Recognizing Isolation, Loneliness, and Depression

Isolation

There are a number of factors that may increase the likelihood of a person becoming socially isolated. Recognizing social isolation early on and getting support immediately could help avoid feelings of loneliness and depression.

Consider the following risk factors:

  • Any history of mental health concerns
  • Difficulty with hearing or vision
  • Living alone
  • No children or family in general
  • Disabilities or health challenges
  • Recent major life changes, such as the loss of friends/relationships, grief, changed living arrangements, etc.

These risk factors can all contribute to a person being alone more often and less able to get out of the house. If you answered “yes” to any of the above questions, the person you care for may be at risk of social isolation. It may be helpful to speak with the person to understand how they might be more socially engaged, what activities would be most enjoyable for them, how they would like to be with other people and when.

When to Seek Immediate Help

  1. Please call 911 immediately if the person you care for is telling you that they plan to harm themselves or others, or you suspect that they will.
  2. If the person you care for has discussed thoughts of wanting to die or that they “wish there were ways to end my suffering” but do not intend to hurt themselves, seek help immediately. ConnexOntario has a free, 24/7 support service for mental health, crisis, addictions, and more. You can call them any time to discuss your concerns and get help with the next steps: 1-866-531-2600 or visit their website for more information at: https://www.connexontario.ca/
  3. To learn more about suicide prevention among older adults, download: a Guide for Family Members.

Loneliness

If the person in your care is at risk of being socially isolated, you may want to consider if they are also experiencing loneliness. The best way to explore these feelings is by speaking with them directly about what you are observing. A good place to start the conversation is by asking the following questions.

  • How often do you feel that you lack companionship?
  • How often do you feel left out?
  • How often do you feel isolated from others?

Activity 7.1

Try a Tool

The questions above are part of a validated screening tool called the Three-Item Loneliness Scale. Once completed, this screening tool can be a great resource to bring with you to visits with a health care professional. Complete the full screening tool: Three-Item Loneliness Scale.

Depression

Given that loneliness is a risk factor for depression, it is important to be aware of common signs of depression. If you observe that the person in your care has had changes in mood and/or behaviour, or is showing signs of persistent sadness, consider the following common signs of depression.

Common Signs of Depression

Signs of DepressionExample
Feeling Hopeless“It’s hopeless; I’ll never get better…what’s the point anyway?”“No one cares about me.”“You are wasting your time because that will never work.”“I don’t want to try anymore.”
Stopping Usual ActivitiesThey no longer take part in activities they once enjoyed (e.g. card games with their social group, going to church, etc.).They seem to have lost interest in hobbies (e.g. they stop gardening, painting, listening to or playing music, etc.).
Mood SwingsMood swings are high and low and come and go quickly.They cry during your visits or they may push you away with anger.
AnxietyThey tell you they often feel nervous or on edge, and they are not sure why.They appear to be worrying all the time about their health, your life, other peoples’ lives, etc.They tell you they feel their heart is racing, their mouth is dry and their hands are shaky.
Altered SleepThey sleep all day or most of the day.They may have trouble falling asleep and staying asleep.
Weight ChangesThey have gained weight as a result of overeatingThey are losing weight as a result of not eating, or eating less than usual.

The more signs you are noticing from the list above, the higher the chance that the person you care for is experiencing depression. You are encouraged to discuss what you are noticing with the person in your care. Ask them how you can help and plan to speak with a health care professional as soon as possible to get connected to the right services.