by Joan Blumenfeld, MS, LPC
Isolation is what we do to punish prisoners. Isolation is what we do to punish psychiatric patients who act out. Isolation — “You need a time out!” — is what we sometimes do to discipline small children. And isolation is a cruel reality of old age.
Our society is growing older by leaps and bounds. By the time people are in their 80s, their social structures have faded away. Children and longtime friends have moved or died. Concerned family members are often geographically unavailable. Spouses may have died as well, leaving the elder in the community alone and lonely.
Frail elderly people are less able to get out and about because of limiting medical factors. Driving becomes problematic. And even for those older adults lucky enough to age with adequate help in the home, isolation becomes a serious matter. The finest of aides can only do so much: feeding, clothing, bathing the elder, managing the household. But they can’t be all things to their patient.
My client, Carolyn, was in just such a jam. At 87, she was widowed and still living in her home of the last 40 years. She was both home-bound and bed-bound with a bundle of medical issues. She had heart disease with a new valve in place. She had also experienced a mild stroke, had memory loss and severely arthritic joints, among other problems. A live-in aide cared for her remarkably well 24 hours a day, but, save for short jaunts to her multitude of doctor appointments, Carolyn was socially deprived. No friends visited. She had not been to church in a year. She was pretty much confined to her home with her aide, and although they were close and got along well most of the time, there was a distinct lack of companionship and mental stimulation.
After meeting in my office with those of her children who could make it, and getting as full a medical/social history as possible, I offered a plan of care that first focused on Carolyn’s isolation. While there were many limitations to what she could actually do, there were also many opportunities for improvement in her quality of life.
First off, I went with Carolyn and her aide to the visit the local Adult Day Program. They offered the companionship of other older, similarly limited adults and a full, well-trained staff of social workers, nurses, aides and recreational opportunities. A hot lunch — another social opportunity — was served and a first-class musician lead a singalong on his keyboard.
At first blush, Carolyn was not thrilled with the meal and not sure about the other participants, but she was captivated by the music and so agreed to come back. Two days a week at the program are now a regular part of her weekly routine.
Next I went to visit her church. Prior to her incapacitation, Carolyn had been a regular attendee at Sunday services, an active member of the political action committee, and a member of the chorus. I got the calendar of events so we’d know what was happening at church each month, and arranged for the visiting committee to schedule some regular visits from friendly church members. Carolyn now attends the services of her choice a few times a month and has a small but steady stream of visitors.
Although the medical issues Carolyn faces are still serious and will remain so, the quality of her life, in terms of human connection, has improved enormously. She is no longer spending long days looking at television or sleeping. Instead, she is engaged with others in activities that are stimulating, meaningful and fun!
Pearl of wisdom: Isolation is bad for physical and mental health. We all need human connection: a smile, a pleasant word, recognition that we are still part of society. Bring visitors in to be with fragile elders. Take older adults out to engage the world at whatever level their abilities allow.
Joan Blumenfeld, MS, LPC is a Geriatric Care Manager practicing in Fairfield County, CT. For information, visit www.joanblumenfeld.com. © Joan Blumenfeld, MS, 2013.