Seniors in group living situations are less lonely and more optimistic

Seniors in group living centers are feeling less lonely now and more optimistic

By Jacquelyn Kung, Robert G. Kramer and Ed Frauenheim

Contrary to popular opinion, recent studies show that older adults are not languishing in lonely isolation. “In fact, a large percentage of seniors in our communities are not lonely,” said Robert Kramer, Founder and Fellow of Nexus Insights and Strategic Advisor for NIC. “The common perceptions —  they’re wrong, ageist and miss the hopefulness of seniors in their finding a sense of community, even in the midst of the pandemic.”

In the past, we have seen people come together during national emergencies “to form communities around a common threat and a common need,” Kramer explained. “The one group we don’t expect it from at all are older adults in senior living communities —  but they are, and they are demonstrating it,” Kramer said.

Authors Jacquelyn Kung, Robert Kramer and Ed Frauenheim point to our elders as role models for healing the nation, and showing us how to live more fully than ever, in their recent column in the Dallas Morning News.


Our poor elders.

Given the COVID-19 pandemic, and media coverage of seniors, you might think basically all seniors today are traumatized and lonely, right?

Wrong.

The stereotype of isolated, forlorn elders belies recent surveys of older adults in senior living settings.

Just 20% of senior living residents are severely lonely, according to a new 64,000-person survey from software firm Activated Insights. In fact, this survey of seniors in assisted living and other congregate living settings reveals a potential decline in loneliness among elders in retirement communities from before the pandemic. Prior studies before the pandemic of community-dwelling older adults found higher rates of loneliness.

We would argue that we as a country have a biased — and potentially ageist — narrative when it comes to elders living in congregate settings.

In fact, we should learn from the resilience of elders in the face of formidable challenges.

The stereotype of isolated, forlorn elders belies recent surveys of older adults in senior living settings.

Granted, the recent Activated Insights survey does not include most nursing homes, where particularly frail elders live. And the number of older adults in senior living settings overall, roughly 2 million people, is a fraction of the total U.S. senior population.

Still, the new research offers inspiration to the rest of the county as we work to construct our post-COVID reality and battle what some have deemed widespread languishing.

A key lesson from our elders in this moment is the power of community, friendship and gratitude.

Consider Patricia Finick of Dallas, co-author Jacquelyn Kung’s mother-in-law. By any measure, the 81-year-old has been through a lot. Her husband of more than 50 years died in 2019. After sitting in an empty home for half a year, she chose to sell her house in Connecticut, 20 minutes from where she was born, and relocate to Dallas.

In January 2020, she moved into Highland Springs, a senior living community in North Dallas. Finick swapped a 2,200-square-foot home for a 900-square-foot apartment. And then COVID-19 swooped in, isolating her in her new home before she had a chance to meet new friends.

Despite a very difficult year, Finick doesn’t feel beaten down in this moment. No, life is looking more hopeful to her. And she’s excited about engaging in more activities. “As long as my legs will let me, I’m going to go out and do it,” she says. “And if my legs don’t work well, I can get a walker.”

A key lesson from our elders in this moment is the power of community, friendship and gratitude.

One key to her optimism is her Catholic faith. Another is her set of friends, both long-standing phone buddies as well as some new friends she has met at Highland Springs over the past year. She’s part of a breakfast club, a group of residents who gather most mornings. “They’re really, really friendly, and we have a lot of laughs together,” Finick says.

Finick’s contentment is echoed by other residents of senior living settings, according to the Activated Insights survey of residents and family members during the first half of this year.

Many elders in these settings expressed gratitude, both for the sense of belonging they experience and for the caring they received from staff members of their communities.

Consider these survey comments from seniors:

“I’m more than satisfied with life. I feel safe and am especially grateful for the careful response to COVID-19. Gratitude and blessings.”

“(I had) a feeling of safety during a time of great vulnerability. Having the opportunity to make new friends helps a lot.”

These aren’t cherry-picked quotes. Before COVID, when asked for comments about the best thing about the senior living community, 20% or fewer responses were about belonging, community, appreciating the staff and being safe. This year, though, 60% to 70% of “best thing” comments mentioned those themes.

As a nation, America could use a booster shot of resilience. Observers note a kind of COVID hangover, or apathy.

Seniors in congregate settings, who in some ways bore the brunt of the pandemic, offer guidance for a brighter path forward. These older adults may be more willing than younger Americans to acknowledge our interdependence as human beings, experiencing the support they receive not with resentment but appreciation.

Far from feeling fearful, sad and isolated, seniors are showing us how to live more fully than ever.

A few months ago in The News, we authors urged the country to rethink how we view senior citizens and engage elders in the work of healing the nation.

The latest data suggests seniors are already doing this work. Far from feeling fearful, sad and isolated, many of them are showing us how to live more fully than ever.

Patricia Finick, for one, looks forward to more dinners and concerts with her new friends. Together, they are eager to put the last vestiges of the pandemic behind them.

Says Finick: “There is a whole world out there to explore.”

Read the article.

Jacquelyn Kung is CEO of Activated Insights and a Nexus Insights Fellow.

Robert G. Kramer is a Nexus Insights Founder and Fellow, and Strategic Advisor & former CEO of the National Investment Center for Seniors Housing and Care (NIC).

Ed Frauenheim is co-author of several books on organizational culture, including “A Great Place to Work for All.”

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Mind games help with long-term brain health

Mind Games – Significance of Lifestyle Interventions to Prevent Cognitive Decline

Humans have long been looking for the fountain of youth. Medical advances mean that most of us can expect to live for a long time. But how we live is an important component of successful aging. Originally published in June, Mind Games is an essay that explores the current understanding of best practices for maintaining a healthy brain as we age.

With my first book coming out in the fall, I am paying more attention to bookstores. I’m finding an increasing number of titles related to aging. It’s probably not surprising as the bulge of baby boomers – the oldest of whom are now in their mid-70s – are looking to successfully age, where a longer life span is matched with a correspondingly long wealth span and health span.

A number of these books focus on brain health. It makes sense as, according to one prominent researcher, Alzheimer’s is the most feared disease, even more than cancer. The loss of independence is devastating and requires comprehensive assistance to manage life. The burden on caregivers, often a spouse or family, can be overwhelming, too. A long life span and wealth span may be of little use if health deteriorates significantly.

It’s no surprise that the recent approval of Aduhelm, Biogen’s new drug for Alzheimer’s, has received significant attention. Its impact could be transformational for millions of people, perhaps with a greater impact on society than the vaccines produced to combat COVID-19. While critics point to scant evidence of its impact on the disease, if successful, it could usher in a new wave of effective innovations to fight cognitive decline.

“We may be soon entering an era without dementia. It could arguably be just as significant as a world without cancer. Such a milestone would be one of mankind’s great achievements.”

Significance of Lifestyle Interventions to Prevent Cognitive Decline

The good news is that many of us can take measures to prevent or delay cognitive decline without relying on a pill. A range of lifestyle interventions can reduce the risk of mild cognitive impairment, characterized as problems with memory, language, thinking or judgment, as well as the risk of dementia, such as Alzheimer’s. Mild cognitive impairment is often a precursor to dementia.

Diet

We are learning more about the role of a healthy diet to help prevent dementia. The MIND diet, which is a variant of the Mediterranean Diet, focuses on whole grains, berries, green, leafy vegetables, other vegetables, olive oil, poultry and fish. Researchers have found that strict adherence to the MIND diet for older adults resulted in about a 50% decrease in Alzheimer’s diagnosis. Even more encouraging is that you don’t have to be rigorous in adhering to the diet to experience a positive impact. Simply eating fish once a week and incorporating greens into a meal each day could be an achievable goal that makes a difference.

Exercise

Scientists are still determining the causes of mild cognitive impairment, but some evidence suggests that a reduction in blood flow to the brain can be a factor. Regular exercise amplifies the healthy flow of blood to the brain while exercising and afterwards. Recent studies show that regular brisk walking is particularly effective in helping older adults with mild cognitive impairment. As last month’s blog emphasized, it’s valuable to move regularly, even if the measures are as simple as taking stairs or parking farther away when shopping or commuting.

Social Connection

The impact of loneliness has been well-documented: it has been found to be as harmful as smoking 15 cigarettes a day and can increase the risk of premature death by as much as 30%. But loneliness is particularly harmful to the brain. Studies have shown that loneliness can increase risks of dementia by 26% and mild cognitive impairment by 105%. Regularly reaching out to friends, whether they live close by or far away, could have a greater impact on your brain health than you realize.

Sleep

Sleep is the single most effective thing we can do to reset our brain and body health each day. Sleep helps cement positive memories, mollify painful ones, and meld past and present knowledge, inspiring creativity. Conversely, insufficient sleep wreaks havoc. Insufficient sleep, or routinely sleeping less than six or seven hours a night, increases the odds of dementia. As we age, we tend to sleep less efficiently and wake up earlier, so it is important to go to bed earlier.

Hearing

Hearing loss has been shown to be a factor in cognitive loss and may also be one of the biggest potentially reversible factors. Hearing loss for a long period causes shrinkage to areas of the brain associated with memory. Proper diagnosis of hearing loss is important, as are interventions such as hearing aids.

Don’t Forget the Role of Place

Place has important direct and indirect impact on our brain health. Some places are objectively poor for our cognitive health. One study found that living near major roads is linked to an increased risk of neurological diseases, including dementia, Parkinson’s, Alzheimer’s, and multiple sclerosis. It is believed to be caused by excessive exposure to air pollution and the incessant noise of vehicles.

Place also has an indirect role, by nudging us to healthy lifestyles. A pervasive culture that values healthy eating makes it easier to eat healthy; environments that are conducive to exercise embedded in the normal course of life are beneficial; areas that promote social connection amongst neighbors can help stave off social isolation and loneliness.

An Era Without Dementia

With advances on various fronts, we may be soon entering an era without dementia. It could arguably be just as significant as a world without cancer. Such a milestone would be one of mankind’s great achievements. As Dr. P. Murali Doraiswamy, Director of the Neurocognitive Disorders Program at Duke University School of Medicine and co-author of The Alzheimer’s Action Plan, says, “It’s a hopeful time.”

But, even if Biogen’s Aduhelm is unsuccessful, we can be hopeful, because the right mix of diet, exercise, social connection, sleep and hearing may just be the antidote we need to keep our minds strong. And don’t forget the role of place, the foundation that helps pull it all together.


Mind Games was originally published on SmartLiving 360.

Place plays a significant yet often unacknowledged role in health and happiness. Ryan Frederick, CEO of SmartLiving 360 and a Nexus Insights Fellow is the author of the upcoming book Right Time, Right Place, in which he explores more deeply the idea that where you live matters enormously – especially during the second half of your life.

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Dr. Sara Zeff Geber on Senior Isolation and Solo Aging

Strategies for reducing isolation among solo agers – an interview with Sara Zeff Geber

Sara Zeff Geber, an expert in solo aging and a Nexus Insights Fellow, noticed something interesting. A lot of Baby Boomers were spending a lot of time, resources, and money taking care of their aging parents. And it occurred to her to wonder, for childless seniors like herself, “Who’s going to do that for us?” 

That question launched a new line of research for her, and ultimately led to her book, Essential Retirement Planning for Solo Agers.

Zeff Geber was interviewed recently by Dr. Namrata Bagaria and Dr. Paul Merkley of Seniors Junction on their podcast “Ending Seniors’ Isolation, One Conversation at a Time.” The two asked Zeff Geber for her insights into reducing isolation and loneliness for solo agers.

Among the many insights she shared:

  • Solo aging is becoming more common. “Almost 20% of Baby Boomer women didn’t have kids.”
  • Everyone, even married couples, should plan as if they will be solo agers. “One spouse will almost always pre-decease the other, and you don’t have a crystal ball.” 
  • “The research shows that isolation and loneliness are more deadly to us than 15 cigarettes a day,” said Zeff Geber. The most important thing, she suggested, is to build and maintain a social network. 
  • As Bagaria points out, “Paul and I have learned on our journey that some people are naturally proactive about connecting and building a network and some have to pick up that skill.” Said Zeff Geber, “Learn to be a joiner; find a group that interests you; it could be a golf club, a book club, a dog-lovers group, or a similar-minded group at your church or synagogue”

Listen to the full podcast.

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Jay Newton-Small and Bob Kramer discuss MemoryWell and person-centered care

Putting the Person Back in Person-Centered Care: Jay Newton-Small and Bob Kramer on the Power of Data to Transform Senior Care

Are your residents truly known, valued, and seen as people by your staff? Are they known as more than the sum of their ADL needs or underlying health conditions? 

Bob Kramer, Founder & Fellow at Nexus Insights and Co-founder and Strategic Advisor for NIC, talked with Jay Newton-Small, founder and CEO of MemoryWell and Nexus Fellow, about the value of data to deliver improved care and quality of life for residents of senior living.

A TIME contributor, Newton-Small developed the concept for MemoryWell from her own experience with her father. She wrote a narrative story of his life to help his care staff understand him better, and to provide better, more personalized care. 

Now her company has taken it further, working with senior living communities to foster connections between residents and other residents, and between residents and staff, based on connections, interests, lifestyle, and historical experiences revealed by their life stories. The company is able to help communities understand what services are needed, and who would most likely use or benefit from those services. 

“We shine the light to help you see who are the people you’re serving.” – Jay Newton-Small

“Where we are now is a shot in the dark,” said Newton-Small. “We shine the light to help you see who are the people you’re serving. So you can market, plan, sell and care for these people in a more focused way, that takes the guesswork out of it.”

The data has other powerful uses as well, which Newton-Small describes in the interview, which aired on Foresight TV. It can be used to get to the root causes of health issues. And, when aggregated, can be used in a predictive way, to help with prevention. “Right now our health care system is a reactive system. It’s an incredibly expensive system because we react to a problem,” said Newton-Small. “But if we know that a problem is coming down the pike and we can match people with resources that are available, then we can delay, defer and even sometimes prevent those problems from happening.”

See the whole interview.

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Overcoming loneliness among seniors

The Opposite of Loneliness

Originally published in 2018, and now even more important and relevant since the start of the COVID-19 pandemic and the isolation so many have experienced, The Opposite of Loneliness is an essay that explores the cost of loneliness, and that recommends effective ways to address is at the personal and the societal level. 

The English language has its limitations. For example, take the word ‘love’. The English language uses one word, for which the Greeks needed seven words – ranging from eros (sexual love) to philia (friendship love) to agape (love of stranger) – to accurately describe.

A similar example is with the opposite of loneliness. Merriam-Webster defines lonely as “being without company,” “cut off from others,” “sad from being alone” or “producing a feeling of bleakness or desolation.”  According to the late researcher on loneliness and pioneer of social neuroscience, Dr. John Cacioppo, English doesn’t offer an adequate antonym. He suggested the closest proxy was “normal”, although that is clearly not a satisfactory solution. It’s too all-encompassing. It’s not descriptive enough.

Marina Keegan, a senior at Yale University at the time, didn’t have a word for the opposite of loneliness in her New York Times bestselling posthumous collection of essays and stories The Opposite of Loneliness, but she knew that’s what she wanted. She says:

We don’t have a word for the opposite of loneliness, but if we did, I could say that’s what I want in life. What I’m grateful and thankful to have found at Yale, and what I’m scared of losing when we wake up tomorrow and leave this place. 

It’s not quite love and it’s not quite community; it’s just this feeling that there are people, an abundance of people, who are in this together. Who are on your team. When the check is paid and you stay at the table. When it’s four a.m. and no one goes to bed. That night with the guitar. That night we can’t remember. That time we did, we went, we saw, we laughed, we felt. The hats.

Sadly, Keegan didn’t experience the opposite of loneliness in the real world as she died in a car accident just weeks before graduation.

Loneliness is Becoming Normal

Unfortunately, loneliness itself is becoming increasingly normal. Loneliness has doubled since the 1980s, and now over 40% of adults report feeling lonely. In his Harvard Business Review cover story, Dr. Vivek H. Murthy, the former US Surgeon General, indicates that loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day, and even greater than that associated with obesity.

One the most powerful predictors of loneliness is living alone. This is particularly threatening for older adults, as about 1/3 of Americans over 65 live alone and over 50% of women over 75 live alone.

But, of course, people living among others can still feel lonely. In this regard, Dr. Cacippo describes loneliness as “perceived isolation.” The viral video, #EatTogether, by a Canadian grocer illustrates that you can live among plenty of people in an apartment building and still feel disconnected.

This phenomenon is not unique to the United States. The UK has over 9 million people suffering from loneliness. More than a third of older adults report being overwhelmed by loneliness. A whopping 80% of British citizens over 85 live alone.

Japan is perhaps the most challenged with loneliness coupled with the highest percentage – about a 25% — of its citizens 65 or older. Demographics coupled with frayed families and communities have made it particularly difficult, according to a recent in-depth article by the New York Times (“A Generation in Japan Faces a Lonely Death”). Sadly some people are even committing crimes to benefit from the social connection in prison.

How Can We Make The Opposite of Loneliness Normal Again

More seems to be known about increasing loneliness than what to do about it. The UK made a PR splash by creating a “Minister of Loneliness” in January. The anticipated focus of this ministry is to (a) create practices and programs that cultivate conversation, friendship and empathy: the founding of community allotments where solitary folks might gather, and (b) instigate knock-on-door initiatives, with volunteers targeting lonely souls. But it is an open debate as to whether we can institutionalize the elimination of loneliness.

Dr. Cacioppo’s research tested a number of methods and tactics, including many that did not demonstrate positive success. One successful tactic is to change how lonely people think about other people, having them understand what happens when their brain goes into self-preservation mode. Dr. Cacioppo’s research suggests that treating it like a disease is difficult because social connection requires a two-way relationship with others.

One simple yet significant approach is to more commonly practice kindness. Lonely people need an especially heavy dose of kindness. If more people were able to identify those lonely around us and choose to act kindly, say by an empathetic cashier to a lonely shopper at check-out, it would certainly help.

The Important Role of Where You Live

What is probably not mentioned enough in these conversations is the role of where we live in the context of loneliness. Living alone is a driver of loneliness. Fortunately, there are emerging, alternative housing models that help facilitate interaction and connection. For example, co-housing, a communal living approach that integrates shared spaces and a common house for community meals, is a popular housing option in Denmark with some successes in the US, and has demonstrated improved social connection, particularly across generations. EngAGE is an organization that integrates a whole-person approach to creative living, providing college-level programs in the arts, wellness and lifelong learning into existing communities.

Living in cities or in more dense suburbs (or “sub-urbs”) offers the prospect of a greater number of interactions with a diverse number of people. Susan Pinker, author of The Village Effect, points out that technology can be helpful in bringing people together for important face-to-face connection. In her research, she has found that it’s not just close friends that keep people from being lonely; it is also a broader network of connections, in concert with close friendships, that help people thrive.

At SmartLiving 360, we believe location, design and an ethos of social connection can go a long way towards helping build sustained social connection. Walkable locations make it easy for people to see others. Accessible, communal spaces designed for formal and informal connection make it easier to get to know your neighbor. In addition, having a culture where social connection is important helps residents self-select to be part of such a community. Our Lifestyle Ambassador is central in our approach as he knows each resident by name and serves as a catalyst for creating community. We have witnessed the positive impact.

The Opposite of Loneliness is Our Responsibility

Technology advances, shifting family dynamics and changing demographics are all conspiring to make loneliness more common. However, as we all become increasingly aware of the risks to our health and well-being, it is important that we make lifestyle decisions to ward off the hazards of loneliness, particularly as we age. Fortunately, new, innovative housing models will make it easier to embrace the opposite of loneliness at every stage of life.

The Opposite of Loneliness was originally published on SmartLiving 360.

Place plays a significant yet often unacknowledged role in health and happiness. Ryan Frederick, CEO of SmartLiving 360 and a Nexus Insights Fellow is the author of the upcoming book Right Time, Right Place, in which he explores more deeply the idea that where you live matters enormously – especially during the second half of your life.

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