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Jeremy Nobel, MD, MPH
Jeremy Nobel, MD, MPH
Loneliness

Lonely No More

It's time to engage older adults through the arts.

Broward County has Florida’s fastest-growing population of seniors over age 85. But even this paradise for retirees struggles to address the loneliness and isolation experienced by many of its older residents, according to a 2018 study. The report inspired the launch of a new program to address isolation, designed to engage some 200 seniors over age 80 in the performing arts at the Broward Center for the Performing Arts.

By connecting older adults to one another through theater, this Florida program joins a wave of innovative arts-based interventions. The creative arts have an almost unparalleled ability to engage us, activate us and ultimately, connect us. The arts give us permission to pause and reflect and take a step back from our hectic and distracted lives. Through the arts, we can be “in the moment” as we experience thoughts and feelings that are then shared with others in transformative ways.

For all these reasons, organizations that work with older adults increasingly focus on creative expression to address the public health threat to older adults of loneliness and social isolation. It is an effort supported by The UnLonely Project, an initiative of the Foundation for Art & Healing, whose mission is to increase public awareness of loneliness, reduce its associated stigma, and encourage effective programming that addresses loneliness.

As a physician and the non-profit group’s president, I argue that we need to create more initiatives that target loneliness among older adults. Such programs are essential tools for tackling loneliness, a known social determinant of health for older adults.

Some 35 percent of U.S. adults age 45 and older are lonely, according to a 2018 AARP survey. Seniors are vulnerable to social isolation and loneliness, so much so that the National Institute on Aging is funding research that explores potential interventions that address the conditions, both risk factors for poor aging outcomes.

Maintaining social connections can provide a level of protection against the cognitive decline that is commonly associated with aging. If unchecked, loneliness in older adults can lead to stroke and heart disease. Loneliness is a common source of distress, suffering, and impaired quality of life for adults after age 60, and is a predictor of functional decline and death, according to a 2012 study.

Whether it’s related to children growing up and moving away, or physical challenges such as reduced mobility and hearing impairment, the experience of aging can mean fewer social connections and increased isolation. Research has documented that loneliness is a reality for many older adults. But as a society, we have not prioritized solutions to reduce loneliness. As the baby boomers who make up nearly 23 percent of the U.S. population continue to age, health care providers, social service agencies, educators, and policymakers must identify solutions that are effective, scalable, and sustainable.

There are many examples. Programs that offer painting or coloring are low-tech, low-cost solutions that help seniors maintain cognitive capabilities and connect to one another. Such initiatives can be offered in accessible and non-traditional settings, such as libraries or places of worship. They can be community-based or offered in senior-oriented housing settings. These flexible solutions are a critical response to loneliness.

The National Guild’s Catalyzing Creative Aging program, for example, is designed to support the launch of innovative arts education programming for older adults in their communities. In July, the initiative announced a round of grants for arts education nonprofits to provide creative arts programming for an aging population. Among the grant winners was the Jacob Burns Film Center, a New York film and media education nonprofit that will use its $7,000 seed funding to pilot a new, 12-week digital storytelling course that will let older adults share a personal memory or experience through images, music, and voiceover.

A toolkit developed by the Assisted Living Federation of America and the American Art Therapy Association posits that ceramics, painting, drawing, sculpture, knitting, and jewelry-making appeal to older adults and are therapeutic activities. Creative expression is a useful medium to process thoughts and feelings about the aging process.

Other community-based programs help older adults “age in place” so that they can access local services and remain in their homes. For older adults, living alone can be isolating. There is a growing need for intergenerational programs such as those offered by DOROT, a social service nonprofit in Manhattan and Westchester County. Some of its offerings focus on alleviating social isolation among older adults through the arts. DOROT runs a variety of onsite intergenerational arts programs for seniors and youth, including theater and painting and storytelling classes, and brings arts and culture to older adults in their homes through oral history projects, teleconference classes, and friendly visiting. Such intergenerational programs also address loneliness in young adults, including one of the fastest-growing demographics of caregivers: millennials.

Another community-based program is the Village to Village Network, which assists neighborhood groups in developing resources to help residents live at homes and remain active. The Village Model is a tool toward reducing isolation by offering such services as transportation, health and wellness programs, home repairs, and social and educational activities.

In fact, rural and low-income seniors are particularly vulnerable to loneliness. To address this population, later this year we are launching a new initiative, the Aging UnLonely Creativity Circle pilot, to focus on rural aging seniors in Maine, as well as low-income seniors in Maine, New York City, and Chicago. Funded in part by the AARP Foundation, these pilots will combine creative arts exercises, mindfulness, and social-emotional learning components.

Targeted initiatives to combat loneliness among older adults share one thing in common. Whether through creative arts programming, or improved access to transportation, or rich offerings at the local senior center, they forge healing connections among the growing population of socially isolated seniors. These are effective, sustainable and scalable solutions that deserve our collective support.

Barbara Benson and Eli Harvey contributed to this post.

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About the Author
Jeremy Nobel, MD, MPH

Jeremy Nobel, MD, MPH, is a Harvard Medical School faculty member and head of the UnLonely Project, an initiative to combat the public health epidemic of loneliness and isolation.

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