cleaning to socialising (and, it turned out, burglary).</p>
<p>This kind of science fiction may turn out to be remarkably prescient. As growing numbers of elderly people require care, researchers believe that robots could be one way to address the overwhelming demand. But while robots might be able to provide care and, in some cases, social interaction, many wonder if they really are the right solution to this uniquely human issue. </p>
<p><a href="https://ec.europa.eu/digital-single-market/en/news/attitudes-towards-impact-digitisation-and-automation-daily-life">One recent survey</a> found that while 68% of people agree robots are beneficial because they can help people, only 26% surveyed said they’d be comfortable with a robot providing help and companionship for them if they were in hospital or care. Commentators in the media have also echoed these concerns, with some even arguing that robots can’t provide those living in care with the <a href="https://www.theguardian.com/commentisfree/2018/jul/02/robo-carers-human-principles-technology-care-crisis">empathy and altruism</a> that human caregivers do. </p>
<p>Loneliness and social isolation are already problems for many seniors and are even linked to <a href="http://www.pnas.org/content/110/15/5797.full">cognitive decline and a higher death rate</a>. With the population of seniors <a href="http://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pdf">expected to rise</a>, many worry that experiences of loneliness will increase, especially if access to care is even more limited.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/we-built-a-robot-care-assistant-for-elderly-people-heres-how-it-works-87108">We built a robot care assistant for elderly people – here's how it works</a>
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<p>But despite concerns, early studies already show that social robots – autonomous robots trained to interact and communicate with humans – really could address issues of care and social interaction. The majority of robotics researchers are largely in favour of introducing robotic technology on a wider scale and believe it could reduce loneliness and <a href="https://link.springer.com/article/10.1007/s12369-016-0350-2">increase independence in elderly patients</a>. The Japanese government even supports <a href="https://www.reuters.com/article/us-japan-ageing-robots-widerimage/aging-japan-robots-may-have-role-in-future-of-elder-care-idUSKBN1H33AB">introducing robots in care homes</a> to solve the country’s ageing population problem. However, many strongly recommend carefully <a href="https://link.springer.com/article/10.1007/s10676-010-9234-6">balancing the care benefits</a> against the ethical costs.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/246836/original/file-20181122-182071-y9vhkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/246836/original/file-20181122-182071-y9vhkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1242&fit=crop&dpr=1 600w, https://images.theconversation.com/files/246836/original/file-20181122-182071-y9vhkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1242&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/246836/original/file-20181122-182071-y9vhkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1242&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/246836/original/file-20181122-182071-y9vhkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/246836/original/file-20181122-182071-y9vhkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/246836/original/file-20181122-182071-y9vhkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A mobile robotic telepresence system.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Webot-2.jpg#filelinks">Dmitry Suvorov/ Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
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<p>A class of social robots – <a href="https://www.hindawi.com/journals/ahci/2013/902316/">mobile robotic telepresence (MRT) systems</a> – have already been shown to generate positive social interactions with elderly patients. MRTs are essentially video screens on wheels raised to head height that can be controlled remotely using a <a href="https://itunes.apple.com/gb/app/beam-smart-presence/id966441190?mt=8">simple smartphone app</a>. They allow relatives and social workers to “visit” elderly people more often, even if they live in rural or distant places. The elderly patient doesn’t need to operate the device, leaving them free to interact with their social worker or family. </p>
<p>Communication still happens through a computer screen, but the robot’s physical presence mimics face-to-face interaction for elderly people. Research has shown that <a href="https://www.sciencedirect.com/science/article/abs/pii/S107158191500004X">people reacted more positively</a> when talking with someone through an MRT than through a regular video call or computer avatar – especially lonely people. However, MRTs still require a human operator, which limits the amount of social interaction seniors can have daily. </p>
<h2>Carers of the future?</h2>
<p>To tackle this, developers worldwide have started creating robot companions programmed with advanced artificial intelligence (AI), which can interact with people on their own. Some examples include pet-like companion robots including <a href="https://us.aibo.com/">Aibo</a> and <a href="http://www.parorobots.com/">Paro</a>, which are made by Japanese developers, and <a href="http://consequentialrobotics.com/miro/">MiRo</a>, which is manufactured in the UK. Other humanoid robots, such as the <a href="https://www.care-o-bot.de/en/care-o-bot-4.html">Care-O-bot</a> and <a href="https://www.softbankrobotics.com/emea/en/pepper">Pepper</a>, are able to provide more complex and comprehensive care. </p>
<p>Though “pet” robots offer limited interaction, they have proved as effective – or even more so – than real pets in <a href="https://www.sciencedirect.com/science/article/pii/S1525861007005166">reducing loneliness</a> for elderly people in care homes. Robotic dogs introduced in one UK care home this year were <a href="https://www.carehome.co.uk/news/article.cfm/id/1598423/robotic-therapy-puppies-care-home-residents">reported to bring happiness and comfort</a> to residents. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/246840/original/file-20181122-182065-c50hkd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/246840/original/file-20181122-182065-c50hkd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/246840/original/file-20181122-182065-c50hkd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/246840/original/file-20181122-182065-c50hkd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/246840/original/file-20181122-182065-c50hkd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/246840/original/file-20181122-182065-c50hkd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/246840/original/file-20181122-182065-c50hkd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Humanoid robots like Pepper can provide more complex care to seniors.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/turin-italy-april-2018-pepper-robot-1071703310">MikeDotta/ Shutterstock</a></span>
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<p>On the other hand, humanoid robots are already advanced enough to <a href="https://www.mdpi.com/2218-6581/3/1/1">provide much-needed care</a> to elderly people. These robots can pick things up and move independently, and have a more natural, human way of interacting (for example, using arm and hand gestures).</p>
<p>More advanced versions have additional sensors and devices, including touchscreens. Many elderly people, finding the touchscreens hard to use, <a href="https://link.springer.com/article/10.1007/s11370-017-0237-6">preferred giving spoken commands</a> to the robot and reading its response off the screen. But for those with age-related hearing loss or vision impairment, having the option to use the touchscreen was indispensable. </p>
<p>Humanoid robots are still being developed, so their capabilities are still limited. And studies of humanoid robots have mainly focused on evaluating <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/soc4.12585">how well the technology functions</a> without really considering the social impact. There is also a general assumption that it will naturally reduce loneliness.</p>
<p>Though research into social robots is just beginning, we do know they can provide some solutions to the challenges mounted by ageing populations, and could even help reduce social isolation and loneliness. At this point, humans are still better in providing care and social contact to the elderly, but robots might be able to fill any gaps, especially as technologies continue to improve. </p>
<p>However, before social robots can be fully integrated into care homes, researchers and service provides must address public anxiety and make it clear that robots are designed to assist social workers, not replace them. As long as humans remain in full control to prevent any danger, robots might well be the future of care.</p><img src="https://counter.theconversation.com/content/106181/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alessandro Di Nuovo receives funding from the European Commission (Grant n. 703489, CARER-AID) and from the UK EPSRC (grant EP/P030033/1, NUMBERS).</span></em></p>Robots address challenges care systems face – and could even provide companionship to those who need it most.Alessandro Di Nuovo, Reader in Computational Intelligence and Robotics, Sheffield Hallam UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/921122018-03-05T19:21:56Z2018-03-05T19:21:56ZToo many Australians living in nursing homes take their own lives<figure><img src="https://images.theconversation.com/files/208842/original/file-20180305-65547-9d6kgs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Over half of nursing home residents suffer from depression.</span> <span class="attribution"><span class="source">from shutterstock.com</span></span></figcaption></figure><p>Around 140 Australian nursing-home residents took their own lives between 2000 and 2013, our new study shows. Published in the <a href="http://onlinelibrary.wiley.com/doi/10.1002/gps.4862/full">International Journal of Geriatric Psychiatry</a>, the study is the first to examine the number and <a href="http://onlinelibrary.wiley.com/doi/10.1002/gps.4299/full">patterns of suicide</a> in Australia’s nursing homes, and the largest such investigation in the world.</p>
<p>We found nearly 70% of those who took their own life were male, 66% had a diagnosis of depression and nearly 80% were experiencing one or more major life stresses, such as health deterioration. Around 43% were experiencing isolation and loneliness, and nearly 30% had trouble adjusting to life in a nursing home.</p>
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Read more:
<a href="https://theconversation.com/the-deadly-truth-about-loneliness-43785">The deadly truth about loneliness</a>
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<p>We examined the electronic and hard-copy records of each state and territory’s coroner and the investigations into these deaths. Details extracted included: the personal characteristics and health status of the individual; how, when and where the incident occurred; and organisational factors such as the size, location and ownership of the facility.</p>
<p>Our findings highlight that older men with depression entering aged care are at heightened risk of suicide and our aged-care system isn’t equipped to provide the support to protect them. </p>
<h2>Depression and suicide</h2>
<p>There are <a href="https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-and-aged-care-service-use/aged-care">more than 170,000 older adults</a> living in 2,700 nursing homes across Australia. This equates to around <a href="http://abs.gov.au/ausstats/abs@.nsf/Lookup/2071.0main+features602012-2013">6% of people</a> aged 65 and older, and represents one of society’s most vulnerable populations who depend on others for care.</p>
<p>Suicide is one of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384446/">leading causes of death</a> <a href="http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/">in many countries</a> for people aged between 15 and 29, so many assume it’s mainly a problem in younger people. But adults over 65 years (particularly males) have one of the <a href="http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/">highest suicide rates</a> of all age groups in many countries around the world.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/elderly-men-have-the-highest-suicide-rate-and-ageism-stops-us-from-doing-something-about-it-46923">Elderly men have the highest suicide rate – and ageism stops us from doing something about it</a>
</strong>
</em>
</p>
<hr>
<p>It’s hard to know how the suicide rate for those living in the community compares to those living in nursing homes, as these statistics are reported differently. But we do know more than 50% of residents in nursing homes <a href="https://www.aihw.gov.au/reports/aged-care/depression-in-residential-aged-care-2008-2012/contents/table-of-contents">suffer from depression</a> compared to just 10-15% of adults of the same age living in the community. </p>
<p>The small proportion of adults over 65 living with depression in the community shows that depression is not <a href="https://www.cdc.gov/aging/mentalhealth/depression.htm">a normal part of the ageing process</a>. Depression can be more difficult to diagnose in older adults, as they may themselves believe their symptoms to be a natural reaction to a physical illness or the life changes they are going through. </p>
<p>But the much larger figure of those suffering depression in nursing homes raises some serious questions. This includes whether these people were depressed before they were admitted to care, or became so afterwards.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208844/original/file-20180305-65541-1lcmy3y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Not everyone who is depressed takes their own life.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
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</figure>
<p>And while there are strong links between depression and suicidal behaviour, not everybody who is depressed takes their own life. Similarly, not every person admitted to aged care has a negative experience or response. So what needs to be done to ensure this tragedy doesn’t occur?</p>
<h2>What we need to do</h2>
<p>Most nursing home providers strive to provide safety and quality of care and lifestyle for their residents. But it’s clear the current approach to providing aged care isn’t enough when it comes to preventing suicides.</p>
<p>Change is required at a national policy level to lift the overall quality of aged care, with a specific focus on improving access to mental health services. Increased recognition of the risk of suicide among older adults is also required so targeted suicide prevention strategies can be included in the national suicide prevention framework.</p>
<p>The owners and providers of aged-care services must examine their own admission assessments for screening of depression and thoughts of suicide among residents, as well as follow-up procedures for residents who are showing signs of depression or not coping well with changes to their living situation.</p>
<p>Family and friends should look to maintain their loved ones’ social connections and feelings of being valued and to advocate for professional assessment and treatment if a resident is sad, lonely, isolated and withdrawing. This is not a sign of ageing.</p>
<p>Our research group has published <a href="http://www.vifmcommuniques.org/wp-content/uploads/2017/12/Recommendations-for-Prevention-of-Injury.pdf">recommendations to prevent injury-related deaths in residential aged care</a>, which includes a section on preventing suicide. This followed our <a href="https://www.mja.com.au/journal/2017/206/10/premature-deaths-nursing-home-residents-epidemiological-analysis">national study</a> demonstrating the extent of premature and preventable deaths in Australian nursing homes.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-older-people-in-care-die-prematurely-and-not-from-natural-causes-77942">Many older people in care die prematurely, and not from natural causes</a>
</strong>
</em>
</p>
<hr>
<p>With the ageing population, this issue should be an important social concern and a priority for prevention efforts.</p>
<p><em>If you or someone you know is experiencing depression or another mental health problem, contact <a href="http://www.lifeline.org.au/">Lifeline</a> 13 11 14, <a href="http://beyondblue.org.au/">beyondblue</a> 1300 22 4636 or <a href="http://www.sane.org/">SANE Australia</a> 1800 18 7263.</em></p><img src="https://counter.theconversation.com/content/92112/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joseph Ibrahim received partial funding from the Commonwealth and State Health Department (Victoria) for this research. Joseph also has funding grants from Dementia Training Australia and Victorian Managed Insurance Authority. </span></em></p><p class="fine-print"><em><span>Briony Murphy does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Around 140 Australian nursing-home residents have taken their own lives between 2000 and 2013, our new study shows.Briony Murphy, PhD Candidate, Epidemiology & Forensic Medicine, Monash UniversityJoseph Ibrahim, Professor, Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/919312018-03-05T14:19:47Z2018-03-05T14:19:47ZLoneliness is not just an issue in old age – young people suffer too<figure><img src="https://images.theconversation.com/files/208889/original/file-20180305-65511-jkj3p4.jpg?ixlib=rb-1.1.0&rect=3%2C329%2C2488%2C1968&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/picture-lonely-girl-walking-along-city-61626385?src=32aPL5BaUzAdO9NqUw5gow-2-83">Shutterstock.</a></span></figcaption></figure><p>In old age, many people experience a decline in their physical health, which can mean they are less confident about getting around and socialising as they used to. Loneliness affects over <a href="https://www.ageuk.org.uk/information-advice/health-wellbeing/loneliness/">a million older adults</a> across the UK; <a href="http://webarchive.nationalarchives.gov.uk/20160105214013/http://www.ons.gov.uk/ons/rel/census/2011-census-analysis/do-the-demographic-and-socio-economic-characteristics-of-those-living-alone-in-england-and-wales-differ-from-the-general-population-/story-characteristics-of-those-living-alone.html#tab-Age-and-sex-analysis">over half</a> of people aged 75 and over live alone, and <a href="https://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Policy/ID202014_agenda_for_later_life_report_2014.pdf?dtrk=true">one in ten</a> people over 65 say they always or often feel lonely. And there’s evidence to show that feeling lonely can cause existing physical health problems such as <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/rb_april15_vulnerability_resilience_improving_later_life.pdf">frailty or chronic pain</a> to get worse.</p>
<p>But while <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/rb_april15_vulnerability_resilience_improving_later_life.pdf">awareness has grown</a> about loneliness among older people, far less attention is given to how it affects young people. <a href="https://www.nspcc.org.uk/what-we-do/news-opinion/loneliness-key-concern-thousands-children/">An NSPCC report</a> revealed that in 2016-17, Childline counselled over 4,000 young people about loneliness. <a href="https://universitybusiness.co.uk/Article/uk-students-admit-loneliness">Students are affected too</a>, with almost half admitting to feeling lonely during their time at university. Indeed, a <a href="http://www.tandfonline.com/doi/full/10.1080/09638237.2018.1437608?needAccess=true">recent survey</a> of university students suggested that loneliness is the leading predictor of mental distress. </p>
<h2>A social issue</h2>
<p>Loneliness is not only a health issue, but a social issue. That’s why social psychologists like myself set out to explore the social causes of loneliness, and understand why people may begin to feel lonely in the first place. People of all ages can face difficulties when adjusting to life’s changes, or seeking a sense of belonging among others who share similar goals and interests. </p>
<p>Young people experience periods of transition, just as older people do. Whether they’re facing changes at school, college, university or work, or difficulties with friends or family, most young people need to readjust to big changes at several points throughout their teenage years or early adulthood. </p>
<p>Transitioning from one stage of life to another often means a shift in identity, which challenges our sense of self. Establishing a new identity can take time, as can finding and connecting with others who seem to think like us, or share similar interests and goals. Whether old or young, most people have a strong need to feel a <a href="http://onlinelibrary.wiley.com/doi/10.1002/1520-6629(198601)14:1%3C6::AID-JCOP2290140103%3E3.0.CO;2-I/abstract">sense of belonging</a>, and a connection with like-minded others.</p>
<h2>A social solution</h2>
<p>Communities can provide the sense of identity and belonging, which protects people from feeling lonely in times of change. Whether it be a physical community, such as a neighbourhood or campus, or a community of people with shared experiences, passions or culture, having a hub of people to connect with is good for our <a href="http://www.compsy.org.uk/Making%20a%20difference%20(proof%203).pdf">health and well-being</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fancy a cuppa?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-granddaughter-visiting-her-grandma-laughing-628433561?src=HfrQnJc8ztIdjHXItitAtw-2-12">Shutterstock.</a></span>
</figcaption>
</figure>
<p>Fostering community is one way to take action against loneliness. Bringing <a href="https://theconversation.com/heres-why-some-dutch-university-students-are-living-in-nursing-homes-68253">older and younger people together</a> can help to tackle loneliness across the course of life, by identifying common interests shared across the generations. Activities such as gardening, photography or simply sharing a cup of tea can spark friendships which span the age gap, and foster a sense of belonging. </p>
<p>For example, the <a href="http://www.emil-network.eu/wp/wp-content/uploads/eScouts-EMIL-case-study.pdf">eScouts</a> intergenerational learning exchange, which took place in several countries across Europe, had almost 100 young people teach 420 older adults skills needed to access digital technology and the internet. The exchange improved quality of life and social inclusion among young and old. And London-based charity <a href="https://magicme.co.uk/">Magic Me</a> runs intergenerational arts projects and works with schools, care homes and communities to bring people of all ages together in creative activities.</p>
<p>These sorts of projects are promoted as a way of reducing loneliness and isolation in older people. But younger people can benefit just as much, given the chance to connect with a community and forge rewarding friendships. Still, community projects alone will not solve the problem of loneliness in young or old. To truly succeed, projects need to be built with older and younger people and not simply for them, they need time and space to develop and appropriate resources such as accessible community centres and equipment. </p>
<p>Beyond that, bigger factors such as <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1468-2397.2007.00503.x/full">poverty and inequality</a> can fuel loneliness in both younger and older people. Community projects alone cannot address these causes, though they do provide opportunities for young and old to connect and build a sense of belonging. For that reason, youth groups, schools, colleges and universities should create as many opportunities as possible for young people to connect with older adults – after all, both will benefit.</p><img src="https://counter.theconversation.com/content/91931/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Wright-Bevans received funding from the Beth Johnson Foundation and Stoke-on-Trent Public Health to support research on intergenerational practice.</span></em></p>Both young and old can feel like they don’t belong. But loneliness is a social problem, with a social solution.Katie Wright-Bevans, Lecturer in Psychology, Keele UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/908042018-02-08T11:20:52Z2018-02-08T11:20:52ZWhat the joyous solitude of early hermits can teach us about being alone<figure><img src="https://images.theconversation.com/files/205374/original/file-20180207-74490-19hsdx8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Loneliness (feeling alone) and solitude (being alone) are not the same thing.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/jessicatam/4126954000">jessicahtam</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>In today’s world, loneliness seems to have reached <a href="http://www.wbur.org/onpoint/2018/01/23/the-loneliness-epidemic">epidemic</a> proportions. Countless studies have highlighted the serious and negative impact that loneliness has on our <a href="http://fortune.com/2017/08/07/loneliness-public-health/">health</a>, our sense of well-being, and our ability to thrive in an increasingly chaotic world. Most recently, the urgency of the problem led the U.K. to appoint a <a href="https://www.theguardian.com/society/2018/jan/23/tracey-crouch-minister-loneliness-friends-powerful-vested-interests">minister for loneliness</a>. Here in the U.S., winter is a particularly lonely time for <a href="https://www.theweathernetwork.com/news/articles/loneliness-epidemic-more-deadly-than-obesity-winter-days-colder-darker-tips/89800">elderly Americans</a>.</p>
<p>But loneliness (feeling alone) and solitude (being alone) are not the same thing. And lessons can be learned from those who have found solitude essential for inspiration. </p>
<h2>In praise of solitude</h2>
<p>Solitude – being alone – has long been praised as a necessary condition for <a href="http://www.simonandschuster.com/books/Solitude/Anthony-Storr/9780743280747">creativity</a>. Author Virginia Woolf, in her book <a href="https://www.bl.uk/collection-items/a-room-of-ones-own-by-virginia-woolf">“A Room of One’s Own,”</a> offered an extended meditation on the writer’s need for solitude. So did many poets. In their writings, May Sarton (“alone one is never lonely”) and William Wordsworth (“the bliss of solitude”) were <a href="https://www.brainpickings.org/2017/12/01/may-sarton-canticle-6-considerations/">especially eloquent in their praise of solitude</a>. Poet Marianne Moore has even argued that “the cure for loneliness is solitude.”</p>
<p>My research on the history of religious <a href="https://www.penguin.co.uk/books/1044263/hermits/">hermits</a> shows that there have long been individuals who seek solitude in remote and silent places, and there are many lessons to be learned from them. The etymological history of the word “hermit” is itself telling: “Hermit” comes from an ancient Greek word, <a href="https://www.areopage.net/PDF/LSJ.pdf">“eremos,”</a> that means both a desolate and lonely place and a state of being alone.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/205380/original/file-20180207-74470-bgl2wt.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/205380/original/file-20180207-74470-bgl2wt.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/205380/original/file-20180207-74470-bgl2wt.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/205380/original/file-20180207-74470-bgl2wt.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/205380/original/file-20180207-74470-bgl2wt.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/205380/original/file-20180207-74470-bgl2wt.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/205380/original/file-20180207-74470-bgl2wt.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">St. George of Choziba hermitage, Judean Desert, Israel.</span>
<span class="attribution"><span class="source">Kim Haines-Eitzen</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Hermits exist in many of the world’s major <a href="http://www.newworldencyclopedia.org/entry/Hermit">religious traditions</a>: They are individuals who choose temporary or permanent solitude in remote and isolated locations, such as <a href="https://www.cambridge.org/core/books/landscape-nature-and-the-sacred-in-byzantium/2493D29303E59E4E8F13B8B528363215">mountains, caves and deserts</a>. These locations are frequently depicted as sites for revelation and transformation.</p>
<h2>Romantic longing of solitude</h2>
<p>The emergence of hermits in early Christianity is particularly striking. </p>
<p>When early Christians read their Bible, they found the word <a href="https://global.oup.com/academic/product/a-patristic-greek-lexicon-9780198642138?cc=us&lang=en&">eremos</a> referring to places for important events: the stories of the Israelites wandering in the <a href="https://global.oup.com/academic/product/the-solace-of-fierce-landscapes-9780195315851?cc=us&lang=en&">wilderness</a> for forty years, how Jesus went to a “lonely place” to pray, or how he was tempted by the devil in the desert. These stories evoked images of remote landscapes that most Christians never visited. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/205381/original/file-20180207-74497-vey51r.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/205381/original/file-20180207-74497-vey51r.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/205381/original/file-20180207-74497-vey51r.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/205381/original/file-20180207-74497-vey51r.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/205381/original/file-20180207-74497-vey51r.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/205381/original/file-20180207-74497-vey51r.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/205381/original/file-20180207-74497-vey51r.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">St. George of Choziba monastery, Judean Desert, Israel.</span>
<span class="attribution"><span class="source">Kim Haines-Eitzen</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>In the fourth century, however, a <a href="https://global.oup.com/ushe/product/desert-christians-9780195162233?cc=us&lang=en&">monastic movement</a> emerged in Egypt, as some Christians began to withdraw permanently into “the desert.” The harshness of a dry and barren landscape suited Christians eager to pursue an <a href="https://global.oup.com/academic/product/the-word-in-the-desert-9780195083330?cc=us&lang=en&">ascetic</a> life. </p>
<p>A common theme in stories about early Christian desert hermits is a desire to leave the distractions of urban life and live a precarious existence in isolation in order to achieve holiness. </p>
<p>The most famous Christian hermit was Antony, whose story was told by <a href="https://www.cistercianpublications.org/Products/CS202/The-Life-of-Antony-The-Coptic-Life-and-The-Greek-Life">Athanasius</a>, the fourth-century bishop of Alexandria. As Athanasius tells it, Antony one day heard a passage from the Gospel of Matthew in his church:</p>
<blockquote>
<p>“If you want to be perfect, go, sell all your possessions and give to the poor, and come follow me, and you will have treasure in heaven.” (Matthew 19:21)</p>
</blockquote>
<p>He felt the passage had spoken to him directly. </p>
<p>Antony sold his property and departed for the desert. The story of Antony’s withdrawal into the desert became an example for later Christians eager to pursue solitude and contemplation. Athanasius says that, in spite of his quest for solitude, the desert <a href="https://www.svspress.com/desert-a-city-the/">“was made a city”</a> by visitors to Antony’s hermitage and by monks who wished to emulate him. Antony needed to move into more and more remote areas to find the isolation he was seeking.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/205376/original/file-20180207-74482-sgjkvs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/205376/original/file-20180207-74482-sgjkvs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/205376/original/file-20180207-74482-sgjkvs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/205376/original/file-20180207-74482-sgjkvs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/205376/original/file-20180207-74482-sgjkvs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=518&fit=crop&dpr=1 754w, https://images.theconversation.com/files/205376/original/file-20180207-74482-sgjkvs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=518&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/205376/original/file-20180207-74482-sgjkvs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=518&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">St. Anthony visits St. Paul in the wilderness.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File%3ASaint_Anthony_Visits_Saint_Paul_in_the_Wilderness_LACMA_M.69.86.jpg">Albrecht Dürer (Germany, Nuremberg), 1471-1528.</a></span>
</figcaption>
</figure>
<h2>The joy of loneliness</h2>
<p>Eventually, <a href="https://books.google.com/books/about/Ascetics_Society_and_the_Desert.html?id=zcSEkYprImoC">forms of monasticism</a> developed that embraced both the solitary and the communal: Monasteries developed around communities of <a href="https://yalebooks.yale.edu/book/9780300049770/judean-desert-monasteries-byzantine-period">monks</a> in the mountains and canyons of Egypt, Sinai and Palestine. Nearby caves served as <a href="https://www.jstor.org/stable/20618791?seq=1#page_scan_tab_contents">hermitages</a>.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/205378/original/file-20180207-74501-1u9gei5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/205378/original/file-20180207-74501-1u9gei5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=739&fit=crop&dpr=1 600w, https://images.theconversation.com/files/205378/original/file-20180207-74501-1u9gei5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=739&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/205378/original/file-20180207-74501-1u9gei5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=739&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/205378/original/file-20180207-74501-1u9gei5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=929&fit=crop&dpr=1 754w, https://images.theconversation.com/files/205378/original/file-20180207-74501-1u9gei5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=929&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/205378/original/file-20180207-74501-1u9gei5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=929&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Is there joy in loneliness?</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/adrazahl/5292753659/in/photolist-4onTXU-5aEC81-YdnJw-76St-6oTV7X-bBtNvY-68XfKx-gmzDWu-aiNBCB-5tzTXL-nkQuz9-bDp7Sf-A7ZBdT-6XT2ob-afEdaQ-5SdiVo-2qjJZw-4k2aAU-6quyQx-5rx29C-JHjENe-5cs7cP-sa2MMe-cw9zq3-dF1H5X-9NxhvJ-bE11aU-5LcVY6-6EyJQQ-4GUmE-cdb9J-FZS7v-nubzLN-4wU1C5-966ZZH-qX4q8C-26pto-5kcwae-tUNYq-dcm3h2-H69ez-94GKgr-4cmTE1-gymTBt-azs49Q-xsbSA-zzNCxG-6MQcai-3g2ZRQ-UTGYrE">adrazahl</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>This way of life was in keeping with what many Christians believed – that <a href="https://www.taylorfrancis.com/books/9781134798957">suffering</a> was necessary for salvation. They praised the hermits who rejected the comforts of city and adopted the communal life. To them, the hermits were models of holiness and, paradoxically, happiness. </p>
<p>Loneliness was transformed into joy. Athansius describes Antony’s <a href="http://california.universitypressscholarship.com/view/10.1525/california/9780520222052.001.0001/upso-9780520222052">face</a> as “radiant” after a long period of isolation. </p>
<p>The lives of hermits may seem distant from our busy contemporary lives. But the romantic appeal of an unencumbered and undistracted life has not disappeared. Hermits in the 21st century come from all walks of life, <a href="https://www.washingtonpost.com/news/in-sight/wp/2015/11/16/inside-the-life-of-a-modern-day-hermit/?utm_term=.328ff80b69a9">religious</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536505/">secular</a>, but share with those from the past a longing for quiet solitude and simplicity.</p>
<p>Could the wisdom of artists, poets, and religious hermits offer comfort in a time of loneliness today?</p><img src="https://counter.theconversation.com/content/90804/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kim Haines-Eitzen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>For those who are finding the social distancing isolating, here are some lessons from ancient hermits, who often found joy in being alone.Kim Haines-Eitzen, Professor of Early Christianity, Cornell UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/889722017-12-18T14:16:02Z2017-12-18T14:16:02ZLoneliness is not just for Christmas – but by the flurry of charity messages you’d think otherwise<figure><img src="https://images.theconversation.com/files/199695/original/file-20171218-27607-1syam0q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It seems loneliness among older people is expected – by everyone except the elderly themselves.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/publicplaces/7465687106/in/photostream/">publicplaces</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>A new pre-Christmas tradition has emerged alongside the traditional activities of present buying, planning huge meals, and attending school nativity plays: a focus in the media by predominantly by age-related charities on loneliness among older people.</p>
<p>And like all other aspects of Christmas this starts earlier each year. I received my first Christmas appeal letter on the subject from Age UK at the end of September, urging that “no one should have no one at Christmas”. The charity created a <a href="https://www.ageuk.org.uk/get-involved/no-one/">short film linked to the campaign</a> highlighting the plight of lonely older people at Christmas. The following week another arrived from the Alzheimer’s Society, bearing the slogan: “No tree, no lights, no family.”</p>
<p>Now that Christmas is almost upon us, the focus on loneliness has intensified. Silverline, a telephone support service for older people, is running a campaign entitled <a href="https://www.thesilverline.org.uk/foamalone/">Foam Alone</a>, with their services <a href="http://www.telegraph.co.uk/news/2017/12/09/got-look-otherduchess-cornwall-urges-public-volunteer-fight/">endorsed by prominent supporters including royalty</a>. Barbers are offering elderly men free haircuts as part of a campaign entitled <a href="http://metro.co.uk/2017/11/22/campaign-urges-barbers-to-tackle-loneliness-by-offering-free-haircuts-to-elderly-men-7097724/0">Shave The Day</a>, while a pub in Wimbledon, south London, is offering a <a href="https://twitter.com/TheAlexSW19/status/930081574204399616">free Christmas meal</a> to old folks who are alone on Christmas day.</p>
<p>Taken together these campaigns paint a specific picture about loneliness in contemporary Britain, and the focus upon older people is obvious. Although some philosophers have argued that <a href="http://www.iep.utm.edu/sartre-p/">loneliness is simply part of being human</a>, it is more typically portrayed as almost inevitably a “problem” that is part of normal ageing: to grow old is to grow alone.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">An Age UK campaign that focuses on social isolation among those in later life.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/howardlake/14488831179">howardlake</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<h2>Perception more than reality</h2>
<p>Surveys which look at people’s expectations of old age show that about one third of respondents indicate they believe loneliness to be one of the major challenges they face. Other data from the <a href="http://www.tandfonline.com/doi/full/10.1080/13607863.2015.1023767">English Longitudinal Survey of Ageing</a> suggest that around 30% expect to get lonelier as they age, and 25% think increased feelings of loneliness is part of ageing. But among older people themselves, only 15% see it as an issue.</p>
<p>Loneliness can be measured in many ways. However research consistently shows that, at any one time, about 10% of those aged 60 and over report significant feelings of loneliness, and that this proportion is <a href="https://www.cambridge.org/core/journals/ageing-and-society/article/has-loneliness-amongst-older-people-increased-an-investigation-into-variations-between-cohorts/34604FCD5672C84FC2D65EEDDE332E35">largely unchanged since the late 1940s</a>. The level of loneliness reported by young adults aged 16-24 is comparable to that for older people – but discussions about loneliness at Christmas rarely feature young people.</p>
<p>As a gerontologist, someone who studies older age, perhaps I should not worry about the exclusion of younger people from debates about loneliness at Christmas, and should celebrate that for once issues around old age and older people are being taken seriously by the media. But the representation of older people as lonely, without family or friends, is not a very positive prospect to look forward to. </p>
<p>It is one of the many negative depictions of older people and later life that abound, and which may explain why many of us have such low expectations of our twilight years. We dread old age, rather than see the opportunity to grow old as a privilege that is a consequence of improvements in public health, workplace safety, and access to good food and housing – the lack of which shortened many lives in the early 20th century.</p>
<p>Another issue is the timing. The Age UK survey from 2017 reports that <a href="https://www.ageuk.org.uk/latest-news/articles/2017/december/almost-a-million-older-people-feel-lonelier-at-christmas/">almost 1m older people feel lonelier at Christmas time</a>. Without comparable data for younger people or other groups, we cannot say whether the perception of increased loneliness at Christmas is exclusive to older people, or something that affects other groups equally.</p>
<p>As an example, a unique but small study asked older people in West London how they felt over the course of a year, and found that feelings of loneliness <a href="https://benthamopen.com/ABSTRACT/TOPSYJ-8-97">rose in summer rather than in winter or at Christmas time</a>. We might speculate that while families may invite older relatives for Christmas lunch, they may be less likely to invite grandma to a family holiday abroad or to a summer barbecue. But without data to compare with other age groups we can draw only limited conclusions.</p>
<p>The new <a href="https://www.jocoxloneliness.org/pdf/_a_call_to_action.pdf">Jo Cox Commission</a> report into loneliness and social isolation, launched after a “loner” and white supremacist <a href="https://www.theguardian.com/uk-news/2016/nov/23/thomas-mair-found-guilty-of-jo-cox-murder">murdered the MP during the EU referendum campaign</a> reported that loneliness does not discriminate between young or old. This should serve to prompt us to turn our obsession away from loneliness among older people at Christmas towards a broader understanding that loneliness can affect other groups of all ages and at any time. Loneliness is not just for Christmas.</p><img src="https://counter.theconversation.com/content/88972/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christina Victor receives funding from ESRC, Dunhill Medical Trust.</span></em></p>Older people are less lonely than we think, but more importantly loneliness is something they face all year round – not just at Christmas.Christina Victor, Professor of Gerontology and Public Health, Brunel University LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/872092017-12-07T13:33:34Z2017-12-07T13:33:34ZIt’s time to recognise how harmful high-rise living can be for residents<figure><img src="https://images.theconversation.com/files/198143/original/file-20171207-5048-1dio4x5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/34547181@N00/28371618145/sizes/l">Phillippe Put/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>The fire at Grenfell Tower has catapulted high-rise social housing into the public consciousness, in a way not seen since the 1960s. Back then, high-rise tower blocks represented a new vision of social progress. They were greeted with hope and optimism by housing officials, architects and town planners across the UK. But now, the mood has turned to one of bitterness, anger and fear. Over the years, most of these so-called “villages in the sky” have become <a href="https://theconversation.com/thatcher-helped-people-to-buy-their-own-homes-but-the-poorest-paid-the-price-50133">concrete containers</a> for society’s poorest and neediest people.</p>
<p>This is not just an issue in the UK. Today, millions of people live in high-rise apartment blocks around the world. In <a href="https://www.emporis.com/statistics/skyline-ranking">Moscow alone</a>, there are 11,783 high-rise towers, in Hong Kong there are 7,833, and in Seoul there are over 7,000, many of which are residential. Understanding the link between high-rise living and mental health is crucial to protect the well-being of tower block residents across the globe. </p>
<h2>Living in fear</h2>
<p>High-rise living evokes unsettling fears – residents could be trapped in a fire, or fall or jump from the tower. The sheer number of people sharing a single building can also increase the threat from communicable diseases such as influenza, which <a href="https://www.cdc.gov/flu/about/disease/spread.htm">spread easily</a> when hundreds of people share a building’s hallways, door handles and lift buttons. </p>
<p>Sharing semi-public spaces with strangers can <a href="http://www.tandfonline.com/doi/abs/10.3763/asre.2007.5002">make residents</a> more suspicious and fearful of crime. Many feel an absence of community, despite living alongside tens or hundreds of other people. And in earthquake-prone countries, residents of high-rise towers face the possibility that <a href="https://www.theguardian.com/cities/2015/sep/18/mexico-city-earthquake-30-years-lessons">their entire building could collapse</a>.</p>
<p>Perhaps most poignant of all is the fear of isolation. During ongoing <a href="https://link.springer.com/article/10.1007/s11205-017-1812-0?wt_mc=Internal.Event.1.SEM.ArticleAuthorOnlineFirst">research into social isolation</a> among older people in the English city of Leeds, residents of high-rise buildings reported feeling lonely and isolated – some were afraid to even open their front doors. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A lonely life.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-lady-sadly-sitting-near-window-769083229?src=9xqshzFU7UQYGWBWXprb4Q-1-0">from www.shutterstock.com</a></span>
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<p>Many of these older residents rely on networks of neighbours, friends and family to help them get around and perform basic chores. One wheelchair user explained how she relied on her neighbour to help her get to the lift and out of the block. If her neighbour is not there, she is stuck. </p>
<p>Living with fear every day means that residents of high-rise housing – and especially social housing – <a href="https://www.mentalhealth.org.uk/a-to-z/f/fear">are vulnerable to</a> mental health issues. Psychologists <a href="http://bjp.rcpsych.org/content/128/3/259.short">have been investigating</a> this link since the 1970s – a <a href="http://trove.nla.gov.au/work/9163615?selectedversion=NBD1538169">1979 study</a> based in Glasgow found evidence that high-rise residents were presenting psychological symptoms more often than other housing residents. </p>
<p><a href="http://www.tandfonline.com/doi/abs/10.1300/J083v16n03_06">Another paper</a> from 1991 compared elderly African-Americans living in high-rise and low-rise buildings in Nashville. The high risers had a higher incidence of depression, phobias, schizophrenia. </p>
<h2>The true causes?</h2>
<p>But researchers aren’t always comparing like with like. In Nashville, although the residents shared the same ethnic background, high risers were poorer, less educated and had fewer social contacts: all factors which may contribute towards mental ill health. </p>
<p>So it’s difficult to say whether it’s the building itself, or other hardships such as poverty, which cause high-rise residents such difficulties. Yet there is some evidence to suggest that high-rise buildings themselves are actually responsible for some of the harms done to residents. </p>
<p>For example, in Singapore, between 1960 and 1976, the percentage of people living in high-rise buildings climbed from 9% to 51%. During the same period, the per capita rate of suicides by leaping from tall buildings <a href="http://www.tandfonline.com/doi/abs/10.3763/asre.2007.5002">increased fourfold</a>, while suicide by other means declined. </p>
<p>This could be for one of two reasons. Either more people became suicidal and would have found a way to commit suicide by any means – or greater access to tall buildings gave more people a means of killing themselves, which they wouldn’t otherwise have done. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=332&fit=crop&dpr=1 600w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=332&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=332&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=417&fit=crop&dpr=1 754w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=417&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=417&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Singapore’s high rise residences.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/volvob12b/17386735395/sizes/l">Bernard Spragg/Flickr</a></span>
</figcaption>
</figure>
<p>The overall suicide rate in Singapore increased by 30% over the aforementioned period but the rate by leaping increased many times faster, which suggests that having more tall buildings leads to more suicides. While suicide rates have been stable for five decades now, jumping from buildings remains a <a href="http://eu.wiley.com/WileyCDA/WileyTitle/productCd-1118903277.html">common method for suicide</a> there, as well as in other cities where high rise buildings are ubiquitous – such as Hong Kong, New York City, Taipei City. </p>
<p>Yet high-rise living can have its positives. Roughly four in five Singaporeans live in public housing – almost all of it high-rise. Older buildings are regularly refurbished and most are near to local food markets, parks and sports halls. Some even have sky gardens and rooftop running tracks. </p>
<p>All of these factors can help to create a less stressful environment. What’s more, in Singapore, the residents of public housing are deliberately <a href="https://www.ft.com/content/49955844-6563-11e7-9a66-93fb352ba1fe">mixed by income and ethnicity</a>, so that each neighbourhood is reflective of the population as a whole – this helps to avoid the kind of social segregation that tends to occur in the UK. If this example is followed in other cities across the globe, then living in high-rise towers might not be quite so damaging after all.</p><img src="https://counter.theconversation.com/content/87209/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrea Wigfield receives funding from Leeds City Council. </span></em></p><p class="fine-print"><em><span>Royce Turner does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Residents may be right to fear for their lives.Royce Turner, Research assistant and policy analyst, University of HuddersfieldAndrea Wigfield, Director, Care-Connect, University of SheffieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/872172017-11-12T23:09:53Z2017-11-12T23:09:53ZLoneliness could kill you<figure><img src="https://images.theconversation.com/files/194015/original/file-20171109-13296-zeo2ob.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Studies are showing that loneliness can be deadly, even more so than obesity. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Independence is glorified in North American culture as a symbol of strength. As a society, we value individual achievement and extol self-reliance.</p>
<p>I am an expert on aging and retirement and I also help employees transition from work to retirement by facilitating seminars and workshops in corporate Canada. And I often wonder however if our “go at it alone” attitude has led us down a lonely and isolating path.</p>
<p>Here are some recent stats: </p>
<ul>
<li><p>40 per cent of Americans <a href="https://hbr.org/cover-story/2017/09/work-and-the-loneliness-epidemic">don’t feel close to others</a> at any given time. And the number of lonely Americans has doubled since the 1980s.</p></li>
<li><p><a href="http://www.carp.ca/2017/06/05/loneliness-survey-results/">In a recent Canadian Association of Retired People poll</a>, 16 per cent of Canadians indicated that they lacked companionship</p></li>
<li><p>Fifteen per cent in the CARP poll said they had nobody to turn to or talk to</p></li>
<li><p>Fifteen per cent were unhappy doing things alone.</p></li>
</ul>
<p>I suspect that these numbers are even higher among the general Canadian population, not just CARP members.</p>
<p>According to science, loneliness shortens our lifespan. <a href="https://news.uchicago.edu/article/2014/02/16/aaas-2014-loneliness-major-health-risk-older-adults">Twice as much as obesity.</a> Yes, you read that right.</p>
<p>Dr. John <a href="http://psychology.uchicago.edu/people/faculty/cacioppo/">Cacioppo</a>, the world’s foremost authority on loneliness, maintains that the number of people in your life does not inoculate you from experiencing loneliness. Rather, it’s the feeling of being lonely that places the brain and body at risk.</p>
<p>Cacioppo equates feeling lonely with feeling hungry. We compromise our survival and well-being when either is ignored.</p>
<p>We are biologically hardwired to respond to our environment. When we experience low blood-sugar levels, we crave food. The feeling of our stomachs being empty is a warning sign to eat and it’s essential to our very survival.</p>
<p>When we feel lonely, we desire connection with others, much like the loud rumble that your tummy makes when hungry.</p>
<h2>A lonely brain is restless</h2>
<p>Loneliness triggers “hyper-vigilance.” That is your brain is on the lookout for social threats, which consequently puts us on the defensive. We become more reactive to negative events and perceive daily hassles as more stressful.</p>
<p>A lonely brain awakens often, experiences fragmented sleep and cannot recover from the day’s stressful events.</p>
<p>A lonely brain is also subject to an increase in depressive symptoms and has difficulty self-regulating. That is why you may find yourself irritable and impulsive.</p>
<p>A lonely brain is also at risk of cognitive and physical decline.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/23232034">A three-year Dutch study</a> followed more than 2,000 participants aged 65 to 86. While none of the participants had signs of dementia at the outset of the study, results revealed that those who reported feeling lonely had a 64 per cent increase in the risk of developing dementia.</p>
<p>People also experience an increase in loneliness when they retire from work. That’s why you want <a href="http://rewiretoretire.com/delay-retirement/">to make sure that you’re retiring <em>to</em> something</a>, and that you have friends outside of your place of employment. </p>
<h2>A lonely body</h2>
<p>Loneliness also affects the body. Psychologist <a href="https://irp.nih.gov/pi/stephen-suomi">Stephen Suomi’s</a> research indicates that loneliness distorts the expression of certain genes. An experiment separating newborn primates from their mothers during their first four months of life resulted in the altered development of immunity-related genes that help the body fight viruses.</p>
<p>Social psychologist <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633610/">Lisa Jaremka’s research</a> indicates that lonely people have higher levels of activated viruses in their system and are at greater risk of suffering from chronic inflammation, which has been linked to Type 2 diabetes, arthritis, heart disease and even suicide.</p>
<p>While obesity increases your odds of an early death by 20 per cent, loneliness increases <a href="https://www.ucsf.edu/news/2012/06/12184/loneliness-linked-serious-health-problems-and-death-among-elderly">your odds by 45 per cent</a>.</p>
<p>What are we to do with an emotional state that is so powerful that it can alter our brains, compromise our physiology and cut short our longevity?</p>
<h2>The antidote to loneliness</h2>
<ol>
<li><p>Seek out connection: We all need a tribe!</p></li>
<li><p>Stop denying and accept “feeling lonely” as simply a craving for connection.</p></li>
<li><p>Acknowledge the consequences of prolonged loneliness. If you ignore hunger, you starve. Same is true of our need for belonging. If you feel lonely, reach out to others.</p></li>
<li><p>Recognize that quality relationships are most effective at feeding this void.</p></li>
</ol>
<p>We are physiologically and psychologically primed for connection.</p>
<p>The next time you feel lonely and out of sorts, acknowledge it as a signal that you are in need of connection and seek out companionship.</p>
<p>Your body and your brain will be thankful that you did, and you may even increase your longevity.</p><img src="https://counter.theconversation.com/content/87217/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gillian Leithman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Loneliness shortens our life spans and some studies suggest it’s even more lethal than obesity. We are physiologically and psychologically primed for connection, so don’t shrug off your loneliness.Gillian Leithman, Assistant Professor of professional business skills and aging, retirement, and knowledge management researcher, Concordia UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/835432017-09-08T00:24:00Z2017-09-08T00:24:00ZWhy more grandparents are raising their grandchildren<figure><img src="https://images.theconversation.com/files/184972/original/file-20170906-9875-1rj6j07.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Grandmother and child walking in the park.</span> <span class="attribution"><span class="source">www.shutterstock.com</span></span></figcaption></figure><p>Sunday, Sept. 10, 2017 is <a href="http://grandparentsday.org/">Grandparents Day</a>. Many grandparents will receive loving cards, calls and emails from their grandchildren.</p>
<p>However, a significant number of grandparents – <a href="http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/11/02/why-more-grandparents-are-raising-children">approximately 2.9 million</a> – will do exactly what they do every day. They will make their grandchildren breakfast, organize their activities and help with homework in the evening. </p>
<p>So-called “custodial grandparents” have primary responsibility for raising one or more of their grandchildren. As researchers and health and social service professionals, we know that this is a <a href="http://www.pbs.org/newshour/rundown/more-grandparents-raising-their-grandchildren/">growing group of often invisible caregivers</a>.</p>
<p>Grandparents Day is a fitting moment to take a closer look at the social contribution grandparents are making and the impact of unexpected caregiving – often in later stages of life.</p>
<h2>Not a new phenomenon but a changing one</h2>
<p>Custodial grandparents are represented in all races and ethnicities. However, grandparents in racial and ethnic minority groups <a href="https://www.census.gov/library/visualizations/2016/comm/cb16-ff17_grandparents.html">are overrepresented</a> in the population of caregivers. It’s also worth noting that 67 percent are younger than age 60, and 25 percent <a href="https://www.census.gov/content/dam/Census/library/publications/2014/demo/p20-576.pdf">live</a> in <a href="https://www.healthcare.gov/glossary/federal-poverty-level-FPL/">poverty</a> despite the fact that about <a href="https://census.gov/library/visualizations/2017/comm/grandparents-support-grandchildren.html">half of custodial grandparents are in the labor force</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=384&fit=crop&dpr=1 600w, https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=384&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=384&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=483&fit=crop&dpr=1 754w, https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=483&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/184992/original/file-20170906-17089-kwc1tz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=483&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Barack Obama with the grandparents who raised him.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/senorglory/3219359111/">Senor Glory</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Grandparent caregiving is not a new phenomenon: Kin care has historically been part of family life. Former President Barack Obama <a href="http://www.penguinrandomhouse.com/books/123909/dreams-from-my-father-by-barack-obama/9780307383419/%22">chronicled</a> his early life experiences being raised by maternal grandparents. In a <a href="https://www.harpercollins.com/9780062300546/hillbilly-elegy">bestselling book</a>, JD Vance writes about his childhood in Appalachia being raised by his “Mamaw.”</p>
<p>While it’s not a new trend, the reasons for and experience of raising grandchildren have changed over recent decades.</p>
<p>Consider, for example, the African-American community. In her 2010 Pulitzer Prize-winning book, <a href="http://isabelwilkerson.com/the-book/">“The Warmth of Other Suns</a>,” Isabel Wilkerson documents the great migration of African-Americans from the South to other regions of the United States between World War I and the 1970s. During this time, grandparents and other relatives served as substitute parents as families resettled and secured employment. In this <a href="https://www.naswpress.org/publications/children/caregiving-care-sharing.html">care-sharing tradition</a>, grandparents and other families were available during times of transition and relocation.</p>
<p>Since the mid-1990s, several social conditions have caused the number of grandparents who are raising their grandchildren to increase.</p>
<p>Addiction and incarceration, child abuse and neglect, and economic factors all have contributed to a rise in the number of custodial grandparents. A recent <a href="http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/11/02/why-more-grandparents-are-raising-children">Pew Trusts report</a> documents how the current opioid epidemic is contributing to this trend. <a href="https://www.cdc.gov/drugoverdose/pdf/pubs/2017-cdc-drug-surveillance-report.pdf">According to the CDC</a>, drug overdose deaths in the United States have more than tripled from 1999 to 2015, and often leave children parentless. </p>
<p>The number of <a href="https://www.nytimes.com/2017/01/16/opinion/young-victims-of-the-opioid-epidemic.html">children placed in foster care</a> has sharply increased, partially fueled by opioid and other drug use. When children are removed from their birth parents, federal law requires that state child protective services give preference to placement with relatives who, more often than not, are the grandparents.</p>
<p>Additionally, increased incarceration rates for women have changed family life. In the 1990s, female incarceration rates <a href="http://www.bjs.gov/content/pub/pdf/iptc.pdf">skyrocketed</a> compared to the rate for fathers. Incarceration, addiction and neglect are often interconnected.</p>
<h2>How caregiving affects health</h2>
<p>In addition to dealing with the challenging dynamics of child care, many of these grandparents are starting to experience their own age-related changes in <a href="http://onlinelibrary.wiley.com/doi/10.1002/jclp.22272/full">health and functioning</a>.</p>
<p>Compared with noncaregiving peers, grandparents who are raising their grandchildren have more extensive health problems. When there are limited resources – whether financial, time or energy – grandparents <a href="http://onlinelibrary.wiley.com/doi/10.1002/nur.21542/abstract">prioritize their grandchildren over themselves</a>. This situation can lead to undiagnosed health problems, untreated chronic diseases and undesirable health practices such as poor nutrition and lack of exercise.</p>
<p>In addition, grandparents can experience depression and anxiety from the stress of child care. In <a href="http://onlinelibrary.wiley.com/doi/10.1002/nur.21542/abstract">one study</a> of grandmothers raising grandchildren, approximately 40 percent scored in the clinically elevated range on measures of psychological distress.</p>
<p>In spite of these challenges, grandparents report rewards and joys that give them a sense of purpose. One grandparent <a href="http://familiesinsocietyjournal.org/doi/pdf/10.1606/1044-3894.177">put it this way</a>:</p>
<blockquote>
<p>“And she’ll come around once in a while and she’ll say, ‘I’m so glad. I’m so lucky I have you and Grandma.’ And I’ll say, ‘We’re lucky we have each other.’”</p>
</blockquote>
<p>Keeping grandchildren in their own cultural community is another important motivation for many. For example, <a href="http://familiesinsocietyjournal.org/doi/pdf/10.1606/1044-3894.40">research</a> has demonstrated the historical commitment to care-sharing in African-American families:</p>
<blockquote>
<p>“Because I came from a bonded family, a really bonded family… We always pitched in and took care of each other. My mother, my grandmother took care of me. Let me see. There was my nannie, my nina, my mother, my uncle and aunt. We all lived together…”</p>
</blockquote>
<h2>Grandparents and policy</h2>
<p>From a policy perspective, grandparents provide the safety net for children who might have otherwise entered the foster care system. Nationally, it is estimated that grandparents and other kinship care providers save the government more than <a href="http://www.gu.org/Portals/0/images/Infographic/12-grandparent-infograph-full.jpg">US$6 billion annually</a>.</p>
<p>But in caring for these children, grandparents <a href="https://www.hindawi.com/journals/cggr/2015/630717/">pay a high price</a>, especially those who are raising the children alone.</p>
<p>What can be done to support these grandparents?</p>
<p>Because of increased recognition of both the prevalence and urgent needs of grandparents raising grandchildren, many communities have created grandparent support groups and “<a href="http://www.nysnavigator.org/">kinship navigator</a>” programs that help identify and access much-needed public and private resources.</p>
<p>Programs such as <a href="http://phg.snhp.gsu.edu/">Project Healthy Grandparents at Georgia State University</a> offer support and health interventions to help grandparents remain healthy and effective care providers. Support includes home visits, early intervention services for children with developmental disabilities (which are often related to prenatal substance abuse exposure) and support groups and parenting classes. Other programs are growing such as Grandhousing, which provides apartments specifically for grandparent-headed families.</p>
<p>Programs for grandchildren are also crucial. In one initiative that replicates our Atlanta-based model in rural Georgia, a van transports the children to an activity day so they can be with others who are are cared for by grandparents. As the driver pulled up to the second house, the two sisters already in the van exclaimed:</p>
<blockquote>
<p>“Look – those girls are being raised by their grandma, too!”</p>
</blockquote>
<p>Clearly, seeing other children in families like theirs was surprising and important to the sisters!</p>
<p>For many, Grandparents Day is celebrated one time per year. And grandchildren’s visits <a href="https://www.naswpress.org/publications/children/caregiving-care-sharing.html">are a “delight”</a> lasting just a few hours. But for about three million children, being with grandparents is a daily fact. </p>
<p>We believe it is time for these families to be recognized more formally by policymakers and service providers. Without more extensive official responses, grandparents may receive little or no support until they experience a physical or mental health crisis.</p><img src="https://counter.theconversation.com/content/83543/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Millions of American children are being cared for by grandparents. To honor Grandparents Day we ask: What are the social and health impacts of this often unexpected turn of events?Nancy P. Kropf, Dean and Professor of Social Work, Byrdine F Lewis College of Nursing and Health Professions., Georgia State UniversitySusan Kelley, Associate Dean and Chief Academic Officer for Nursing and Director, Project Healthy Grandparents, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/734832017-07-12T09:28:24Z2017-07-12T09:28:24ZHow loneliness in older people makes them more vulnerable to financial scammers<figure><img src="https://images.theconversation.com/files/174296/original/file-20170618-18169-6wao60.jpg?ixlib=rb-1.1.0&rect=0%2C183%2C4896%2C2924&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/elderly-woman-looks-out-window-249281512?src=o3Ec9b4_x6DPq5SUHjcnKQ-1-8">Marlinde/shutterstock.com</a></span></figcaption></figure><p>Fraud investigators have warned that people are being targeted by scammers who persuade them to invest their pensions in self-storage units. The UK’s Serious Fraud Office <a href="https://www.sfo.gov.uk/2017/05/22/sfo-seeks-information-from-investors-in-storage-pod-schemes/">launched an investigation</a> in May, saying that a thousand people had invested around £120m into the schemes. </p>
<p>This is just the latest <a href="https://www.ncoa.org/economic-security/money-management/scams-security/top-10-scams-targeting-seniors/">in a line</a> of financial scams to emerge, many of which target older people. And sadly, loneliness increases the risk of being <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2804623/">targeted by unscrupulous predators</a>, including financial scammers. </p>
<p>For some people, their only form of social contact comes from communication with commercial organisations or scammers. These can include telemarketing phone calls or letters from “clairvoyants”, prize draws or catalogues. Strong relationships can develop <a href="https://www.researchgate.net/publication/236964907_The_Importance_of_Consumer_Market_Interactions_as_a_Form_of_Social_Support_for_Elderly_Consumers">between the victims and perpetrators</a> of financial scams who maintain a high level of contact. </p>
<p>Some people can receive multiple phone calls each day or large amounts of scam mail in the post. The <a href="http://www.nationaltradingstandards.uk/work-areas/scams-team/">National Trading Standards scams team</a>, who we are conducting research with, have told us of victims who receive over 30 pieces of mail a day. Responding to the quantity of calls and mail can become an administrative job that provides routine and purpose, which may be highly valued by the scam victim whose time would otherwise be unstructured. </p>
<p>A sense of a personal relationship with the correspondents often develops, and the value of this relationship to the victim may outweigh the potential financial cost of the scam. Lonely people have fewer opportunities <a href="http://www.ageuk.org.uk/documents/en-gb/for-professionals/consumer-issues/age%20uk%20only%20the%20tip%20of%20the%20iceberg%20april%202015.pdf?dtrk=true">to meet with others</a> to discuss finances or scams and are therefore unable to check with a trusted contact whether an offer, or relationship, is genuine.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/175402/original/file-20170623-17502-1lvadu3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/175402/original/file-20170623-17502-1lvadu3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/175402/original/file-20170623-17502-1lvadu3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/175402/original/file-20170623-17502-1lvadu3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/175402/original/file-20170623-17502-1lvadu3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/175402/original/file-20170623-17502-1lvadu3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/175402/original/file-20170623-17502-1lvadu3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Daily calls target people who have little other social contact.</span>
<span class="attribution"><span class="source">via shutterstock.com</span></span>
</figcaption>
</figure>
<p>Financial scammers are skilled at using marketing techniques to establish rapport and familiarity with victims. The language used is persuasive and personal, deliberately designed to appeal to <a href="http://longevity.stanford.edu/blog/2011/10/12/consumer-vulnerability-to-scams-swindles-and-fraud-a-new-theory-of-visceral-influences-on-persuasion/">the human need for social contact</a>. </p>
<p>The loneliness of some scam victims can be <a href="http://journals.sagepub.com/doi/abs/10.1177/0269758015571471">exacerbated</a> by feelings of shame and embarrassment, reinforced by <a href="https://www.fraudhelpdesk.org/debunking-three-myths-fraud-victims/">language</a> sometimes associated with scam victims such as “stupid”, “gullible” or “greedy”. Such words suggest they are culpable, rather than a victim in need of support. This can influence victims’ willingness and ability to report their experience, and may be part of the reason why scamming is an under-reported crime. Because of this, agencies must respond to scam victims <a href="http://staffprofiles.bournemouth.ac.uk/display/journal-article/196931">in a supportive way</a>, sensitive to the reasons why the individual may have become involved.</p>
<h2>Tackle loneliness to beat scammers</h2>
<p>The research we are doing in collaboration with the scams team is looking at the experiences of victims. We are also identifying effective interventions and producing good practice guides for professionals working with victims and potential scam targets. One way to disrupt and prevent financial scams is to identify the reasons – such as loneliness – why people are drawn in by them. </p>
<p>Loneliness exposes people to a diverse range of significant risks to <a href="https://link.springer.com/article/10.1007/s00127-014-0951-8">mental and physical well-being</a>. It affects people of all ages, but is often triggered by <a href="http://discovery.ucl.ac.uk/1639/">particular life events</a> such as bereavement, poor health, or cognitive impairment. Three in ten people aged over 80 in the UK report <a href="https://webcache.googleusercontent.com/search?q=cache:dx91KcUIStsJ:https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/measuringnationalwellbeing/2015-10-01/pdf+&cd=3&hl=en&ct=clnk&gl=uk">feelings of loneliness</a> – higher than any other age group.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/174302/original/file-20170618-28802-e8ua9q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/174302/original/file-20170618-28802-e8ua9q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=455&fit=crop&dpr=1 600w, https://images.theconversation.com/files/174302/original/file-20170618-28802-e8ua9q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=455&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/174302/original/file-20170618-28802-e8ua9q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=455&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/174302/original/file-20170618-28802-e8ua9q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=572&fit=crop&dpr=1 754w, https://images.theconversation.com/files/174302/original/file-20170618-28802-e8ua9q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=572&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/174302/original/file-20170618-28802-e8ua9q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=572&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Preventing loneliness could stop the scammers.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/edlerly-mom-sharing-laugh-her-visiting-139072550?src=gz2sk1oFzdQKOFHpgVb7YA-1-67">intoit/shutterstock.com</a></span>
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<p>Building on <a href="https://www.cambridge.org/core/journals/ageing-and-society/article/div-classtitlepreventing-social-isolation-and-loneliness-among-older-people-a-systematic-review-of-health-promotion-interventionsdiv/06510CBA74BBCF3FD2821BB96525647C">previous research</a>, we found that successful interventions aimed at alleviating loneliness are those that focus on well-being and promoting ways of developing a person’s resilience and social networks. </p>
<p>Facilitating <a href="http://www.who.int/ageing/age_friendly_cities_guide/en/">social engagement</a> in community activities to promote older people’s self-esteem can help build <a href="https://www.cambridge.org/core/journals/ageing-and-society/article/resilience-thoughts-on-the-value-of-the-concept-for-critical-gerontology/7E49BB754E9F00642DE0EADB53675E58">their resilience</a>. This can then reduce the likelihood that they will respond to scams. Empowering people to safeguard themselves against scams through increased awareness is equally important. Groups set up to promote financial awareness and literacy can help, as can learning materials produced by initiatives such as <a href="https://www.friendsagainstscams.org.uk/">Friends Against Scams</a> and <a href="http://scamsmart.fca.org.uk/">Scamsmart</a>. </p>
<p>It is estimated that £5-10 billion is <a href="http://www.rand.org/content/dam/rand/pubs/research_reports/RR1500/RR1510/RAND_RR1510.pdf">lost annually</a> by victims of scams, with the average age of a victim being 75. In an ageing society, the number of people over 65 living on their own in England is <a href="http://www.poppi.org.uk/">projected</a> to increase from 3.5m in 2015 to 4.97m in 2030. This means that unless society makes a concerted effort to tackle loneliness, significantly more people could be at increased risk of being scammed – it is detrimental to their health and the well-being and the economy.</p><img src="https://counter.theconversation.com/content/73483/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lee-Ann Fenge receives funding from New Dynamics of Ageing (a unique collaboration between five UK Research
Councils—Economic and Social Research Council, Engineering and Physical Sciences Research Council, Biotechnology and Biological Sciences Research Council, Medical Research Council and Arts and Humanities Research Council), and the Big Lottery Fund.</span></em></p><p class="fine-print"><em><span>Keith Brown and Sally Lee do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Scammers target people who crave social contact.Keith Brown, Director of the Centre for Post Qualifying Social Work, Bournemouth UniversityLee-Ann Fenge, Professor of Social Care, Bournemouth UniversitySally Lee, Post-Doctoral Research Fellow, Bournemouth UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/762482017-04-14T00:49:53Z2017-04-14T00:49:53ZWhy addressing loneliness in children can prevent a lifetime of loneliness in adults<figure><img src="https://images.theconversation.com/files/165296/original/image-20170413-25898-sud4tc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Loneliness in adults is often a result of loneliness in childhood. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/small-boy-sad-expression-548630776?src=V48QRwFTqd_mdEdytsi6gQ-1-82">From www.shutterstock.com </a></span></figcaption></figure><p>The Republicans’ controversial effort to repeal the perhaps optimistically named Affordable Care Act because of rising premiums may be fatally stalled. But there are other ways to rein in health care costs that have been almost entirely overlooked. Making a serious effort to reduce loneliness could make a real difference. </p>
<p>Lonely people put <a href="http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2014.302427">heavy demands on our health care system</a>. Loneliness impairs immune response and makes people more likely to develop serious medical problems like <a href="http://dx.doi.org/10.1136/heartjnl-2015-309242">heart disease and stroke</a>.</p>
<p>According to <a href="http://journals.sagepub.com/doi/abs/10.1177/1745691614568352">one meta-analysis</a>, loneliness increases the risk of early death as much as smoking or being 100 pounds overweight. The risk is highest in people younger than 65. But lonely people don’t go to doctors just for medical care. They’re also dying for social contact.</p>
<p>Although loneliness is now recognized as a <a href="http://www.ucsf.edu/news/2012/06/12184/loneliness-linked-serious-health-problems-and-death-among-elderly">major public health problem</a>, there hasn’t been much discussion about how to address it. </p>
<p>As a clinician who treats mental health issues caused by loneliness, I’ve come to believe that we can’t develop effective interventions for loneliness without first understanding what causes it.</p>
<h2>More than social isolation</h2>
<p>Although <a href="http://ccn.aacnjournals.org/content/33/6/8.full">isolation</a> is an important risk factor, having company doesn’t always prevent loneliness – and being alone doesn’t always cause it.</p>
<p>Someone in a bad marriage may feel lonely in the presence of a distant or rejecting spouse, for example. Loneliness is the experience of being not alone but without the other in a way that feels meaningful. What matters is the internal experience.</p>
<p>Some people are content on their own. As the British psychoanalyst <a href="http://www.goodtherapy.org/famous-psychologists/donald-winnicott.html">Donald Winnicott</a> explained, people like this never actually feel alone internally. </p>
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<p>What protects them is the early experience of having what he called “a good-enough mother.” A good-enough mother isn’t perfect, but she cares deeply for her child and values him for who he is. Wherever these contented souls go, they carry with them an ongoing sense of the mother’s caring and attentive presence.</p>
<p>But many people are not that lucky. It’s well-known that <a href="https://www.childwelfare.gov/topics/can/impact/long-term-consequences-of-child-abuse-and-neglect/health-and-mental-health/">people who were abused</a> as children are at higher risk of getting into abusive relationships as adults. Similarly, people who suffered from <a href="https://www.cdc.gov/violenceprevention/childmaltreatment/consequences.html">emotional neglect</a> as children have a high risk of reliving that experience as well. They felt lonely and uncared for as children, and they feel that way as adults too.</p>
<p>Chronic loneliness can be the aftermath of early emotional neglect. This kind of neglect is often invisible to others. A child may grow up in a family where everything seems normal on the outside, but still feel lonely if he can’t get from his mother the love and attention he needs to thrive.</p>
<p>A depressed, withdrawn mother is not likely to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724169/">emotionally available</a> to her child, even if she goes through the motions of doing what’s needed. Sometimes a mother may feel so depressed and deadened herself that she <a href="http://www.apadivisions.org/division-39/publications/reviews/dead-mother.aspx">deadens the relationship </a>with her child, as described by the French psychoanalyst Andre Green.</p>
<p>In other cases, the mother may be distant and rejecting – or so oblivious to her child’s thoughts and feelings, and so out of touch with who he is, that she leaves the child feeling stranded emotionally and alone.</p>
<p>Fathers are very important too, of course; they can mitigate or worsen the effect of mothers in this regard. But since mothers are usually the primary caretakers, particularly of very young children, they usually have the greatest effect when it comes to providing a buffer from loneliness or leaving children vulnerable to it.</p>
<p>Anyone who tried to get close to his mother as a child and failed may well feel hopeless about developing close relationships later in life. Sometimes hopelessness has a neurological basis: <a href="https://www.ncbi.nlm.nih.gov/pubmed/25455063">Severe early neglect</a> impedes development of neurons responsible for optimism.</p>
<h2>Lessons learned from neglect can harm for decades</h2>
<p>But, sadly, people who suffered from emotional neglect as children may also act in such a way as to make the expectation of loneliness a self-fulfilling prophecy.</p>
<p>Children who feel uncared for generally blame themselves. As adults, they may <a href="https://www.sciencedaily.com/releases/2013/05/130508092835.htm">hang back from others</a> because of a lingering sense of shame about feeling unwanted, or because they feel they don’t deserve to be loved.</p>
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<p>Some people do more than hang back. They almost seem to cling to loneliness and to the social isolation that feeds it. <a href="https://www.ncbi.nlm.nih.gov/pubmed/22079507">Neurobiological mechanisms</a> may play a part in this, because loneliness activates the fight-or-flight response, making people hypersensitive to threat and more likely to respond to others in a fearful or defensive manner.</p>
<p>But psychological factors are important too. If loneliness was the most powerful feeling you had with your mother, you may cling to the feeling of loneliness because that’s what connects you most closely to her. Without realizing it, some people may be reluctant to relinquish isolation and the loneliness it creates because loneliness feels like a kind of private space which is shared with a distant and rejecting mother.</p>
<p>Of course, we could all ask, “Why would you want to hold onto that?”</p>
<p>Well, we’re not always rational! We all bear the imprint of early relationships with parents; most of us replay even painful parts of those relationships over and over again. Freud called this the <a href="https://www.ncbi.nlm.nih.gov/pubmed/20798678">repetition compulsion</a>. We fall into old patterns in part because they’re familiar, and in part perhaps as a way of showing loyalty to parents who were once everything to us.</p>
<p>According to the Scottish psychoanalyst <a href="http://psychoanalysis.org.uk/our-authors-and-theorists/ronald-fairbairn"> W.R.D. Fairbairn</a> and others, nothing motivates us more powerfully than the longing for intimate connections with others. All else being equal, nobody would choose a painful relationship, but if that’s what he’s given as a child, that’s what he has – and that’s what he holds tight to. Painful relationships are better than nothing.</p>
<p>This can be seen in a highly controversial experiment by American psychologist <a href="http://www.pbs.org/wgbh/aso/databank/entries/bhharl.html">Harry Harlow</a>. Harlow first deprived baby monkeys of maternal affection, causing them to become panicky, and then offered each monkey a choice between a cloth mother and a bare wire mother that held a bottle with food. The monkeys preferred the more huggable cloth option; each baby monkey became attached to its own cloth mother, and would cling to this inanimate surrogate even though it offered no food.</p>
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<h2>Children have a need to love, even when they’ve been harmed</h2>
<p>Children love their parents even when they’ve been abused. The same holds true for children who’ve been neglected. If a child’s relationship with his mother leaves him feeling profoundly lonely, that’s what he has, and that’s what he holds tight to.</p>
<p>Paradoxically perhaps, the less emotional nourishment someone gets from her mother, the more tightly she may want to hold on. It’s a lot easier to separate from a mother who makes you feel loved and secure in the world than it is to turn away from a mother who seems to be on the brink of disappearing emotionally herself.</p>
<p>Some people may cling to social isolation because isolation is what most closely reflects their emotional experience as children. Longstanding loneliness may signal what is perhaps best understood as a kind of attachment disorder, with ongoing attachment to a depressed, withdrawn or rejecting mother.</p>
<p>When chronic loneliness comes from childhood neglect, social outreach programs are not likely to be sufficient. We need to think more carefully about what causes loneliness, and what seems to be the peculiar attachment of some people to a condition which they find deeply painful. Then we can tailor interventions to address the cause, rather than just the condition of being alone.</p><img src="https://counter.theconversation.com/content/76248/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Elizabeth Tillinghast does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Loneliness is a major cause of health problems, and many programs have aimed to alleviate it among the elderly. But it might be wise to treat loneliness at its roots, which for many is in childhood.Elizabeth Tillinghast, Assistant Clinical Professor of Psychiatry, Columbia UniversityLicensed as Creative Commons – attribution, no derivatives.