Social Isolation Circle Discussion- July 2014

We held a 30 minute HaveYourSay circle at our July Aging in Place Meet-up. I've participated in HYS circles about this topic before, and each time I get some new insight. Here are some salient points from this circle.

Adoption Resistance

Sometimes declining faculties cause a senior to isolate themselves from others. For example, a person who has some significant hearing loss may be unable to fully participate in group conversations. This person may then choose to stay away from groups, thus leading to social isolation.

In some cases there may be a technical solution, or some kind of aid, that would provide assistance but the person doesn't use it because they don't want to feel or appear to be "old". For instance, imagine a person living in a senior housing building. The person may come to the point that they are unable to walk very far unaided. This person doesn't want to use a cane or walker for fear of being seen as "old" and so they stop visiting neighbors and going to group events; they spend more time in their own apartment. This leads to social isolation.

We coined the term "Adoption Resistance" to describe the problem where a solution exists (or at least a partial solution) and yet the person does not want to take advantage of the solution. In the case above, a hearing aid might help the person participate in conversations, but "only old people use hearing aids."

You can see Adoption Resistance in much younger people as well. Consider the case of reading glasses. We all know people who obviously need them, but vanity prevents them from using them. We know people who use reading glasses in the privacy of their own home, but not in public forums.

We talked about some people who resist moving from their home to an independent living facility. Yet, once they finally make the move they report that their life is "so much better." These facilities let a person retain their independence but in a supportive setting with a rich social environment. Several in the circle said they knew of people who "blossomed" when they moved from a single family residence into an apartment at an ILF.

Overcoming Adoption Resistance

This is a difficult task. Some of the resistance comes from an unwillingness to look "old" or frail to others. Some of the resistance comes from an unwillingness to internally accept that one is getting older. And some of the resistance comes from misperceptions about what the aid actually is.

For instance, many hearing aids are so small that a social companion is hard pressed to detect it. (Particularly when one's companions have declining visual acuity! Maybe the young people see it, but one's peers do not.) Canes can be very helpful and can even by stylish. Without current data, many people think of independent living facilities as dismal places.

One person suggested that ILFs should be "party places" with cruise directors and loads of fun things. Why not keg parties? The residents are old, but not dead! Another person said that some facilities are like that, others are not. Another suggested that ILFs should be populated based on the interests of the residents... One for world travelers, another for stamp collectos, another for train buffs, another for gardeners, etc.

Another idea was a mixed use facility. It was mentioned that it takes about 200 units to get the critical mass for a well run, activity filled ILF. There are condominium complexes, apartment houses, and townhouse complexes with 500+ units. In a big complex could we designate 200 units to be an ILF. The units would not be contiguous, but spread throughout the building(s). There would be a dining room and laundry and activity facilities that are paid for and used only by the people living in the 200 designated ILF units. There would also be a more contiguous set of units - owned and paid for by the ILF units - that would be used for the skilled nursing component of an ILF. The other units would be owned or occupied by anyone, just as a regular complex would be. This design of a "embedded ILF" would provide a rich social environment that also allows seniors to continue to interact with people of all ages.