+

In every U.S. state, at least 4 of 10 older Americans cannot or can barely afford basic needs while aging in their homes. Boomers of the lower and middle-class have around $9K in yearly retirement income, though $45K is the goal. Over 50% of older Mainers live below the poverty line when adjusted for late-life income and expenses (called the Elder Index, which you can calculate). Looking overseas, despite economic growth, almost 20% of older Chileans live below the poverty line. These kinds of choices become limited or non-existent, and all can relate to loneliness:

+ Little say in where home is.

Few savings force you to move to a subsidized apartment where few neighbors now stop by, to disconnect from familiar people & places. It'd help to have your kids' help, but they can’t make a living in your small town, and while some government funding is available, it’s not enough to make being your caregiver affordable. Or, upkeep may be draining & costly, making home unwelcoming or uncomfortable.

This is the financial reality for almost half of older adults across the nation. Even for well-resourced older adults who can pay for a safe home and homecare, it is expensive to age in place. Family caregivers can help with costs, but often rural towns are home to primarily elder residents as their children, grandchildren move southward and to cities to support themselves. Often a risk for lower-income people, living alone and/or in an unhappy situation triggers loneliness and poor health.

+ Fees, transport, even basic needs unaffordable.

To say ‘yes’ to dinner and a play with a new acquaintance, to exercise classes, book clubs, day trips, you’ll need: gas in your car, a car itself, a ticket at the door… disposable income, on a fixed income. There’s no real decision here- you'll get groceries instead.

Low social security and small or non-existent pensions, big expenses on things like healthcare, and assets like a home all lessen disposable income. When money is tight, social events with a price tag are cut in favor of housing, food, healthcare, transport, and other clearer necessities. 10+ million older Americans, which is 16% of all older adults, face hunger each year. Not only does chronic hunger take paying for any social gathering off the table, it also reduces energy, will, and desire to join in. Senior discounts go a long way, but even a few dollars may be too much. Hosting organizations cannot afford to make events free, nor pay for transport and other needs to help older adults get there. Financial freedom to spend spontaneously is a massive benefit, but is hard to come by.

+ Audio Translation - Older Adult in Chile

"In Chile, retirement is like a punishment. [Government-provided pension] is 30 percent of what you made when you were actively working. So you have a terrible disadvantage."

+ Social Service Coordination Perspective

"If there were all the money in the world, I’d use it to tackle transportation. Besides going out to do home visits and ensuring people are getting the resources in their specific community, it's hard to bring them to some of the programs we’re putting on. If we had money for transporation assistance or a shuttle, that would change."

Community Health Education Coordinator, SeniorsPlus in Lewiston

+ Continued need to work.

You'd go to church or meet with a group, but services are during the day, and you only get a day off once in a blue moon. Plus, by the time you get home after a long day of work, it's just too draining to make plans with others or go to an event of interest. You may have connections with co-workers, maybe a roommate or family, but there just isn't time, energy, or money leftover to connect with community.

Almost 3 in 10 full-time workers 55+ years old hold a low-wage job, compared with about 2 in 10 younger workers. Partly because older Americans are less likely to have a high school diploma than the general population. Low-wage employment, built-up debt, and the fact that layoffs are more common over age 50 can delay retirement, sometimes until an unknown date. While more people 65+ are working white collar jobs often by choice, full-time, draining work can take engAging opportunities off the table. Those in labor industries are most likely to be in this position, including older white Mainers supporting kids and grandkids, as well as New Mainers supporting families back home. In Chile, both indigenous Mapuche people making a living off their land, as well as under-paid city-dwellers, have less say over their work lives.

+ Audio Translation - Older Adult in Maine

"The causes [of loneliness]: I think many times it’s poverty. Necessity brought us here… It is one of the main causes we have. It’s better for the family to go forward."

+

Aging brings a wave of diagnoses, medications, and lifestyle changes, some a natural part of the process, and many preventable and treatable with the right support. 8 in 10 older Americans have at least one chronic disease, and 7 in 10 have at least two. In Chile, 3 of 4 people 60+ have at least one chronic disease. However, 3 of 4 of older Chileans are independent and half report excellent to good health. Many older adults adapt with resilience and grace, often helped by partners, family, caregivers (especially family caregivers), and providers. Yet certain conditions, in tandem with a person's financial, living, and other circumstances, reduce social interaction and make the person, and their caregiver, feel out of control and lonely. Because loneliness also takes a toll on health, these struggles can reinforce each other:

+ Mind is changing, bringing frustration, shame.

You used to play bridge every Friday, maybe even count cards, but it’s just too frustrating now, though you miss your fellow players. You’d talk more at dinner with family or friends, but it’s hard to follow conversation and make the witty jokes they’ve come to expect of you.

The number of Americans living with cognitive impairment totals twice the population of New York City. Cognitive impairment describes when a person has "trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life." This experience can range from from mild to severe, and can change overtime. Alzheimer's Disease is the most well-known, and over the next 30 years, the number of people diagnosed with it is expected to triple. Age is the greatest risk-factor for cognitive conditions, though we're learning more and more about ways to lower risk. These conditions can be frustrating and heartbreaking for older adults experiencing them, as well as loved ones. These changes can bring shame, worsened by social stigma, then disengagement, without a plan to adapt.

+ Maine State Office of Aging Perspective

"Should the state support Adult Day Centers? There are social barriers and financing barriers. Socially, caregivers do not want to utilize the services because they feel they are letting the person down. Some individuals do not want to go. It's hard to tease out a single barrier.

"For example, Southern Maine tried to create an Integrated Adult Day Center. They gave vouchers to reduce financial barriers. But, internalized ageism and stigma around neurocognitive issues like dementia became an issue. Individuals with early on-set dementia attended alongside those in advanced stages, and they stopped going. Individuals with no cognitive impairments didn’t know how to interact with those with cognitive impairments. Younger older adults would say: 'I’m not that old.' They were faced with their future reality."

Aging Services Manager, Office of Aging and Disability Services for the Maine Department of Health and Human Services

+ Physically difficult to go & join in.

Your spouse used to drive the two of you to a play in the next town over, but you’re both reluctant to drive at night these days. With how your eyes are now, it’s stressful and unsafe. Plus, it's exhausting just to get in the door of your yoga class, or weekly lunch with former work friends. Or, you’re homebound following a surgery or indefinitely, missing the movement and chatter of your walking group.

Almost 2 million older Americans are completely or mostly homebound, while over 5 million more have physical limitations which make it hard to leave their homes. Comfortable movement both enables socially-engaging activities, and is itself one of them. When injury, sickness, and pain get in the way of physical independence, loneliness is a common result. Likewise, hearing loss gets in the way of relating and bonding. Older adults are also more likely to misuse prescription substances due to chronic health conditions, so substance misuse is a highly related concern. Changes in abilities, brief or lasting, may be overcome, but call for both professional, familial, and friendly helping hands. As well as planning and thinking outside the box.

+ Geriatric Research & Education Perspective

"We did a project up in Buxport, Maine, which is very rural. A woman that we were speaking with lived alone in a trailer, and she was functionally comprised, physical function. The plan that she had with her neighbor was that she would open her blinds in the morning, and the neighbor knew that she was okay.

"And what that woman stated for us, quote un quote: ‘loneliness is the worst sickness there is.’ That was ten years ago. And I still remember that quote"

Professor and Director of Geriatrics Education at the University of New England in Biddeford

+ Home Health Care Perspective

"Home health care is for folks who have a rehab need and a goal to improve their situation. Some are rotating in and out of the hospital, and in and out of our services. I see most of all people who live alone, in a world where they can't do what they're used to doing for themselves. Maybe it's been a lifetime of struggling with making connections. But now, it's 'how do I actually get a meal? How do I take a bath? How do I actually even go to the bathroom? How do I drive or get somewhere? How do I get my groceries?"

Palliative Care Educator and Social Work Supervisor, Androscoggin Home Health & Hospice in Lewiston

+ Public Library Perspective

"There are accessibility concerns here in Maine. It's cold, icy, and snowy a good chunk of the year. We're in downtown, so if you park in a nearby garage, you have to walk two blocks. This can be the biggest barrier for visitors. I mean, we have one handicapped space, and we're opening that up to two upcoming because we've gotten feedback. But, I mean, that's two spaces.

"You hear a lot of people brush that kind of thing off like, ‘Oh, well, we live in Maine, you should be used to that.' I think that's insensitive to some very real concerns that affect quite a bit of our population."

Director, Lewiston Public Library

+ Unaided in spousal, child, or grandchild caregiving.

Your partner has developed dementia, or is bedridden. Your dedication to your loved one’s wellbeing overrides needed time to recharge & connect with your best friend, go to your usual library talks, and paint in solitude. You signed up for a caregiver respite program, which gives you a few hours off a week, but those only stretch so far.

Many homebound people have great difficulty even seeing a primary care doctor, and some are unable to do so altogether. Without help to manage illnesses, many depend on overwhelmed family caregivers. Older caregivers are more likely to care for a spouse or partner. Many caregivers of older adults are themselves growing older, and a third are themselves in poor health. 10 million older Americans care for a person with dementia without pay. Older adults are caregivers not only for partners or older family, but some 2.5 million are primary caregivers for children and grandchildren, too, including some with disabilities, and 2 of 3 are women. In Chile, too, caregivers are most often older family members. While some find a balance with help, other older adults become full-time caregivers- dedicating as many as 9 hours per day- especially vulnerable to isolation and loneliness.

+ Geriatric Reseearch & Education Perpective

"We've done research around the state, and found that care partners, especially those with partners with dementia, found that their kids, their friends, slowed or stopped interacting with them. This leaves them physically alone. So if there is an impetus for loneliness, it might be that physical isolation."

Professor and Director of Geriatrics Education at the University of New England in Biddeford

+

Older adults experience loss more often than in young adulthood. Intimacy, desired company, family or friends to lean on— all are tested by loss concentrated in later life. Older adults are generally as resilient as younger adults, paving a path forward. However, experience with grief does not shrink the need for support— both professional and person-to-person. Likewise, mental health conditions and (especially common among baby boomers) substance misuse, personal or of loved ones, can be a source of distress and disengagement. And can, too, be heightened or introduced by loneliness. Many older adults adapt with support, but some become newly or more lonely:

+ Loss of partner, of intimacy.

You wish for conversation with the person who knows you best, who you know best, to slip your hand into theirs, and to be intimate. You miss coming home to your partner, and sharing nighttime together, as you imagined you would for years in the future.

1 in 4 older Americans are divorced or widowed. Epecially for a generation married early, the end of a many-decade romance and bond may & absence in the home may devastate for years. Women are more likely to be widowed and live alone following. With family, friend, and other support, counselling is not always needed, but is tremendously helpful for the almost 1 in 10 older adults experiencing "complicated grief," related to other struggles. Elder men are more likely to lack supports like friendships, as well as counseling and support groups. The passing away or parting from a partner who connected you to friends can shake both daily social routine and sexual activity, contributing to loneliness. Some are reluctant to date again, others open to love, but wary of marriage.

+ Audio Translation - Older Adult in Chile

"When one is left widowed, and he’s barely functioning… the ‘computer’ I mean [pointing to his head, laughing.] It's hard on you. It's hard on you to be alone. One has to find a way to [find someone.] Because human beings are practically born to be accompanied."

+ Loss, separation, or conflict with family, friends, even pets.

You bear the passing of your child before your own, stop speaking to your brother, attend services for childhood friends, and the pet who gave steady comfort, always under foot, is no longer there. Or, immigrate to the U.S. without your family, and struggle to talk about your loneliness with them, and hold onto hope of their arrival.

Older adults must live through not only deaths of spouses, children, other family, and friends, but also estrangement due to disagrements, moving away, or losing touch over time. 1 in 10 older Americans has lost a child. For newcomers, family members’ immigrant, refugee, or asylee processes may prevent reunions for years. The long wait and difference in economic, cultural, and social experiences can be especially burdensome emotionally if it is difficult to find others experiencing the same struggle. Mental health conditions, such as substance use disorders are also a common source of distress for and among people, linked also with involvement in the legal system. Some 5+ million older Americans suffer from substance use disorders, and these numbers are particularly high for the baby boomer generation. The intensity and combination of these losses can both shock and numb older adults longterm, especially without the right support.

+ Audio Translation - Older Adult in Maine

1st Speaker: "Loneliness? Well, yes, it is a bit sad. Loneliness on account of being separated from [our] families. More in times like the end of the year, when one would like to be with family… [like] Christmas. Because of matters like work, sometimes one can’t go there.

2nd Speaker: "[The loneliness we feel] it’s not mutual. Because it’s only talked about. It’s not felt [by family in Mexico]. It’s felt here [gestures to his heart.]"

+ New Mainer Public Health Perspective

"The Trump administration's immigration policies basically stopped family unification, or minimized it. America as a country used to accept 20,000 or 30,000 immigrants for a given country, and every state opened to some. But now, no one is allowed from certain countries, or very low numbers. Out of that, also there is no unification for families."

Program Director, New Mainers Public Health Initiative of Lewiston

+ Unease or fear of dying, especially alone.

You know that death is coming for all of us at one time or another, but it's different now that you're seeing others, people you knew well, die around you. In some ways, it's a comfort that all face this, and maybe you have faith in what comes next. But when sick and alone, it feels like there's few or no one to turn to.

Fear of dying is incredibly common, facing the younger and the older. Hospice and palliative care greatly offset worries. And, those with religious or spiritual beliefs often face death with less emotional distress, helping many. And those on the verge of dying often express acceptance and postivity. Beyond experiences of loneliness, anxiety about death relates to panic, depressive, and other mental health disorders. When all-consuming, this feeling can therefore can call for professional help, even if supported otherwise. But for some, it is the thought of dying with no one to witness and give comfort which makes a person lonely or lonelier.

+ Audio Translation - Older Adult in Chile

"I think that someday when I die, I'll be alone in my house. Because my daughter has her world. My son has his world."

+ Homehealth and Hospice Perspective

"I think being alone near death, against your will, creates this terrible loneliness at a critical, vulnerable time in our lives. How at peace do you feel with your loved ones? That moment of death and dying, in that aloneness, it can be full of a lot of anger. What we try to do in hospice is help people prepare so that they are ready. They aren’t alone."

Palliative Care Educator and Social Work Supervisor, Androscoggin Home Health & Hospice in Lewiston

+

Be it art, performance, craftsmanship, debate, poetry, and on, some hobbies are lifelong, others discovered, perhaps in older adulthood. But, too many are put down and never picked up again, because of limited spaces and offerings, or little appeal to varied interests and language needs. Creativity and critical thinking are important not only to stay cognitively healthy, but also provide solitude when undertaken alone, and social interaction in groups, lessening loneliness. Because of a slow or sudden disconnect from these passions, it may be hard to occupy, recognize, and distinguish yourself:

+ Few reachable places to pursue interests.

You’d give ceramics a try, but the closest studio is 30 minutes away. You’d got a catalogue offering a politics class at a senior college, where your friend the next town over goes twice a week, but there isn’t one in your area. Your small town doesn't have a library, either.

Many senior centers, libraries, museums, and other local sites reach older adults with well-organized and well-attended offerings of a wide range of interests. But, such events and programs require publicity, space, supplies, an instructor, and a big enough crowd to sustain them. Older adults have their own barriers to attending, as well, like lack of transportation, help just getting in and out the door. Some older adults rarely or never participate, and feel a void in hobbies and interests, which are social, too. In rural areas, such resources are particularly limited.

+ Audio Translation - Older Adult in Chile

"To keep yourself active, you have to recover your creativity. The state gives you a space, but it’s limited for older adults— to play games, to dance tango.

"But space for critical thinking, reflection, of that there is very little. We have to create it. If we’re together, loneliness is cut in half."

+ Geriatric Mental Health & Neuropsychiatry Perspective

"One patient told me he doesn’t go out like he used to because the local Tim Horton’s closed. Which was "the senior center." He would only have to drive a few miles, but that’s big enough of an obstacle. So now he loses his socialization. That’s how tenuous and fragile the network is."

Chief of Geriatric Mental Health and Neuropsychiatry, Acadia Hospital in Bangor

+ Unaware of, intimidated by goings on.

You used to paint, but that was a long time ago, and who knows where you’d go to do that now, anyway. You used to talk politics over dinner, but you often eat alone now, and that weekly lunch with old work friends isn’t the place for that. You're aware of some programs around town, but it'd be easier to go with a familiar face.

Though community sites host far more than luncheons and bingo, that message may reach only frequent participants, and newcomers may feel intimidated starting something new. A barrier here is having someone to attend with, especially when joining an established group with experience in the activity or topic at hand. Many organizations distribute flyers widely, post newspaper ads, mail catalogues, and train staff to spread the word, which are effective tools. But publicity about events is increasingly online, which benefits tech-savvy older adults, but leaves those with limited access out of the know.

+ Limited language & topics of offerings.

You’d go to a film showing at the nearby museum, but its played only in English, and you’d need Somali subtitles. You'd join the discussion to follow, but you'd need other Somali-speakers to discuss with. Or, you have experience in wood-working, and would get back into that now retired for some time, but you've checked and found no programs around you.

While funding, spaces, and publicity present barriers to offering programs and events, so does support for offerings for people of varying cultures, national origins, and native languages. Both English-language learning courses, and opportunities to engage in creative and intellectual events in languages older adults are comfortable speaking in, are crucial for already-excluded groups. Some area agency on aging centers have bilingual classes, as do immigrant resource centers, but a push to raise consistency, variety, and attendance is still needed to involve English-language learners in particular. Further, opportunties for older adults themselves to lead activities which appeal to their interest areas are needed.

+ Social Service Coordination Perspective

Of difficulties incoroporating New Mainers into the agency's programs:

"The language barrier is still very prevalent. Currently, we do not have any bilingual staff- Spanish, Somali, Arabic-speaking staff. Or any of the dialects. We have been working with community partners, and we’re not forgetting the need to offer these programs in those languages. It’s just something we’re still tackling.

"For example, SeniorsPlus tried to establish a social dining site (for free or for a $3 donation) with New Mainers. For six months, no one attended. It fell apart. But we’re open to collaboration."

Community Health Education Coordinator, SeniorsPlus in Lewiston

+

Nuclear families- in which younger adults live separately from parents, often with kids- came along with economic changes after WWII. Multi-generation households are on the rise with immigration, and for some the practice never faded, yet 80% of older Americans live without children. In a post-industrial Chile, too, aging parents live alone at higher rates than 50 years ago. As such, it’s ever more common to age in assisted living or a nursing home. Alongside, technology impacts how we keep in touch. With all this, some older adults feel independent and heard, others detached, undervalued, and lonely:

+ Living alone, far from kids.

Especially as a multi-generation Mainer, New Mainer, and also as an indigenous person in Chile, you likely grew up with grandparents or other older adults in your home or down the road. You saw first-hand how this grows respect and closeness within the family or neighborhood, and between generations. If you have kids or young family, maybe you planned age in the same home, or same town. But young families have moved from your smalltown to a city, maybe across the country. Or, even if nearby, you're not involved in their lives.

U.S. immigrant families, or Chilean indigenous families, may continue to merge households, or not given new job, housing, lifestyle realities. 45% of older adults in Androscoggin County live alone, versus 30% nationally.. Living alone can bring independence if you have the means and say in it. Without those, the pressure grows for older adults not only to learn housing, homecare, and welfare systems to find other supports, but also to find where they belong, in a larger sense.

+ Audio Translation - Older Adult in Chile

On the cultural and generational change among Mapuche indigenous people as Chile’s economy modernizes without them:

"In that [prior] time, the affection between neighbors, the unity, the visitation, I was able to see that. I saw neighbors of course talking in Mapudungun [Mapuche language].

"It’s been a massive change… I was born in the countryside. The poverty— subsistence was very complicated, very difficult. So the young person these days is always looking to emigrate in search of their welfare. And from there, you can bring your family. Why are there so many of my people [Mapuche’s] in Santiago [capital city], for example?"

+ New Mainer Public Health Perspective

"Loneliness becomes a problem after we cross overseas to the U.S. For example, I was born in Ethiopia. I grew up with my grandma and grandfather, both paternal and maternal lived with us.

"In Maine, many of the youth are leaving for Portland or big cities like Boston. Once you get a degree, do you come back to the community? Not so much. So out of necessity, grandparents are alone in apartments, unless they go outside to just stand for no apparent reason other than to meet people. The loneliness comes.

"You know, when you come to America, things that you never thought about surface: now you see the necessity of having extended family."

Program Director, New Mainers Public Health Initiative of Lewiston

+ Hispanic New Mainer Outreach Perspective

(Translated from Spanish)

"Kids of Hispanic New Mainer families are adopting the American culture. Because they are American. I mean, the daughter of a Hispanic family moved to Boston for college. Her parents sold their house and went with her! But many can't manage that for their families."

Hispanic Outreach Coordinator, Prince of Peace Parish of Lewiston

+ Conversations & news go online.

You know that the senior center or museum has lots of programs, but you don't know how to find them online, or you don't have a computer to check. You use Facebook only a little, or not at all, and find that old friends don't call as much anymore. Your grandkids use their phones a lot during visits, but you're not sure how to keep in touch with them that way.

Technology offers an opportunity to meet and reconnect with people, encouraging in-person meet-ups. 3 in 4 adults 50+ use internet daily, and 7 in 10 are on social media. Nearly all older technology users do use it to talk to friends and family. But, only about half of Americans 80+, and half of lower income older Americans, use internet. So, technology is a connector, but can be expensive, hard to use, and hard to get used to. This rather quick change in how we communicate, especially with younger generations, and share news and events, can be alienating.

+ Audio Translation - Older Adult in Chile

On how her grandkids' use of technology, plus a negative public view of older adults, has interrupted her conversations with them:

"Now, we have a huge intergenerational gap. For example, when I was little, my grandfather sat with us and told us stories of his life... of the 14 grandchildren that I have, there are two who ask me for family stories."

+ Public Library Perspective

"In this day and age, we still do traditional press releases, especially for our senior population. That is absolutely the number one way that people learn about things happening at the library. But Facebook is a close second, Instagram, Twitter, community email lists, too.

"But there's still a group that falls outside of all of those. How do we get to them? We can't run commercials on ABC- that's not in the budget. So how do we get to people, short of going door-to-door to every single house in Lewiston?"

Director, Lewiston Public Library

+ Unseen or unheard due to age, plus race, gender, citizenship, sexuality.

You feel dismissed in town meetings, invisible at the grocery store, maybe brushed aside by family when you make decisisions about your future. Your grandkids or neighborhood kids don’t heed your advice, and it few public spaces seem designed to be comfortable for you.

While circumstances in a person's life play a role, ageism can remove your seat at the table. "Ageism" is a word to describe being treated as less capable because a person is older, with words, actions, or barred access to resources. Spurred by nuclear families, technology, and little education about aging, young people can habor these feelings without fully realizing. Being treated as lesser is maybe newly unsettling for (especially wealthier) white men, and is further discounting for women and elders of color.. That's because ageism layers on top of racism (treated unequally due to race) and sexism (due to gender). Sexuality and citizenship status are further points of vulnerability. While many treat patients or clients as equals, when professionals do not respect older adults, both quality and attempts to seek help drop. Public places can be unwelcoming, too. These are all much-needed supports for lonely people.

+ Audio Translation - Older Adult in Chile

"[Older adults are forgotten] because you were head of the household, then the grandparent, and then erased. [Stuck in] a corner one would say. More like a piece of furniture, or a chair. We can still do many things."

+ Audio Translation - Older Adult in Chile

"I have a bad impression of geriatricians. Because they specialize in older adults. They know the older adult is deteriorating. But they look at you like you’re deteriorated.

"[Mimicking voice of speaking to child] 'Do you speak to your kids? Do you have it clear, what day it is today?' [Softening voice] How is your emotional life? How are your kids? Your friendships? Your social life, your sexual life? [Doctors should ask] these things, I believe. But they don’t have the patience. It doesn’t interest them.

"Nobody talks about a sex life for older adults. Nobody. It’s prohibited."

+ Geriatric Mental Health & Neuropsychiatry Perspective

"Individuals who are who are discriminated against, members of minority groups, who don't have the resources to maintain genuine, productive connections with people and institutions are at greatest risk of loneliness.

"That means folks of low socioeconomic status, minority groups in the state like Maine, which is the whiest state in the nation, and LGBTQ+ older adults in in Maine, who all by definition or likely have weaker, less stable social networks."

Chief of Geriatric Mental Health and Neuropsychiatry, Acadia Hospital in Bangor

+ Maine Faith Organization Perspective

On the impact of citizenship and race on being active in the faith community:

"There is significant participation from the Hispanic community and French-speaking Catholics from the African diaspora in the church. The Hispanic outreach for the Parish uses the word 'accompanimiento,' accompanying people. But an alarming barrier has emerged: Folks want to attend the mass, but apparently ICE has been hanging out, and that’s intimidating."

Deacon, Prince of Peace Parish of Lewiston

+

Retirement, becoming an empty-nester, or moving on from other long-term investments of time and energy can bring well-earned freedom. But what to fill it with? Or who to fill it with? Some have plans, others struggle to transition. Older adulthood can present the challenge of how to stay tied to former work, home, and commmunity roles, to a higher understanding of the meaning of life, and to people and places who share your values. Volunteering is a common way to stay tied to all of these areas, in fact 6 out of 10 older Americans volunteer in some form, and 2 in 10 still do paid work. Others face hurdles related to gender, income, rural versus urban-dwelling, religious confusion or exclusion, and on, which can alienate:

+ Disconnect from occupation & roles.

Retired from work, kids on their own now, committee seat passed on, it's time for ease and time to dedicate as you like. But also, these investments gave you certain roles that guided how, with who, and to what end you interacted not only with others, but how you see yourself.

Supporting a household, workplace, committee, farm, and on, can bring frustration, conflict, self-doubt. Leaving work does not always make a person lonely, especially because workplace loneliness is a serious issue. But for older men and growing numbers of working women, work was a main social connector. Volunteering in an area of expertise or in something new maintains these connections. More older Americans who still work volunteer, but those who no longer work paid jobs volunteer for more time. While some hold onto and modify these social roles while aging in place, others may feel their age or other factors mean they have little to offer their communities, that perhaps being “old” is what defines them most. For those who take pride in the roles they once held in their community, this can be distressing, daunting, and disconnecting.

+ Social Work Research & Education Perspective

"The workplace has represented for for older men, traditionally, where they turn for to interact with others. For them, the challenge is transitioning from work to retirement, and then having to rebuild or create a new social network."

Professor of Social Work and Director of University of Maine Center on Aging

+ Struggle to find meaning & purpose.

You used to be active in your church community, or a constant on local non-profit boards, until you retired and took a step back. You’d love to get back into it, but it’s hard to know how to help now. This gets you thinking: Have I done enough? Am I doing enough now?

Especially in later life, it's common to think about your impact and the purpose of your life. Changes in attitude or beliefs in this regard are a normal part of aging, as well as preparing for death. Some reflect on their younger years, others focus on how to use many more remaining years wisely and happily, and many do both. This time can be can be heartening for some, or distressing and alienating for others. Because we find meaning through interactions with one another, staying or becoming more social in ways which appeals to an older adult is a pivotal part of this process. Religion and spirituality offers purpose and social support for many older Americans, (especially rural-dwelling) Chileans,and indigenous Chileans, of varied traditions, and others hold secular beliefs which encourage reflection, gathering and volunteering. But too many feel unmoored, alone, and uncertain of their contributions.

Audio Translation - Older Adult in Chile

"I think that for all people who grow old, it is a concern, really: How to live my last years on this earth, at least?"

+ Maine Faith Organization Perspective

“Sometimes older people may not have been practicing for a while. They come in, and they’re really looking for answers to the big questions. What is life all about now that I’m at this stage? Sometimes there’s deep loneliness there.”

Deacon, Prince of Peace Parish of Lewiston

+ Independence, shyness makes reaching out hard.

You've done your fair share of small talk at the watercooler, or on the building site, and you'd rather not go back to that. Or, you've been a farmer, in Maine or rural Chile since childhood, and you know just about everyone around. Meeting new people, or talking with those who have different priorities, makes you tired, discouraged, and feeling even more alone than staying home. And maybe because or on top of all this, maybe you didn't grow up talking about mental health. So, you worry reaching out for help will reflect poorly on you.

Some shyness is just part of a person's personality, which carries over into older adulthood like so many other individual qualities. Being an introvert- someone who recharges by spending time alone- is partly genetic, but introverts are not necessarily lonely. So, the stigma that certain people are "just lonely" discourages help. But social anxiety can also be a new condition, commonly prompted by a stressful event like the the death of a spouse, physical impairment, etc. It is more common in single older adults, those with lower education levels, and multiple chronic health problems. Older adults experiencing this are less likely to get help from their doctor, friends, family, too. Likewise, a great sense of personal pride in being independent, especially common for white men, prevents getting professional help in particular. For older adults who find social events stressful or unnecessary, as well as those who don't, having comfortable, mutually-interesting topics to deepen conversation is a priority. Language barriers, and (especially rural) communities without spaces to gather with people they enjoy spending time with, can contribute to loneliness.

+ Social Work Research & Education Perspective

On his pioneering research on men's caregiving giving experiences and tendency to seek help:

"There's an inclination I've discovered among Mainers, and among rural Mainers and particularly, to display what I would call a "stiff upper lip" mentality, which keeps them from expressing that they may be unable to manage on their own. They are, you know, a highly independent bunch.

"If rural Mainers have that mentality, older men, and older male caregivers, probably represent the most stoic of all groups of older adults. And that's really worrisome. They don't see physicians as often as women. And they don't reveal issues as openly as women to healthcare professionals. Perhaps that's why men have the highest suicide rate of all older men. And older white men in particular, have killed themselves more frequently than any other group of older adults. Because they wait until they reach a crisis, and feel that's their only way out."

Professor of Social Work and Director of University of Maine Center on Aging

+ Geriatric Mental Health & Neuropsychiatry Perspective

"Sometimes with patients, loneliness comes down to inertia. You don’t have the energy, the desire, the interest in conversation ('People are boring. I don’t want to listen to people anymore!'). I realize they are not hanging out with the right people. So I try motivational interviewing- What is it they do want? How can they achieve that? Why aren’t they getting joy from interacting with other people? Sometimes its past experience. There’s circuitry in the brain that needs to be retuned— they’re depressed! But what it often comes down to is: I don’t want to be a burden. And then you have to reach out to others to break the ice.”

Chief of Geriatric Mental Health and Neuropsychiatry, Acadia Hospital in Bangor

New Mainer Public Health Perspective

"For most Somali people, mental health is a taboo thing. It's like you are creating your illness or suffering by your own actions. Even I'm guilty of it - of believing that you can get yourself up. And so with mental health for older Somalis here, I mean, you can't say, "I'm so lonely, and it's making me unable to get out of bed."

Program Director, New Mainers Public Health Initiative of Lewiston

Chilean Mental Health Social Work Perspective

(Quote translated from Spanish)

"Among Mapuche [indigenous] people nowadays, you hear a lot of talk about not wanting to annoy or be a burden on your kids or on your community. There are older adults who don't understand, or don't recognize, that it's normal to live together and help each other. What's not normal is this modern, 'go on, get out,' way of living. It is not that you're totally dependent, or have no autonomy. But sometimes I just can't get through to them."

Mental Health Social Worker for the city and rural surroundings of Temuco, Chile