Social Isolation & Loneliness from a Wellness Perspective

Transcript:

Hello everyone, welcome to the Senior Home Companions podcast. It is Kirstin McCarthy here, Marketing Coordinator with SHC. Today, we are going to be discussing the statistical and anecdotal findings regarding socialization in seniors, and looking at it from a wellness perspective. We are joined today by Chuck Gillespie, a veteran of wellness, workplace management, and social impact organizations for over 25 years. Chuck, would you mind explaining your background and introducing yourself?

Yeah, hi Kirstin, and thank you very much for the time today. Again, Chuck Gillespie. I spent the first part of my career in the HR space. When I was an HR manager at one of my very first organizations, a public utility, I got this thing called wellness added to my list of things that I was supposed to be doing. One of the things I've always had good luck with is the fact that during that period of time, when I got this new assignment as the HR manager, it reminded me that my sister was actually the director of wellness for the Savannah Riverside for the Department of Defense. So, I thought, I’ll just call her and find out what I’m supposed to be doing with this.

I moved into another position, a director of HR for a large trucking and transportation company. In my interview during that period of time, the CEO I was reporting to asked me what I wanted to do in my first 90 days. I said, "We’re going to set up a culture of wellness and well-being so that our people really understand the culture that we’ve already developed here at the organization and can take it and move it to the next level." What we saw in that period of time was a reduction in our total turnover, reduction in our total cost of hire, and increases in our tenure—the folks that were actually working there—in a very short period of time, about just a year and a half, after installing just a very simple, basic concept of wellness and well-being.

Now, I want to start by understanding exactly how I identify wellness and well-being. Wellness is actually functioning optimally within your current environment. So, when you think about it, don’t think about wellness as fitness. Don’t necessarily think about it as mental health. Don’t necessarily think about it as any of the other factors that you hear that term wellness being used for over time. Think about it from the whole concept of functioning optimally within the current environment. When we talk about that, we’re trying to make sure that people are physically, mentally, and emotionally healthy. It is all things, and that’s really the whole impact of what you're going to do now moving forward.

I actually spent almost 15 years working as a wellness association leader. I was the head of wellness for the Indiana Chamber of Commerce, the Wellness Council of Indiana, and then I spent five years as a CEO of the National Wellness Institute. During that time, my sister, who I was talking about just before, spent 16 years—almost 20, really—as the professor of wellness management at Ball State University. So, the two of us have been collaborating together in that space for nearly two decades. Know that this is something I’ve spent a lot of time and energy on, and what’s really great is that we’ve talked about it not only from the workplace and community perspective, but we’ve talked about it specifically in senior living, and the whole aspect of how we can create these wonderful cultures and environments for our seniors to live a life worth living.

Yeah, no Chuck, you have an incredible background, and we're just so honored to get the chance to talk to you today. I know that you have so much knowledge to give all of our listeners, specifically leaning into the senior industry and how you've seen that in the wellness industry. We’re going to be diving into isolation and loneliness in seniors. Can you kind of tell us why this is such a huge issue for seniors?

Absolutely, and let me start by explaining how I view social isolation and loneliness, and the differences between the two. Social isolation is not having contact with people. Now, let's remind ourselves, there are people in this world that don’t want to have social contact. I totally respect those folks, but that is such a small percentage of our population that we’ve got to identify the fact that that is a unique individual. We have got to have people that are connected with others, have relationships with people, and support from others. In a lot of ways, that's where a lot of the senior living and senior opportunities are—whether you're in a living space, whether you're at home, you still need that support network. And again, I'll talk about it from my own mother-in-law's perspective and my mother's perspective. Knowing that, that’s why both of them had a good life worth living.

But my mother-in-law, who had a lot more of a social isolation situation simply because her husband had passed away almost 15 years ago, and when she moved from her hometown of 40 years to near where my wife and I live, she didn’t really have any other family and friends other than my wife and I, and a cousin who was truly connected to her. So, she became very socially isolated, and that loneliness was seen from that perspective.

Conversely, my mother, who grew up in a small town in Southern Indiana, and who and my dad were the only two from both sides of their family that left the town, retired, and moved back there, had been there for 35 years. My mom had my father, my sisters and I, my aunts, my uncles, my cousins, and other family members and friends that they'd grown up with all their lives, around her all the time. My mom was wheelchair-bound for about 10 years before she passed, but my dad was the person who went out, bought the nicest wheelchair, bought the van, and so when she was put in a senior living facility, he would still go in two to three times a day. But even two to three times a week, he would grab her, throw her in the wheelchair, throw her in the van, take her out to Chick-fil-A for lunch, or take her back home for a little while. You saw that my mom was constantly with people and had that support network.

My mother-in-law, on the other hand, went into the senior living facility right during COVID. Not only was she lonely because she was moving to a brand new place, but even my wife and I couldn’t come and see her and give her a hug, or even just that simple thing. We communicated with her all the time on the phone and we did stop by when we could, but that was really all we could do. We saw my mother-in-law’s dementia really kick in hard, and it probably accelerated as a result of that loneliness and isolation. Her dementia probably progressed faster than it would have had she not been so socially isolated, and lacked that social support network.

I think it's so interesting just to look at the difference between social isolation and loneliness, because when we think about the two, there becomes this gray area of what does that mean? Being in the home care industry, we see this all the time. But I think it’s so important for the community to know the difference and the different social aspects of that.

Well, there’s a statistic out there, and this is not just for senior living, this is for everybody, and again, I’m not going to get the numbers right, but essentially, only about one-third of the population of the United States feel like they have somebody that they can call at 3:00 in the morning for an emergency. That’s a sad state of affairs. I’ll be the first to tell you, I can think of five people in my cul-de-sac that I could call.

My list is pretty short, too.

But I’m just talking about just my cul-de-sac. That’s not including my family, my friends that live nearby, all these different people, but just my cul-de-sac alone, I would have no problems calling any one of them. So that’s where you really start to understand that difference between being isolated and lonely.

You know, the CDC statistics say that one in three adults in the US report feeling lonely, which basically means you could still have all the friends in the world, but you're still lonely. And that's a huge mental health issue. That’s where a lot of suicides really start to kick in. You know, I hate to say it, but think about Robin Williams. He was one of the most beloved individuals, and yet he ended up committing suicide simply because he felt lonely.

One in four adults report not having social and emotional support. 25%. That’s a huge number, and that just exacerbates when we get into senior living, especially for those folks like I said before. My mother-in-law moved here from four and a half hours away. My brother-in-law, at the time, lived in Colorado, and now he lives in Canada. So, as much as he tried to get back as much as he could, it was really up to my wife and me to ensure my mother-in-law was taken care of, especially as her friend group started to slow down, or move to their families, or move into senior facilities, or pass away.

And again, let me reiterate, my mother-in-law lived to be 87 years old, and she had a great life. My mom lived to be 84, and she also lived a great life. But I do believe my mother-in-law’s dementia would not have moved as quickly had she been able to be more socially connected. And that capability, now, part of it was truly COVID. We see the statistics out there, I mean they’re everywhere, about how many people died due to that lack of social impact, that lack of social connection.

So when you think about it from that perspective, and some of the items and services your organization is providing. My wife and I would have liked to have been able to connect into and that's really what it's all about—making sure that if you can't do it, you have the ability to find that group or organization to either supplement what you're doing or help you do it all together. Yeah, and I think that you said a lot of really important things there and created great real-life examples. We see that every day. You know, the kids live out of town, maybe a spouse has passed away, and there is a lot of social isolation and loneliness involved. Yeah, and especially as the dementia starts to kick in. I'll just say it this way: my mother-in-law couldn't make phone calls. We got her a very basic remote; she couldn’t handle her computer anymore. You don’t have that ability to connect with them unless you have somebody there to even set that up.

One of my favorite stories, and I’ll just say it, is very emotional. Her brother—she and her brother were best friends—lived in the Boston area. I can still remember on one of her last really good days, probably about four weeks prior to her passing away, my wife ended up getting on a FaceTime call with him. My mother-in-law couldn't speak much at that point, but just hearing his voice and watching her face light up… It was the mother-in-law that I knew and loved. I got to see that one more time. That was what it’s all about. Those are the kind of things that we’ve got to remind ourselves about what's going on.

My mother’s last full good day was when she had all of her grandkids in front of her. She had everybody but my oldest sister. It was Easter weekend, and we had a wonderful day. Four days later, she passed, because she was like, "My day is good. I’ve had a good day." That’s what we’ve got to remind ourselves. This is not about anything more than making sure we’re really taking care of those folks and giving them that emotional support. If we can’t do it, let’s make sure we have that going on right now.

Thank you, Chuck, for sharing such a personal and emotional story. I think I’m going to start tearing up because all of these stories resonate, and I know a lot of our listeners have been through these personal experiences without a doubt. It’s really just hard to go through that process. It’s never easy. But at the same time, I remember going back to the senior living facility, and the folks who really blew me away were the cafeteria staff who loved my mother-in-law because she was always this bundle of joy. One of the folks who did a lot of the cleaning came in and cried with my wife because she was going to miss my mother-in-law that much. The impact that those individuals made on my mother-in-law was huge, and it made that transition that much better and stronger. It’s not always the people you think it’s going to be, right? That’s why it’s so important to really make sure, especially if you have the means to do so, that they have those things. Even in the senior living facilities, they do an amazing job, but they’re still understaffed and never going to be fully staffed. That’s just the reality.

We’ve got to remind ourselves—and again, the research is through the roof. If you want the research, go look at Gallup’s research on well-being. Jim Harter, who I’ve got a good relationship with—he’s the chief scientist at Gallup—has done so much work in this space. It’s all about understanding that purpose. What is your purpose in life? For a lot of people, during their career days, their job is their purpose. But for a lot of people, you’ve got to understand that when you retire, you’ve got a new job. It’s still a job; you just may not get paid the same as before. We’ve got to remind ourselves that this is what we need to be looking at.

The Centers for Disease Control has amazing information about social impact and loneliness, and I would highly recommend it. One of my absolute favorite statistics—and again, I can’t remember where I found this, I don’t know where it came from—but I know it’s a fact because I actually saw the research at one point in time. If you really want to look at your longevity, for anybody over the age of 40, the number one way to determine whether or not you’re going to have a long life has nothing to do with your physical health. It has everything to do with your social connection with the people you interact with daily, weekly, or monthly. Anybody over the age of 40, the number one statistic for longevity is your social connectedness.

And again, we’ve all seen this. We’ve all seen the husband and wife who basically kept each other alive for years, and when one passes, the other one is quick to follow. As a matter of fact, the cousin I mentioned earlier, who lives nearby and was my mother-in-law’s cousin, her mom and dad were that exact thing. They had folks who came into their home and took care of each other. Then she passed, and he passed literally a month later. These are the things we’ve got to remind ourselves. We know the statistics are there, the research is there, but almost every one of us can point to stories like this.

I hear about those stories all the time. When one spouse passes, the other is quick to go. It’s extremely sad, but it underscores the importance of companionship without a doubt. And again, it’s not an easy journey. Let’s just leave it out there—it’s not an easy journey. But we’ve got to remind ourselves how important that journey is. I miss my mom and my mother-in-law every day. But I also know that they lived a life worth living, and that’s what puts a smile on my face. It reminds me every day that I need to go and make sure I’m doing the right things. I love going down and spending time with my dad. The winter time for my dad is actually one of the hardest times because he doesn’t really have a good hobby in the winter. We’ve got a farm and a lake, so we spend a lot of time there.

He loves it. He gets on his tractor, gets to go out and just be. He gets to plant his vegetables. I mean, he’ll plant six or seven rows of corn, and half of them will get eaten by the deer. But it’s not about the conclusion of getting the corn per se—it’s the journey of making it happen: planting it, seeding it, watering it, nurturing it, and watching the deer eat it. But that’s really what it’s all about. So we’ve got to make sure that we have that connection.

He just found a grieving group, and what was great about it is he went for the first time, and then his next-door neighbor, whose wife passed away three months before my mom, asked him to come along. Now they’re getting that social connection. That’s what we’ve got to be able to do. And if you can’t have that, then what can we do with an organization like yours to add those things in? Because this is what’s critical. This is what’s important to our society.

Another great statistic out there: the happiest people on Earth, according to Gallup (and if you notice, I’m a Gallup nerd), are Hispanics. The reason why—again, a former colleague of mine who was on my board of directors at the National W Institute always tells the story. She says, “Chuck, when we were happy as Hispanics, we danced. When we were sad, we danced.” The whole idea about it was, we are going to dance, but we’re not dancing alone. We’re always dancing together.

When you think about it, culturally speaking, Hispanics always take care of the elders. That’s something that we’ve got to make sure we continue to emulate as a society. It’s something I absolutely love—the fact that I get to spend time with my dad today, because I know one of these days that won’t happen. At the same time, I’m looking at my daughter, who just graduated from college and is getting ready to go to professional school in May. We do a dad-daughter trip every year. This year, my wife, daughter, and I are going to New York City for Christmas. We’re doing the Rockettes and the whole thing, but we’re doing it a couple of weeks before Christmas. The point is, I want to make sure we have that because it’s so important. It’s what I remember growing up with, with my parents.

I remember my mom came to every sporting event I did. I still jokingly remember when I was a freshman in high school. As we were teeing off for the golf tournament, the guy I was competing against asked, “Who’s that lady?” I said, “That’s my mom.” He was confused that my mom was there, and I was confused that his mom wasn’t. That’s something we’ve got to remind ourselves: we only have so many hours in the day, but we also only have so many hours with our families and friends. That’s something we’ve got to remind ourselves of every day.

Getting into that senior living space again, how do we make sure that as we are growing and aging, we are aging in a way where we can live our best lives? But it’s also about aging… My least favorite term right now is “aging in place,” but my absolute favorite term is “aging in the right place.” I love that. And I know it’s just adding one word, but it’s such an important thing. When we age in place, that place may not necessarily be the right place for you. We’ve got to make sure we have that right place to age, and sometimes it’s not necessarily the geographic location—it’s the social connection.

We need that connection to reduce loneliness, which can contribute to things like psychosis, or increase dementia from kicking in more deeply. We need to focus on the physical and mental well-being that we need to continue to gravitate toward. But I’ll also remind everyone that we have to take care of those who are taking care of our loved ones. I think that’s so important. It was something I was actually working on: well-being for caregivers.

It was hard. Luckily, because of what I’ve done in my life, I was able to be a huge support network for my wife, especially in those last few weeks when the dementia was really kicking in hard. But to know what I knew was such a huge help for me. I can’t imagine going into a situation like that and not having it. So, we’ve got to make sure we’re also taking care of those folks who are taking care of our people. Take care of the caregivers, and we’ve got to make sure caregiver support is just as important as care for those folks we’re taking care of.

Yes, I could not agree more. We do a lot at Senior Home Companions to give back to our caregivers. From grief groups to outings, we know how important it is. That’s not a surprise to take care of them.

Self-care is the best care, exactly. But it's also important to remind people that some don’t necessarily know what self-care is. That’s very true. This, again, goes back to social isolation and loneliness. The statistics show that one of the number one issues in social isolation and loneliness, ironically, is type 2 diabetes. Why? Because we eat our emotions. So, we’ve got to remind ourselves that we need to do things that are healthy for us to handle and cope with those emotional challenges.

I think that is very true. We can all pick up a tub of Ben and Jerry's ice cream pretty quickly when we're feeling down. I'm not saying that’s not important, but I’m also saying it's important to maybe take a walk for five minutes after that Ben and Jerry's.

I agree. I couldn’t agree more. And then, I want to hone in on a current estimate that says we have 13.8 million seniors living alone in the United States. What problems have you heard about this tidal wave of lonely seniors, and what are they experiencing?

First, I hate to say it this way, but I can tell you right now, I think that number is low. So, I think 13.8 million is probably a low number, especially with the baby boom generation reaching retirement age. When you had 94 million baby boomers, that’s why I think 13.8 million is actually too low.

What are we seeing? It’s what we were talking about. It’s those physical ailments that become much more of a problem, especially when you're alone. If nobody is there to support you, why take the pills? Why do this? Why do that? It becomes a crutch more than a joy.

Getting up out of bed, waking up in the morning, and having a purpose—that’s what’s missing. What is that purpose we’re going to do? It just becomes something that doesn’t seem important. You’ll start to see more depression and anxiety. You’ll see folks who are just worried about nothing because there's nothing to worry about. I know that sounds really weird to say it that way, but it’s really about understanding that every morning, each and every one of us has a reason to get out of bed. What is that reason?

For folks who are living alone, especially seniors who don’t necessarily have that job they’re going to, or don’t have someone coming to support them or hang out with them, or play cards with them, who are they going to take on? Again, I’m running into this with my cousin, who’s in her late 70s. She’s dealing with some issues and doesn’t really have a support network outside of my wife and me. So, how do we make sure those things are taken care of?

How do we make sure those things are happening? And that’s where we start to look at the issue of suicides, self-harm, sitting around too much because you don’t have anything to do. That increases the opportunity for heart disease and stroke to really kick in. So, we need to remind ourselves over and over again that, number one, 13.8 million is probably a low number. Number two, how can we solve that problem? Well, we’re not going to solve it—it’s too big of a number. But what we can do is affect it positively.

One of the best ways to do that is to figure out good ways to get those folks who are lonely and isolated connected—whether that’s getting them connected to a community center, getting them connected to other aspects of what's going on, or getting them connected to the services that you’re providing. That’s how we do it. All we’re trying to do is give them the best life and a life worth living. If we don’t, we’ll see early deaths, and that’s the last thing we want. We want them to live a great life, but living a great life includes that social connection.

It sure does. And I think you touched on so many important things. I know you’ve already answered my next question, but research has linked social isolation and loneliness to higher risks of a variety of physical and mental conditions. We’ve talked about mental conditions, diabetes, and dementia. What would be the number one health or mental condition that you see directly related to loneliness?

This may sound strange, but I’ve talked about this so many times, especially when I was in the workplace wellness space. We learned quickly that the number one health risk for most people was anxiety. The number one anxiety during your working life is financial well-being. So, if you really want to fix some of the health risks people are dealing with, make sure you have a good financial wellness program in place for your people.

Now, as you get out of that job and get into the senior space, you still have some issues with money. You may be living on a pension or Social Security only. So, you might not have the financial stability that some people do. Most people don’t, unfortunately. We don’t have enough people with enough retirement savings today to handle that. That’s a whole other conversation, but as we get into the senior space, as we get into senior living, their number one health risk is social connectivity. That’s the number one health risk. There really isn’t a number two.

Yes, they may have some cancer issues. Yes, they may have diabetes issues. Yes, they may have depression and anxiety. But I can tell you right now, if you support them socially, many of those things will either be less of a problem or they’ll manage them better—or they may not even develop those health risks associated with those chronic diseases.

So, understand how important social connectivity really is. It is not something we spend enough time addressing.

And energy doing this. As a matter of fact, going back to Gallup, going back to Jim Harter, I remember talking to him one time. I said, "Jim, according to Gallup, the number one way of being well-being is your purpose, your career." I totally respected that, but I asked, "How do we get our purpose and career?" Seventy-five percent of people who get their jobs do so through their social network. So isn’t social network, or social well-being, maybe even your number one choice, as opposed to career, because that’s actually where you’re going to get your purpose from?

I actually made the chief scientist and researcher for Gallup think for 10 seconds before he could answer. He said, "That makes a lot of good sense." But the data still says career and purpose. I said, "No, that's a great point, but that’s what we’ve got to understand. We've got to handle the physical elements, but if you’ve got social connection and people who want to see you succeed and survive, you will."

My mom had lung cancer in 1999—April of 1999 was when she was diagnosed. She had a 5% to 6% chance of survival. She lived to be 84. Twenty-five years later, she finally passed away. Why? Because she was a fighter. She had a social network—her family, her friends, and her community—that made her want to keep fighting. So, know that it can be done. But we’ve got to make sure that we understand that it is the people around us. It is that connectivity. It is those people—family, friends, those who work for them—that’s where the connectivity comes in.

That’s so important. And then I want to move into this quote from Dr. Cole. He said that the biology of loneliness can accelerate the buildup of plaque in the arteries, help cancer cells grow and spread, and promote inflammation in the brain, leading to Alzheimer’s disease. Loneliness promotes several different types of wear and tear on the body. I just think this is so interesting—what loneliness can actually physically do to our bodies. And we don’t give it enough time or credit.

I don’t know what else to say about that except, "Yeah." I mean, I hate to say it that way, but it’s just the reality of what it is. We have to remind ourselves that when we get anxious, how do we breathe? We breathe differently. How do we act? We act differently. Our systems start to fight each other. Think about gut health. Yeah, we can put as many probiotics in our system as we possibly can, but if you’re so anxious that you can’t, for lack of a better term, go—well, that’s what starts causing a lot of these buildups.

We’ve got to remind ourselves about what's important, and sometimes we get too emotionally attached or detached to various aspects of what's going on because it’s not going our way, or we don’t like what’s happening, and we take it too personally. Now, we’re going to take things personally, let’s not lie, but that’s what stress does to us. Stress, loneliness, and isolation just make it worse. That’s what we’ve got to remind ourselves. What a great quote. Yeah, I just think it’s such an interesting thing to talk about.

I also want to move into another really great quote I heard from Attorney General Vivek Murthy. He said, “The health and societal impacts of social isolation and loneliness are a critical public health concern.” And the previous Surgeon General, Dr. Jerome Adams—who’s actually from here in Indiana—he was a good friend of mine. Jerome even talked about community health for economic prosperity. So, taking Dr. Murthy’s quote and Dr. Adams’ quote and kind of slamming them together, it goes back to your sense of community. Where does that sense of community come from? It comes from your home, your neighborhood, your city or town, your state, your nation, and your world.

Going back to Gallup, Gallup will tell you that the number one health risks are within a one-mile radius of your home. So, think about what's around your house. Do you have your friends and family nearby? As I talked about earlier, my cul-de-sac is a small, quiet place. There are only about five houses, so I can name every single person who lives on that cul-de-sac. In fact, we have our Christmas gathering coming up every year. That’s something very unique about what we’ve got. But we’ve got to remind ourselves—when people feel out of their element, that’s when social isolation and loneliness kick in.

Dr. Murthy’s done a great job as Surgeon General, and Dr. Adams did a great job too. I’m very impressed with both of them.

Well, Chuck, I have to say I’m impressed with you. You've created such a great conversation today, and you really keyed in on so many important topics. I think our listeners definitely gained so much knowledge from this. I know I did. But that’s all the questions I have for you today.

Well, hopefully, everybody enjoys this. And feel free, if you ever want to reach out to me, go through Kirsten here, and I’m happy to have any kind of conversation.

Well, thank you so much for being here again, Chuck. It’s been such a great conversation, and we will see you again on the Senior Home Companions podcast.