Scoping Review of the Literature Social Isolation of Seniors 2013-2014
Consequences
Social isolation can have deleterious consequences for seniors that are often difficult to separate from the risk factors associated with isolation (e.g. mental health and social isolation); and furthermore, it is difficult to determine the inter-relationships among these various factors. The results of this association can be self-reinforcing or cyclical patterns of social isolation that become difficult to break. In addition, since social isolation is by definition separation from one’s social networks and community, it is often a hidden problem. Consequences of social isolation have been grouped under three themes: economics, health/mental health and social.
Economic
The contributions of seniors to the community, such as through volunteering, decrease when they experience social isolation (British Columbia Ministry of Health, 2004; Raymond et al., 2008). Given the degree to which seniors volunteer and the valuable contributions that seniors provide to the community as a whole, the negative impacts of social isolation should be considered an issue for the entire community (British Columbia Ministry of Health, 2004).
Older Canadians also make an important contribution to the paid economy (Edwards & Mawani, 2011). Seniors themselves and society in general benefit from continued engagement in the labour force (National Seniors Council, 2010): increased income, increased intergenerational learning opportunities, and retention of technical skills, leadership talent and corporate memory. However, many of the risk factors associated with social isolation are also barriers to labour force participation (i.e. poor health, information caregiving responsibilities, ageism, and lack of awareness of opportunities) (National Seniors Council, 2011).
Physical health, mental health and utilization
The British Columbia Ministry of Health (2004) noted that there are multifaceted interactions between the variables of social isolation, loneliness, use of social services and one’s health status. Therefore, it is difficult to determine the direction of causality; that is, the lack of a social network may lead to poor health and/or poor health may lead to the breakdown of the social network (Keefe et al., 2006). Some research indicates that lonely individuals are more likely to use health services (Geller, 1999, as cited in Bolton, 2012, p.20; AQCCA, 2011) or demonstrate inappropriate service utilization (Keefe et al., 2006; Medical Advisory Secretariat, 2008), while other research reveals no significant differences with regards to the use of health services between isolated individuals and their non-isolated counterparts (Cloutier-Fisher et al., 2006).
According to Mistry, Rosansky & McGuire (2001), research has revealed linkages between social isolation and readmission to hospital (as cited in Seymour & Gale, 2004, p.41). Cloutier-Fisher et al., (2006) noted the possibility that socially isolated individuals will be more of a financial burden on the healthcare system in the long run as they often do not seek the medical attention they require until they are older and in poorer health.
Likewise, social isolation and loneliness have been associated with decreased use of services due to lack of awareness or an increased used of services as a substitute to companionship (British Columbia Ministry of Health, 2004; Hall, 2004). Nonetheless, British Columbia Ministry of Health (2004) indicated that seniors with a healthy social network seem to appropriately use health and social services.
Hawton, Green, Dickens, Richards, Taylor, Edwards, Colin & Campbell (2010) investigated the relationship between social isolation and the health status and health-related quality of life of older people who were either socially isolated or at risk of becoming isolated. They demonstrated that social isolation is negatively associated with the health status and health-related quality of life of older people. Moreover, they concluded that the effect is clinically relevant and independent of other factors such as depression levels, physical co-morbidities, age, gender, etc. which has implications for policy makers and researchers (Hawton et al., 2010)
As per Keefe et al., (2006), consequences of social isolation include physical and emotional harmful effects (Li, 2010; Timonen & O’Dwyer, 2010; Cotten et al., 2013), which result in depression (AQCCA, 2011), poor nutrition, decreased immunity, anxiety, fatigue, premature institutionalization and perhaps even death (Keefe et al., 2006). More specifically, the disintegration of the social networks and loneliness from lack of relationships has been identified as detrimental to older people’s mental health and well-being (Seymour & Gale, 2004; Hall et al., 2003; Medical Advisory Secretariat, 2008). Fratiglioni et al. (2000) noted that individuals who live alone and do not have a close social network have an increased risk of developing dementia. Therefore, close social ties are seen as a protective factor against the onset of dementia (as cited in Seymour & Gale, 2004, p.37).
Social
Consequences of social isolation can have a negative impact on the community and society as a whole. For example, inappropriate service usage, lack of social cohesion and reduced civic participation and involvement in community activities (Keefe et al., 2006).
Overall, social isolation of seniors can cause communities to suffer a lack of social cohesion (Hall, 2004), higher social costs, and the loss of unquantifiable wealth of experience that older adults bring to our families and communities (British Columbia Ministry of Health, 2004). It can also result in reduced social skills, vulnerability to elder abuse and alcohol or drug addiction (Hall, 2004; Truchon, 2011; Social Planning and Research Council of British Columbia, 2011).
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