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Spiritual Care’s Role in Combatting Loneliness Among Older Adults in Long Term Care

Loneliness is a silent epidemic that pervades the lives of many older adults in long-term care and assisted living facilities. For leaders in long term care and assisted living, understanding the profound consequences of loneliness in this vulnerable population is paramount. In this blog, we will delve into the substantial effects of loneliness on mental and physical health, mortality rates, and healthcare utilization among older adults. Moreover, we will explore the vital role that spiritual care can play in alleviating these negative impacts.

Loneliness: A Silent Epidemic in Long Term Care Settings

Loneliness and Mental Health: Depression, Anxiety, Dementia, and Suicide

Loneliness is not merely a fleeting emotional state; it is a pervasive condition with profound implications for mental health. Research has shown that loneliness significantly increases the risk of developing mental disorders such as depression and anxiety. As discussed in the 2020 study, “Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report”, Donovan et al. highlight numerous studies that conclude that loneliness elevates the risk of depression and anxiety across age groups and especially among older adults.

Moreover, among older adults, loneliness is intrinsically tied to cognitive health. Loneliness accelerates cognitive decline and impairs cognitive functioning. Specifically, chronic loneliness is associated with a 50% increased risk of developing dementia (Kuiper et al., 2015) and associated with higher levels of brain amyloid and regional accumulation of tau protein, the physical manifestation of early Alzheimer’s disease.

Loneliness is more than just feeling isolated; it has a physiological impact as well. Loneliness is associated with heightened levels of stress hormones, particularly cortisol. This contributes to chronic stress, which, is detrimental to overall health. Moreover, as described in the 2010 study “Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms” by Louis Hawkley and John Cacioppo, loneliness has been associated with personality disorders and psychoses, suicide, impaired cognitive performance and cognitive decline over time.

These findings underscore the critical need to address loneliness as part of comprehensive care for older adults.

Loneliness Takes a Toll on Physical Health

Weakened Immune System

The physical health consequences of loneliness are equally concerning. Loneliness weakens the immune system, leaving individuals more susceptible to infections and diseases. Studies have shown that lonely individuals exhibit higher levels of inflammation and reduced immune responses, making them more vulnerable to various health threats (Jaremka et al., 2013). Additionally, loneliness can slow down wound healing, a critical aspect of recovery in older adults.

Cardiovascular Health

Loneliness also impacts cardiovascular health. Researchers have discovered that loneliness is associated with a 29% increased risk of developing coronary heart disease and a 32% increased risk of having a stroke (Valtorta et al., 2016). Furthermore, lonely individuals tend to have higher blood pressure and heart rates, indicating cardiovascular strain (Hawkley et al., 2010). These findings highlight the importance of addressing loneliness not only as a psychological concern but also as a significant risk factor for heart-related issues.

Sleep Disturbances

Another concerning aspect is the effect of loneliness on sleep. Lonely individuals are more likely to experience insomnia and disrupted sleep patterns (Cacioppo et al., 2010). Poor sleep quality, as a result of loneliness, can further harm physical health by impeding the body’s restorative functions during sleep.

Loneliness and Mortality

Increased Mortality Risk

Perhaps the most alarming revelation is the connection between loneliness and mortality. Social isolation and loneliness have been associated with a 29% and 26% increased risk of mortality, respectively (Holt-Lunstad et al., 2015). The impact on overall life expectancy is equally shocking. Chronic loneliness is estimated to reduce life expectancy by an extent similar to smoking 15 cigarettes a day (Holt-Lunstad, 2018). These statistics underscore the life-and-death consequences of loneliness.

Influence on Chronic Conditions and Terminal Illnesses

Furthermore, loneliness can worsen the progression and severity of chronic conditions and terminal illnesses. Loneliness can aggravate existing health conditions, such as diabetes, arthritis, and respiratory illnesses, making management and treatment more challenging, according to a “A Systematic Review of Loneliness and Common Chronic Physical Conditions in Adults”, published by Petitte et al. In the context of long-term care and assisted living, addressing loneliness becomes not only a matter of improving quality of life but also a crucial component of healthcare delivery.

Healthcare Utilization Among Lonely Individuals

Lonely individuals in care settings tend to have significantly higher healthcare utilization rates. A study published in the Journal of the American Heart Association found that heart failure patients who reported high levels of social isolation had a >3.5 times increased risk of death, 68% increased risk of hospitalization, a 57% higher risk of emergency department visits, and a 26% increased risk of outpatient visits (Manemann et al., 2018), compared with patients reporting low levels of loneliness. Loneliness has also been found to be associated with hospital readmissions, longer lengths of stay and the over utilization of healthcare resources for cardiovascular disease (Lofvenmark et al., 2009). This illustrates the impact of loneliness on healthcare systems, patient outcomes, and the potential for increased costs associated with caring for lonely individuals.

The Role of Spiritual Care in Combating Loneliness

Addressing Loneliness Through Spiritual Care

Amidst this grim landscape, there is hope in the form of spiritual care. Spiritual care is among many approaches that recognizes the holistic needs of individuals, encompassing their spiritual, emotional, and social dimensions. For patients who self-identify as religious or spiritual, spiritual care provides emotional support, a sense of purpose, and a sense of community, all of which are vital in combating loneliness (Marin et al., 2015 and Peteet, et al., 2018) .

Spiritual care extends beyond religious practices and ideology; it’s about creating an environment where individuals feel heard, valued, and connected. This can be achieved through meaningful conversations and supportive relationships between an individual and a chaplain as well as activities that align with an individual’s spiritual values and beliefs.

Spirituality Among Older Adults

Spirituality often holds a central place in the lives of older adults. In fact, adults aged 65 and over are the most religious individuals in the United States. In their 2018 study “Integrating spirituality into the care of older adults”, researchers Peteet et al. describe how spiritual and religious beliefs and practices often serve as a source of solace and strength for older adults, especially when dealing with challenges that come with later life. Spirituality helps with coping with loss and navigating life’s transitions. Many older adults draw upon their religious and spiritual beliefs to find meaning in their experiences and to seek comfort during times of sorrow or isolation.

Moreover, research has consistently shown that religious involvement and spirituality are closely linked to better physical health and greater overall well-being among older adults. Engaging in religious or spiritual practices not only fosters a sense of community and support but also encourages healthier lifestyles and positive psychological states. This strong connection between spirituality and well-being highlights the potential of spiritual care to address the multifaceted challenges posed by loneliness among older adults in long term care settings and in community. By recognizing and respecting the spiritual dimensions of residents’ lives, healthcare leaders can further enhance the effectiveness of spiritual care initiatives in mitigating the impacts of loneliness and promoting holistic well-being.

Recap: The Benefits of Integrating Spiritual Care into Long Term Care for Seniors

As assisted living executives and healthcare leaders, integrating spiritual care into your facilities can yield numerous benefits. Residents who receive spiritual care report improved emotional well-being, reduced feelings of isolation, and an enhanced sense of belonging. This sense of connection can counteract the negative impacts of loneliness on mental and physical health.

Spiritual care also helps residents find meaning and purpose in their lives, which can be especially important for those facing health challenges or life transitions. Providing opportunities for residents to engage in spiritual practices, whether through prayer, meditation, one-on-one spiritual counseling with a chaplain, or group discussions, can foster a sense of community and support.

As demonstrated throughout the numerous studies presented here, the impacts of loneliness among older adults in long term care settings are profound and far-reaching. From mental health challenges to physical health issues, increased mortality rates, and elevated healthcare utilization, loneliness is a pressing concern that demands attention.

As long term care and assisted living leaders seek to address loneliness among residents, integrating spiritual care into facilities should be among the tools receiving investment to combat loneliness and enhance the overall well-being of residents. By providing emotional support, fostering a sense of purpose, and creating a sense of community, expanded access to spiritual care can make a significant difference in the lives of older adults.

Andrew Savitz
Chief Executive Officer