The loneliness crisis and how to help your parent

Loneliness is bad for their health.

Birthdays were important in my family. I was an only child, and my parents made a big deal about my birthday. They often planned a trip and a party. There’s no question I was spoiled.

After my mom died, I felt like it was my job to make my dad feel as special as they had always made me feel on my birthdays. I took him to dinner, bought him too many gifts, and begged people to call him. I’d text my aunt, my cousin, my dad’s friends, to remind them it was his birthday. “I think he’d love to hear from you!”

As my dad grew older, I had to do more and more cajoling to get his friends and family to call, send a card, gather for dinner. Why was everyone dragging their feet on seeing my dad?

When he was hospitalized in 2020 for appendicitis, and then shunted off to rehab after rehab, visiting him was complicated. You had to make an appointment, meet him outside, and talk from behind glass like you were visiting a convicted murderer instead of an octogenarian obsessed with solving TV murders with Poirot. It was hard to hear each other, and you only had 15 minutes before the next family showed up. But when people asked me what they could do for me, to help with my dad, I always said the same thing: go visit him. Call him. Ivan and I (and our baby of course) were the only people who ever went to see him in rehab or the hospital that year.

Visiting with my dad at a nursing home in 2020. He mostly got to know my baby from behind glass.

I know COVID made things like visiting vulnerable people feel impossible, but I couldn’t help but feel sad about how small my dad’s world had gotten at the end of his life. For such a joyful, extroverted, charmer of a person to be alone at the end was heartbreaking.

Even before my dad was hospitalized, his world seemed to get smaller by the day. When he was still driving, he’d go to Publix most days. The interaction with the cashiers wasn’t deep, but research shows small, casual interactions are still impactful. He couldn’t drive his friends to dinner, organize trips to the local horse racing track, or make more than a short appearance at family get-togethers. Even before COVID, he was alone in his apartment more and more.

Loneliness and social isolation have dire consequences for older adults. “Loneliness and isolation are related, but there’s a distinction: isolation is structural; loneliness is psychological,” M.T. Connolly says in “The Measure of Our Age.”

In other words, there may be lots of people around you (which means you aren’t isolated) but if you have nothing in common with them or don’t connect with them for whatever reason, you might still feel lonely. And similarly, you might be socially isolated but content and not feeling lonely. Perhaps you are just wired to require less social interaction than others. But when you ask older adults, many of them do report being socially isolated and lonely. Even before the pandemic made social connection impossible for older adults, about 43 percent reported feeling lonely.

Loneliness and poor social connection are associated with not only the psychological consequences you’d expect, like depression and anxiety, but also with heart disease, diabetes, and dementia. They also make the elderly more susceptible to fraud and financial scams that prey on lonely seniors.

It’s impossible to determine whether loneliness causes these poor outcomes or is just associated with them, of course. It may be that folks experiencing a slowdown in their physical abilities become isolated because they are no longer able to drive, walk up stairs, or participate in activities as they once did, and so it’s really the physical decline causing the loneliness, not the opposite. But research also shows that the less social interaction someone gets, the less open and understanding they become, so the less able they are to make the social connections that would decrease their loneliness. In other words, you don’t hang out with people as much, so you get kind of crotchety. No one likes to hang with a Grumpy Gus, so you get fewer invites and are less likely to accept the ones you do get, and so you become even more lonely.

For my dad, as his heart slowed down, so did his ability to get out of bed, shower, and get dressed. It all felt like a lot of work, and he could barely do it in service of the important things, like holidays and doctors appointments. Doing all that to spend time with friends on a random Thursday began to seem out of the question.

For me, caregiving was also lonely. During COVID, it was lonely because when I was with my dad, social distancing made it so that I was alone with him. And I was an only child anyway, so there wasn’t a sibling with whom I could share the caregiving burden.

I’m still grappling with the bitterness I have regarding the way my dad’s friends and family failed to show up for him at the end of his life.

I think there were two things happening. One, seeing my dad at the end of his life felt uncomfortable for folks. It reminded them, maybe, that they, too, might one day be isolated, alone in an apartment, no longer able to do the things they once enjoyed. They might end up in a rehab facility or a nursing home. It’s hard to be confronted with that truth. Also, it was a clear reminder that my dad would die, and I think people preferred to close their eyes to that reality and leave him frozen in their memories as he was 10 years ago, when he was reliable and steady in times of stress and joyfully present at every gathering.

Just as I think my dad’s loneliness at the end of his life was more about his friends and family than about him, I also think my bitterness isn’t so much about him as it was about me. In “A Bittersweet Season,” Jane Gross writes about how she begged her mother’s friends to come to see her in her final days:

“What they also both understood was that my summons had been a call for help. I wanted them to take care of me. I wanted somebody to take care of me. I wanted a mother.”

Being the only child with one remaining parent is constantly longing for someone to swoop in and parent you. I think, like Gross, that I kept reaching out to my dad’s friends and family hoping in part that they would see how much I was doing, how hard I was trying, and envelop me in the love and approval I’d been missing.

It’s lonely being in a nursing home at the end of your life, hearing about your friend’s deaths, turning on the news and learning another singer or actress you admired is gone, missing the family members who don’t call or show up, but it’s also intensely lonely being a caregiver. And the health risks to lonely, isolated caregivers are the same.

Here are five strategies for helping your parent dig out of a hole of loneliness, and five bonus strategies for you to try, as a caregiver, to ensure you don’t fall into one yourself:

• Bring your parent to social events even if it’s hard, even if they don’t want to stay very long, even if they complain. If they don’t want to go, get curious about why. Are they having trouble hearing? Are they embarrassed about their health? Do they doubt their ability to get to where they need to go? Instead of just pushing them, get to the bottom of why your parent is resisting, and see where you can help eliminate obstacles.

• Help your parent get comfortable with FaceTime or video chatting with family or friends they can’t see in person. Sometimes, it might seem like this technology is intuitive, but it can be challenging for older adults to manage.

• Try group activities. My dad was predisposed to opting out of any organized activity at every facility he stayed at, but if you can get your parent to try out various activities, you might find one that works for them. Your local Area Agency on Aging or rec center might have options you can try out. The key is helping your parent stay open to the possibility that they might like one of the activities (or maybe meet some other grouch to grouse with).

• Seek grief support. My dad was alone because he lost my mom and then refused, at 67, to even consider dating anyone else. He wore her wedding ring on the finger next to his own. Meeting other people going through the loss of a spouse and getting support might allow your parent to open up to new friendships.

• Look for volunteers. If your parent is homebound or living in a nursing home, check whether there are programs where a younger person will visit. Sometimes high schools or youth groups will visit with older people as a community service project.

Tips for caregivers:

• Seek out a support group for caregivers of people with your parent’s specific diagnosis, if applicable. On Facebook or through a hospital or university, you are likely to find other folks dealing with the same challenges you are. You will benefit from not only getting advice but also from giving it to others. Start by Googling: “name of diagnosis + support group” or “name of diagnosis + foundation.”

• Accept and ask for help. You may not be able to get help in your specific caregiving tasks (though if you can, great!), but you can probably get help in other ways. Maybe a friend can take your dog out for you when you’re stuck at the hospital or your neighbor can bring in your grocery delivery. Be creative in what kind of help you ask for.

• Schedule a walk or a phone date with a friend. You might feel like you don’t have time for this, but the pressure it relieves will prove it’s worth the time you spent on it. You will be less likely to lose your temper, feel less lonely, and be more able to tackle your caregiving tasks if you take care of yourself.

• Find ways to find joy in your caregiving. Remember that you’re caring for this person because you love them, and try to reconnect with a feeling of gratitude. Checking off something from your parent’s bucket list will help you feel more connected to them and might reduce burnout.

• Microdose your hobby. You might not be able to start a new crochet project when you’re overwhelmed with caregiving, but maybe you can watch a YouTube video about crochet. Or maybe you can’t get back into running marathons, but you can do one mile on the treadmill or listen to your favorite running podcast. Set aside even the tiniest amount of time to reconnect with a hobby you had before you started caregiving.