Isolation adds to burdens for older people

Bill Roberts, 78 and disabled, rarely leaves his home. One of his most meaningful sources of interaction comes twice a week, when his favorite Meals on Wheels driver delivers lunch – bonus points if it’s his favorite Hawaiian comfort food, loco moco.

On a recent Thursday morning, he greeted a driver at his front door, leaning on his walker before accepting his bagged lunch.

“It’s nice to have people come by,” Roberts said.

These morning visits break up loneliness and isolation that is common and potentially dangerous for seniors.

While a growing number of Americans feel lonely — a recent AARP study found that 40% of U.S. adults share that sense of isolation, up from 35% in 2018 — factors that accompany aging can make it more acute for seniors. Retirement, reduced mobility, the deaths of spouses and peers, and cognitive decline are all part of growing older that make seniors susceptible to isolation.

“Loneliness is more common among older adults because they’re often not in contact with people through routine activities like work,” said Doug Oman, an adjunct professor of community health sciences at UC Berkeley.

The health outcomes are particularly familiar to the aging: Isolation is associated with increased risk of heart disease, dementia, stroke, depression and premature death.

“There are a number of older people who are objectively lonely,” said Laura L. Carstensen, director of the Stanford Center on Longevity. “People who don’t have anyone to call if something happens to them.”

That sense of loneliness, she explained, can be damaging to psychological, physical and mental health. Research shows that significant social isolation takes a toll at any age, but in older adults, it can also affect longevity.

Scientists increasingly understand loneliness as more than an emotional state. Feeling socially disconnected can activate the body’s stress response, Carstensen said, and chronic stress can affect cells and increase inflammation. Some of the leading theories suggest that sustained inflammation may accelerate aspects of the aging process.

Public health officials have long worried that loneliness is bad for physical and mental well-being — U.S. Surgeon General Vivek Murthy called it an epidemic in 2023, and San Mateo County has declared the problem a public health emergency.

“Anyone can be vulnerable,” said Lee Pullen, the director of aging and disability services at San Mateo County Health. “This is not a race, ethnicity or income issue.”

Local groups, including San Mateo County Health, seek ways to ease the isolation that can accompany age through support services, public transportation, and social programs.

Meals on Wheels works with the county to pair meal delivery with regular check-ins for homebound older adults. Conversations at the door can serve as a lifeline for seniors who might otherwise go days without interaction.

“I’m glad loneliness is finally being recognized as an emergency; seniors are forgotten a lot,” said Meals on Wheels Peninsula Volunteers CEO Peter Olson. “We can’t forget about the people who built our communities.”

On that recent Thursday morning, before visiting Roberts, the senior with the disability, the first stop for one Meals on Wheels driver in San Mateo was a studio apartment.

Stephanie Figeira, the program’s director of nutrition services, was greeted by Larry Dahl, 74. He receives meals on Tuesdays and Thursdays. Once a regular on Stanford University’s campus, Dahl now spends most of his time alone at home due to brittle bone disease.

Dahl said he started feeling increasingly lonely as more of his friends died.

“It’s depressing,” Dahl said. “I’ve had 3 close friends die within the last 12 years.”

For Dahl, joy arrives along with the Meals on Wheels staff when they show up at his door. Perched in a yard chair on his back porch, Dahl and Figeira talked for nearly half an hour. He shared stories about his early days organizing library shelves, the trees he planted in his backyard decades ago, and the time he left the Meals on Wheels cafeteria lunch with six extra beef stews.

“Sorry I kept you so long,” Dahl said as he finished sharing about the limericks he writes in his free time.

Figeira assured him it was time well spent. When she turned toward the SUV to deliver the next meal, Dahl lingered at the door briefly, like there was more he wanted to say.

The following week, someone would be back to listen.