Why do people with dementia become lonely and isolated?

Nobody wants to feel isolated and alone, but for people with dementia, loneliness can be one of the most common and painful effects. Read on to find out why it happens.

Loneliness and isolation is a problem for lots of older people, but it's particularly difficult if they are also struggling with dementia. In fact, people with dementia tend to be lonelier than the population as a whole and a survey by the Alzheimer’s Society in 2013 found 38% of people with dementia felt lonely. The nature of dementia makes loneliness worse, rather than loneliness causing dementia, although there is evidence (a study in the Journal of the American Medical Association in 2007) which suggests that the risk of Alzheimer’s disease more than doubles in older people experiencing loneliness. So what can you do?

Good to know

First off, it’s important to clarify what is meant by loneliness and isolation.

What is isolation?
This is where a person lacks social contact with friends, family or the community. It’s an objective state and can be measured by the amount of people they come into contact with.

What is loneliness?
Loneliness is different, because it’s more of a subjective state. People can experience loneliness differently – for example, someone can feel lonely, even if they have regular contact with friends and family, while others may have limited contact with people and not feel lonely. There are two types of loneliness: emotional and social loneliness. Emotional loneliness is when you feel lonely because you lack a significant other who you can form a close bond with. Social loneliness is caused by a lack of a regular group of friends or social network.

Causes of loneliness and isolation

Lack of face-to-face interaction

These days it can be tougher to have regular face-to-face contact, especially if family members don’t live nearby. The Alzheimer’s Society report on loneliness found more than one in 10 people spoke to friends of family face-to-face less than once a fortnight. This type of contact is important because these conversations provide visual and sensory clues which can help them form memories more easily.

Infrequent telephone contact

Where face-to-face contact isn’t possible, having regular phone calls can help. However, if someone with dementia struggles to follow conversations on the phone, doesn’t manage well with technology or simply doesn’t like speaking on the phone, it can make it harder to talk, and the chances of isolation and loneliness increase.

Lack of meaningful relationships

As people get older, they may find that their friends and family move away, go to live in residential homes and pass away. This can lead to a shrinking of their social circle and less contact with people. On top of that, if they don’t have a particularly meaningful relationship with their neighbour – which can be common in larger towns and cities – it can lead to loneliness. Nearly a quarter of people with dementia admit they speak to their neighbour less than once a month.

No confidence and fear of stigma

This can be a real issue for people with dementia, preventing them from talking to people, getting out and about and even letting their neighbours know about their diagnosis because they worry about being judged. And this isn’t helped by people not feeling confident about how to talk to someone with dementia, with 35% of people admitting they would not feel comfortable talking to a person with dementia.

Isolation from activities

Having to stop doing favourite or regular activities can contribute to loneliness in people with dementia. Often this is because they either cannot do that activity anymore (either because of dementia, or because of other issues such as illness or mobility problems) or because they don’t have the confidence to go out to do it, worrying that they become confused or lost.

So what next? There are plenty of things you can do to either connect with more people, or help the person you’re caring for feel less lonely. Find out about what befriending services there are available for people with dementia here.