How loneliness leads to health problems for family caregivers

We tend to think of lonely people as those who live by themselves and spend most of their time alone — those who are reclusive or homebound.

Older adults who have outlived their spouses and friends come to mind.

In fact, loneliness is much more than being alone or feeling isolated. And the truth is that it impacts all ages, personalities, and circumstances. People we’re close to may be suffering from loneliness and we don’t know it.

Like family caregivers.

Statistics tell us that caregivers are especially vulnerable to depression, isolation, and loneliness.  It’s a troubling problem. It’s also often overlooked because many who care for their loved ones feel alone in their challenge but choose to meet it silently. They may feel shame in admitting loneliness, as if it’s a personal failure.

Sometimes it’s just easier to say, “I’m fine.”

In 2017, U.S. Surgeon General Vivek Murthy warned of a loneliness epidemic. Early in his tenure he and his staff toured the country to ask people about their pain points. They heard things they had expected to learn — the opioid crisis and chronic disease were most often mentioned.

But in the course of their travels, they saw an emerging pattern: “Loneliness ran like a dark thread through many of the more obvious issues that people brought to my attention, like addiction, violence, anxiety, and depression.” (Together: The Healing Power of Human Connection in a Sometimes Lonely World, Vivek H. Murthy, MD)

So we know that loneliness occurs when we encounter changes in our life that keep us from the people and activities we usually connect with. Becoming a caregiver includes such changes. It’s important to know that loneliness can be a side effect, and there are a number of reasons why this is so.

There are also a number of health consequences that impact caregivers who allow loneliness and isolation to encroach on their well-being.

The good news is that there are strategies for reducing caregiver health risks, along with local resources to turn to for help.

Caregiving is hard work, and loneliness makes it even harder

If you’re the spouse or adult child of someone needing care, when caregiving becomes your responsibility it means assuming a new role in your family and community. Your loved one’s relationship with you changes to one of dependency. Your social network takes on a different look as well because your regular lifestyle is partially or wholly replaced with caregiving duties.

Your outside employment may be impacted — you may need to work reduced hours or leave your job. Other aspects of your normal routine also change. It can mean a major adjustment.

If caregiving requires your 24/7 attention, your likely response is to limit outside connections or perhaps retreat from them completely. Early on you likely feel a strong commitment to your loved one’s well-being, even to the neglect of your own. 

Here are some common caregiver experiences that might ring true for you:

• If you’re an adult child of an older adult needing care, the role you play in your own family might be disrupted as your primary focus changes to the needs of your parent.
• Your self-care activities take a hit — you have little time for exercise and for planning and preparing healthy meals. You may lose out on precious sleep, especially if your loved one needs round-the-clock care.
• Taking care of routine errands for yourself, like grocery shopping, haircuts, and medical appointments, can feel impossible to fit in.
• You may feel unable or unwilling to take time away from your loved one in order to visit with friends or be involved in activities for your own enrichment. Your hesitation might be due to the unpredictable nature of your loved one’s condition. It’s hard to make plans when someone else’s well-being is irregular.
• There may be times when you feel resentful or angry about your new responsibilities. Then you might feel guilty for thinking this way.
• It may occur to you that no one else is fully able to understand your burden and the daily challenges your responsibilities cause.
• When your world revolves around your loved one’s care, it’s easy to neglect your own intellectual stimulation. You might feel as if you have nothing of interest to offer others, so you avoid interacting.
• You might choose to avoid outings with your loved one because explaining your situation to others can be uncomfortable.

It’s not difficult to see how these changes add up to a withdrawal from your normal life. Friends, family, co-workers, and community can readily take a back seat to the daily care of your loved one. It’s emotionally painful to pull away from the activities and connections that were once important to you.

It can ultimately be physically painful as well. Your own health might be on the line when loneliness and social isolation dominate your daily caregiving experience.

The dangers of caregiver isolation include physical and mental complications

If you have any kind of regular daily routine around exercise, meals, work, and activities, chances are you’ve achieved a working balance in your life. Caregiving responsibilities can upset that balance and lead to a disrupted routine. The result? Your physical and mental health pay a heavy toll.

Early in your caregiving experience you may feel overwhelmed at the scope of your duties and anxious about the uncertainty of your loved one’s health. There are living arrangements to figure out, medical appointments to attend, and often insurance issues to sort through. And not enough hours in the day to accomplish them, let alone practice self-care.

There’s sadness to grapple with because your loved one’s health is declining.

Caregiving is like being a project manager whose job is to pull everything together. And you may feel like the entire weight of the situation rests on your shoulders.

All of these factors mean a separation from your regular habits and lifestyle. And that fuels loneliness, which can lead to:

• depression — which can include pain, fatigue, and changes in appetite and sleep patterns;
• stress — with associated risk for high blood pressure, weight gain, substance abuse, and gastrointestinal problems; and
• a compromised autoimmune system — which opens the door to more chronic conditions.

Loneliness is also a culprit in increased rates of cognitive decline in older adults, according to a study conducted by researchers at Brigham and Women’s Hospital and Harvard University. If you’re an older caregiver, the social isolation you experience as you care for your loved one must serve as a red flag for you.

Strategies for overcoming loneliness

Caregiver self-care is a responsibility that’s every bit as important as what you do for your loved one. It’s easy to talk about and difficult to do.

Here are some things to think about and some actions to take that have some potential for helping you break through the loneliness and isolation you feel.

Plan to invest two precious resources in yourself to protect your health — time and money. You may feel as if you don’t have enough of either to spare, but it’s essential to recognize that this is an investment that could save your life. Investing in your own health is the most important thing you can do for yourself and everyone who loves you.

Ways to invest time:

• Get some exercise, even if it’s a short walk, a few jumping jacks, or some wall push-ups. Physical activity like this helps to clear your head and freshen your outlook. If you can get outside for a while, take enough time to appreciate your surroundings.
• Connect with someone outside of your household – an out-of-town family member or an old friend — to let them know you’re thinking of them. Making this effort, which might only take a few minutes, helps to take your inward focus and direct it out toward someone else. Pick up the phone and make a call. If you’re unable to offer news of your own, be the friend who asks questions and learns how someone else is doing. Connecting can also be a simple exchange with someone at the grocery store or taking a minute to extend thanks to someone who provides a service to you — such as your mail carrier or sanitation crew. Even small moments of connection create a sense of belonging in the world, and you’ll feel better for it.
• Find a caregiver support group. Most are still meeting online, which can end up being more convenient for many. Locating others who really understand your situation connects you and also adds a new dimension to your social network. See resources listed in the section below.

Spend some money to:

• Talk to a therapist. You deserve to meet with someone who’s dedicated specifically to you and the challenges you’re facing. Since you spend most of your time focusing on your loved one, therapy is a way of reminding yourself that you matter a great deal. If you have negative feelings about caregiving, you can lighten your emotional load in confidence with a non-judgmental therapist. Many local therapists are doing remote sessions. Some national organizations include BetterHelp and Talkspace.
• Arrange for respite care. Give yourself a caregiving break so that you can rejuvenate, take a short vacation, or just arrange for some regularly-scheduled time to step away from your responsibilities. There are local organizations that offer day programs for older adults — see the resource section below. You can also find expert care from an in-home care service such as SeaCare.
  
  

Resources for caregivers

The Aging Care Caregiver Forum is a useful tool for learning about other caregivers’ solutions to common challenges. You can pose a question, contribute to ongoing discussions, or subscribe to a newsletter to read about a variety of caregiving topics. Because it’s made up of real caregivers facing familiar problems, it’s a great way to feel connected and learn what’s worked for others.

Resources for support throughout King County:

• Alzheimer’s Association Caregiver support groups
• American Parkinson’s Disease Association(Northwest Chapter) support groups
• Community Living Connections of Seattle & King County various support resources
• A good article on the value of support groups and connections from Aging and Disability Services (Area Agency on Aging for Seattle and King County)

Read a highly recommended book. Surgeon General Vivek Murthy, MD’s Together: The Healing Power of Human Connection in a Sometimes Lonely World, is an excellent and very readable book about how prevalent loneliness is in our country. Hearing an insightful perspective on the problem might help you feel less alone with your situation. Find it through the King County and Seattle Public Library systems.

Please contact the staff at SeaCare to learn about in-home care services as you plan your caregiving strategy. We’ll share ways we can support your family’s journey.

Katie Wright writes about aging and senior wellness from Bellingham, WA. You can read more about her here.