Are you Lonely tonight?

Watch and listen HERE or read below

Loneliness is a pandemic. And it is killing more people than anything we have seen.

By now, most people have at least seen the headlines from the CDC report that came out a couple of years ago and the recent Surgeon Generals Report on social isolation and loneliness.

25% of people over 65 are considered “socially isolated” with a third of people over 45 reporting extreme loneliness.

The CDC placed the overall risk of premature death for people who are socially isolated on par with smoking and obesity.

The risk of dementia? 50% higher. Heart disease? 29% higher. Stroke? 32% greater risk.

Socially isolated patients with heart disease? 400% increased risk of death.

Let’s not even get into the depression, anxiety, and suicide risks

But how are we addressing loneliness in senior care and IDD?

The two main approaches seem to be:

1.??????Cramming people into “senior communities” in some type of age-based apartheid,

or

2.??????The very popular and nice sounding “age in place” which works on the assumption that just because someone doesn’t want to live in a nursing home they will be somehow happier and less isolated living on their own. Statistically speaking they will be - alone, with no transport, far from any family that might visit, with no friends nearby, retired with nowhere to go and nothing to do.

There are many approaches that have had some success. Eden/Greenhouse homes (who identified loneliness as a major issue back in 1994) or host home/shared living programs have been wonderful for many people with IDD.

The solutions to loneliness in vulnerable populations have to be as diverse as the people they support. Not everyone wants the same thing in the same way. But the underlying need that all those solutions must address is removing structural barriers to, and facilitating, connection.

Attempts to legislate our way to this desired state are as mixed and disappointing as you might expect. The U.S. Supreme Court’s 1999 Olmstead decision.?Olmstead v. L.C.?stated that the unjustified segregation of people with disabilities is a form of discrimination.

Subsequent attempts to define this in practice have often had the opposite to the intended effect.

In Minnesota last year, my company tried to change licensure on 2 buildings. They had been an intermediate care facility for adults with intellectual and developmental disabilities. We were trying to create private rooms and still have a way for these 16 men (some of whom had been there 50 years) to stay together. That is what they wanted. But the state rules on patient choice meant that they could not be covered under home and community based funding as the two buildings were too close together. They could fulfil the patient choice regulation only by moving out of their home and living in a way that was the opposite of what they actually chose.

As a nursing home administrator in training, at least once a week I would have to go and fish the resident escape artist, Ted (93) out of the strip club across the street. We would reset his chair alarms, door alarms, and security monitoring. The man was practically a prisoner “for his own safety”.

Ted did not want to play bingo.

Ted did not want to read bible verses.

Ted had no interest in arts and crafts club.

Ted wanted to go and visit the ladies of negotiable virtue across the street.

But the CMS regulations on protecting patient rights? They didn’t extend to Ted’s right to go where he wanted. I would never have even got my license if we hadn’t worked to contain poor Ted.

When Dr. Judy Singer first coined the phrase “neurodivergent” she made the case that just as a healthy thriving ecosystem requires biodiversity, a healthy thriving culture requires neurodiversity.

It is such an obvious and simple concept – we all benefit when we include people of all ages and all abilities and all ways of looking at the world. There is certainly a large body of research on the benefits of diversity. Education, critical thinking, tolerance, reasoning and compromise skills - all increase.

All of this is leading us back to what our great great great grandparents knew intuitively. A good community looks after each other and everyone is better because of it.

I am often asked (usually with incredulity or disdain) why on earth I learned to play the accordion. I try to sound as cool as is possible for an accordionist and say that I saw James Fearnley play for the Pogues, or Phil Cunningham with Silly Wizard, or Yuri Lemeshev from Gogol Bordello.

But none of that is true.

My grandad was fading away. He was lonely, bored, and ready to die. My dad got the idea to have him teach me the accordion. Jim (Hamish) had been a professional player at one point in his life and there wasn’t much else I had in common with him when I was aged 10. This was a guy who rode a motorbike, smoked a pack a day, and worked in the coal mine – all by age 11. Royal Air Force (RAF) boxing champion, and mechanic on spitfire engines in World War 2 – this was a tough old guy.

He was a terrible teacher.

‘Just do this,’ he would say while his sausage fingers moved in a blur under his massive fists. But he started playing again. He even started talking. Then going out to the RAF club and playing music and having a drink or 5.

He found connection and meaning. I found out a lot about who my grandad was and what he had learned and I gained a love of music.

That is community. That is connection. It is that simple.

Whether you are writing legislation, caring for seniors or people with IDD, or just a human being who knows people with challenges – start with the person. What do they want? What do they love, where do they find meaning? How can we help them connect with others?

It might be church or a strip club. It might be heavenly harps or accordions from the bad place.

What kind of communities could we have if everyone found one thing they could connect with everyone else over? If we could all find one thing with everyone we meet that binds us together – or even just that we can learn from or appreciate about them.

Loneliness and all it’s negative impacts does not have to be. We can end loneliness for those who are isolated – and have better communities for everyone.