Diverse Older Adults Struggle With Social Isolation
Despite connectivity, language and other barriers continue to exist
When asked by staff of the Diverse Elders Coalition about the aging services available in her area, Elva, an American Indian elder from New Mexico, relayed how important her local Elder Center was to her and her peers’ well-being: “We as elders need a place to come to, [where we] have meals, do activities and visit with friends and relatives.”
Elva noted that the Elder Center was a place where she could get information about benefits and other available resources. “Many times, as a Native elder, we feel that we don’t exist,” she said.
In our increasingly digitally connected world, there might be a tendency to think that social isolation is on the decline. But evidence suggests that isolation, especially among older adults, is of growing concern. And older adults in communities of color, in American Indian and Alaska Native communities and in LGBT communities, experience isolation differently than do older adults in the mainstream.
There are, however, a number of culturally and linguistically competent interventions across the country demonstrating a promising reduction in feelings of social isolation among populations of diverse elders.
Language Is a Cause of Isolation
A primary cause of social isolation among the constituencies served by the Coalition is linguistic isolation, which contributes to social isolation, increases depression among older adults and restricts access to important information and services.
Among Southeast Asian American older adults, for example, more than 85% of Vietnamese, Laotian, Cambodian and Hmong older adults are limited-English proficient, and many of these elders live in households where no one speaks English. These language access concerns are echoed in communities of Hispanic older adults, Asian American and Pacific Islander older adults, and in many other immigrant communities.
Expanding the social networks of limited-English proficient older adults has been shown to decrease isolation and improve health outcomes in these communities. One program, hosted at the Southeast by Southeast Community Center in Philadelphia, addresses the unique needs of older refugees and connects them with other older refugees in their communities. Revitalizing positive memories and tapping into elders’ strong sense of cultural heritage are crucial to foster in refugees, as these approaches support their sense of well-being. Encouraging older refugees to venture out of their houses and gather to share images and stories from their native countries through engaging in various artistic projects improves these elders’ mental and emotional health.
When adult day services community art and education programs and job training programs, such as the Senior Community Service Employment Program, include culturally competent programming and linguistically appropriate translation and interpretation services, more diverse older adults will participate in — and benefit from — these services.
Isolation in Indian Country
While access to resources via computers, smartphones and the internet has increased — and many older adults report frequent use of Internet-based services like Facebook — more rural parts of the United States, including Indian Country, have been left behind. American Indians and Alaska Natives face a digital divide that limits or outright prevents consistent access to Internet connectivity in their homes and communities.
In these frequently remote, rural areas — the geography of which may also impede American Indian and Alaska Native elders’ access to health care and community services — social isolation is associated with depressive symptoms and poorer health. However, social support and spirituality offer promising mechanisms to bolster resilience among American Indian and Alaska Native older adults.
Community leaders and health care practitioners working in Indian Country should engage family and community support to improve health outcomes, especially by directing individuals to their local Elder Center or Benefit Enrollment Center for social support, as well as for practical guidance on accessing available resources and benefits. Other family members, friends and neighbors who may be supporting tribal Elders also should be engaged in their care.
Programs like Wisdom Warriors — tribal community chronic disease self-management program that combines traditional beadwork with health and fitness activities and encourages Elders to connect with healthy aging resources — provide best practices for culturally competent engagement with older adults in Indian Country.
Isolation and LGBT Older Adults
Older adults who identify as LGBT are twice as likely as non-LGBT older adults to live by themselves, which, when coupled with having to endure a political climate that is openly hostile toward LGBT identities plus a lifetime of discrimination, can create severe social isolation among this population. LGBT older adults are five times less likely to seek medical care or social services than the general public.
Friends, neighbors and peers are essential to the well-being of LGBT older adults, who are also less likely than non-LGBT populations to have children. Friends and neighbors who are not biologically related to an LGBT older adult may be responsible for making decisions about that elder’s healthcare, may be coordinating care for that person, and/or may themselves be providing care — and they are essential to that person’s health and well-being. There is an increasing need for health care and aging organizations to be aware of these “families of choice” and to include them in their policies and programming.
Ending Isolation Among Diverse Elders
More research and programmatic support are needed to uncover and address the unique social isolation concerns of communities of color, American Indian/Alaska Native, and LGBT communities. The Diverse Elders Coalition continues to monitor federal policy for opportunities to help those on the front lines of providing support to our constituencies. We are following the upcoming renewal of the Older Americans Act, which provides funding for programs like Meals on Wheels, and the developing Healthy People 2030 report, which should explicitly acknowledge that reducing social isolation in older adults is a key component in any strategy to improve the health of America’s older population.
Through consistent engagement with diverse older adults, their families and their caregivers, the Coalition will amplify best practices at all levels and advocate for policies and programs to end social isolation in our communities.
(This article first appeared in print in Aging Today, the journal of the American Society on Aging. It was first published online on the Diverse Elders Coalition blog.)