10.3 -
Social Isolation & Health
Social engaement and the meaning of life
Learning Journey "Stop-See-Learn" Spot #4 of 6
The School of Health Sciences, Ngee Ann Polytechnic, Singapore
Social Isolation, Loneliness and Depression
As discussed earlier, the biggest transition faced by most elderly is the transition from an active life to a possible one that is much more passive. By passivity, we are not just talking about physical activity but also things within the social environment such as lost of key social role and statuses. But the negative effect of these can be mitigated as discussed in the previous segment within the Activity, Continuity and Civic Engagement theories.
But in this section, we will look at the emotional traps that elderly face if they could not redefine who they could become in the late adulthood period . One of the biggest dangers facing the elderly is one of loneliness caused by social isolation (lack of social contact). This in turn can create depression among the elderly. This was the statistics that you first encountered at the start of this week. National University of Singapore's Yong Loo Lin School of Medicine found that 20% (1 out of 5) elderly in Singapore have signs of depression (Yong Loo Lin School of Medicine, 2018).
Social Isolation and Loneliness - A Brief Introduction
This awareness video by Bracknell Forest Council can be found in its original site in its YouTube channel: https://youtu.be/fNyJmYGMhXA
Social Isolation and the Depression of the Elderly
Social isolation is the key threat to the elderly. Below is a framing of the issue by Channel NewsAsia.
In Summary...
In the first little video you encountered in this section, a link was established by the researchers from the National University of Singapore between social isolation, loneliness, depression and health. This is summarised in the graphic below. You can click on the picture below to relook at page 1 of this section.
Oh, and, One More thing...
As commonly discussed in this and previous sections, one of the reason why ageing is the change in the way the elderly see their social world. The looming presence of death with or self or loved ones. Death also need not be a physical death but the loss of social networks known in Sociology as a a Social Death. Some elderly may experience a mild form of this. As the families shrinks in wealthier countries, the likelihood of elderly without children is increasing. For them, the loss of a lifelong partner can be extremely painful. Mr Desmond Seah speaks bout this pain:
"It hurts a lot.When she was sick, I looked after her. When I was sick, she looked after me. But I did the cooking because her legs were weak, I stayed (by her side) four days and four nights. She didn’t pass away. I went out for two hours. She passed away. I was heartbroken. ... I once cried for three days. The pain feels like a knife poking my heart." (Paulo, 2018)
Here in discussing the vulnerability of developing depression in the elderly we should touch on the concept of Grief because they may encounter Grief in the following forms:
Death of a loved one or spouse.
Social Death in the form of abandonment or social isolation.
So in order for us to effectively counsel our future patients, we should also look beyond the theories on ageing but also on theories about Grief and Grieving. SciShow has a very good video that discusses and critique various theories on Grieving.
This video lecture on Theories of Grieving is originally published in SciShow's YouTube channel at this site: www.youtube.com/watch?v=9LudhllbeXs
Optional Additional Readings
If this topicin this stop of your learning journey interests you and you would want to explore further, here are some news and academic articles that allow you to stretch your learning (Click on hyperlinks to download full article):
Elderly Depression: Signs and Causes. (Cheong , n.d.)
Like a knife poking my heart - CNA Insider (Paulo, 2018)
Loneliness and Mortality: Results from a Longitudinal Survey of Social Isolation, Health, and Lifestyles. (Chan, Raman, & Malhotra, 2012)
Prevalence of Depression among Older Adults—Results from the Well-being of the Singapore Elderly Study. (Subramaniam, et al., 2016)
Number of suicides committed by the elderly hits record high as Singapore population ages. (Rashith, 2018)
Singapore's elderly and their desperate battle with isolation, loneliness and depression. (Gonzalez, 2018)
Social Death (Borgstrom, 2017)
Next Section
In the next section we will look at how to make use of the knowledge gained from the Activity, Continuity and Civic Engagement Theory to help fend off depression in the elderly via the Transtheoretical Model of Behaviour Change.
References
Borgstrom, E. (2017). Social Death. QJM: An International Journal of Medicine, 110(1), 5–7. doi: 10.1093/qjmed/hcw183
Bracknell Forest Council. (2015, November 13). Social isolation and loneliness. Retrieved March 10, 2020, from https://youtu.be/fNyJmYGMhXA
Chan, A., Raman, P., & Malhotra, R. (2012). Loneliness and Mortality: Results from a Longitudinal Survey of Social Isolation, Health, and Lifestyles. Retrieved March 4, 2020, from https://www.fas.nus.edu.sg/swk/doc/Survey of Social Isolation Health and Lifestyles.pdf
Cheong, T., & SingHealth Group. (n.d.). Elderly Depression: Signs and Causes. Retrieved March 4, 2020, from https://www.healthxchange.sg/seniors/ageing-concerns/elderly-depression-signs-causes
Gonzalez, M. (2018, October 8). Singapore's elderly and their desperate battle with isolation, loneliness and depression. Retrieved March 4, 2020, from http://theindependent.sg/singapores-elderly-and-their-desperate-battle-with-isolation-loneliness-and-depression/
Martin, P., Kelly, N., Kahana, B., Kahana, E., Willcox, B. J., Willcox, D. C., & Poon, L. W. (2015). Defining successful aging: a tangible or elusive concept?. The Gerontologist, 55(1), 14–25. https://doi.org/10.1093/geront/gnu044
Paulo, D. A. (2018, April 23). 'Like a knife poking my heart': Loss, loneliness and the killing pain of elderly depression. Retrieved March 4, 2020, from https://www.channelnewsasia.com/news/cnainsider/elderly-depression-lonely-dementia-chronic-illness-treatment-10159670
Rashith, R. (2018, July 30). Number of suicides committed by the elderly hits record high as Singapore population ages. Retrieved March 4, 2020, from https://www.straitstimes.com/singapore/more-than-1-in-3-suicides-committed-by-elderly-as-singapore-population-ages
SciShow. (2018, March 22). The Truth About the Five Stages of Grief. Retrieved March 10, 2020, from https://www.youtube.com/watch?v=9LudhllbeXs
Yong Loo Lin School of Medicine. (2018, April 23). Do not neglect elderly depression. Retrieved March 4, 2020, from https://nusmedicine.nus.edu.sg/medias/news-info/1775-do-not-neglect-elderly-depression