Loneliness and the elderly: opportunities for health promotion.

I once met a retired, twice divorced commissioning engineer who told me that ‘To be lonely is like losing your sight – I don’t think that anybody who is not in that situation can understand it.’ There are many elderly people who find themselves in the same situation as the man I met, especially because more people are living longer as a result of improvements in science, technology and social care. The trend towards an ever older population is universal. By 2011, life expectancy had already exceeded 75 years in 57 countries of the world, and by 2017 the population aged over 65 years worldwide will outnumber children under 5 years of age. The theme of World Mental Health Day 2013 is mental health in the elderly. This provides an opportunity to consider the particular challenge of loneliness and isolation in old age. Social isolation and loneliness may be related, but are different. Social isolation typically refers to physical separation from other people, such as living alone or residing in a rural geographical area. Loneliness refers to a subjective emotional state of being alone, separated or apart from others. The experience of feeling lonely while in the midst of a social network can be described as alienation, and research shows that there is a relationship between social isolation, loneliness and health outcomes, and also quality of life. There is so much that can be done to prevent loneliness, and the focus of World Mental Health Day 2013 enables us to double our efforts. Practical interventions that are effective include befriending schemes, social group schemes, regular home visits, telephone contacts, problem solving and Community Navigators. The man whom I met, who likened feeling lonely to losing one’s sight, might have benefited from simple community interventions such as volunteering or joining a social group. As a retired engineer he still had so much to give. Perhaps we, as a community, need to find ways to better recognise the problem of loneliness and social isolation, so that practical support can be given to enable individuals to maintain that sense of connection, social role and belonging. You can make your contribution by becoming an advocate for the theme of World Mental Health Day 2013 (www.wfmh.com/00WorldMentalHealthDay. htm).