Isolation V. Loneliness: The Difference And Why It Matters

Guests

Andrew Steptoe, professor of epidemiology and public health, University College London
Jon Hamilton, science correspondent, NPR
Mary "Yogi" Wess, executive director, Little Brothers: Friends of the Elderly, Cincinnati Chapter

Researchers from University College London followed thousands of people over the age of 52 for seven to eight years to assess the effect of loneliness and isolation. Isolation, not loneliness, may actually shorten people's lives regardless of health or income.

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NEAL CONAN, HOST:

This is TALK OF THE NATION. I'm Neal Conan, in Washington. Many older people prefer to live alone. Others like to get out of the house, to work or meet up with friends and family. A new study from University College London followed thousands of people over the age of 52 for seven or eight years. The idea was to assess the effect of loneliness and isolation.

It turns out both may actually shorten people's lives, isolation even more so. But those are averages. Individuals vary, and again, some prefer life alone, and do not report that they're lonely. If you're in this age group - over 60, let's say - what's your story, and what has the effect of your choice been on your life? 800-989-8255 is our phone number. Email us: talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.

Later in the program: lint alive, the bacteria of the belly button. But first, Andrew Steptoe is professor of epidemiology and public health at University College London, one of the authors of a new study "Social Isolation, Loneliness and All-Cause Mortality in Older Men and Women." He joins us from BBC Studios in London. And it's good of you to be with us today.

ANDREW STEPTOE: Not at all.

CONAN: And I know you started with 6,500 people age 52 and older, and I have to begin by saying a whole lot of us would say 52, that's not so old.

STEPTOE: Exactly. But this study is one that we've been running for a number of years, where we're interested in what happens as people grow older, as they move towards retirement, and then through retirement into old age. So we started with a sample of people aged from 52 right up to 100, actually, and then followed them up over time.

CONAN: And for the purposes of this study, how did you define isolation and - even more difficult, I suspect - loneliness?

STEPTOE: Well, isolation is a kind of objective indicator of the sorts of social contacts people have. So what we do is to ask people about the amount of contact they have with their families, with friends, with relatives and whether that's maybe daily or weekly, or possibly once a month or less than that.

And we also people if they were involved with organizations such as social clubs or churches or other groups of that sort. And so through using those different kind of measures, putting them together, we get an indicator of social isolation.

But loneliness, as you say, is more complicated. It's really a subjective experience. It's a feeling of being - of lacking companionship, possibly lacking intimate feelings with other people. And that's much more subjective. And so we use a pretty well-established scale, which actually was developed in California for this purpose, and classified people on that.

CONAN: And your findings - and when you say all-cause mortality, I assume that's death from any reason whatsoever.

STEPTOE: That's right. I mean, the - during this follow-up period of over 6,500 people, just over 900 people died, and they died of, you know, the causes you would expect. You know, quite a number of people died from heart disease, some from cancer, some from respiratory complaints, and so forth. And that's why we talk about all-cause mortality, because we're grouping those all together.

CONAN: And yet there was a - if someone was defined as more isolated, it seemed that they may have died earlier.

STEPTOE: That's right. I mean, we found both isolation and loneliness actually predicted a shorter life. But one has to think carefully about the sorts of people who might be prone to dying. For example, age is an obvious factor. Someone who entered the study at age 90 would be much more likely to have died over this follow-up period than someone age 55. So we have to take that into account.

And we also have to take into account their baseline state of health, you know, what sort of illnesses they had right at the beginning, as well.

CONAN: I was wondering, in terms of isolation, some people - would people living as a couple, but not seeing a lot of other people, would that count?

STEPTOE: Yes, it could do. It's - being a couple is obviously a very good thing as far as isolation is concerned, probably for loneliness, as well. But even among married couples - and we had quite a lot in our study - the other indicators might not have been so good, so that the couple might be quite sort of isolated, if you like, as a couple and not having much contact with other people.

CONAN: And as these studies have - they're continuing?

STEPTOE: Yes, this is part of a large study, which goes on and continues through time.

CONAN: And are there measurable health benefits to having lots of friends?

STEPTOE: Well, it does seem like that - not only from this study, but also from other research carried out in the U.S. and in this country - that people who have more contacts, both with relatives, friends and others, seem to be in better health. It's always a difficult issue teasing out the chicken and egg here, you know, whether someone is unwell, and so they withdraw, maybe, socially.

But even when we take account of the initial state of health of people in this study, we have found that over the following years, the more isolated people were more likely to die.

CONAN: And do you find that people living in isolation, or relative isolation, is that a choice, or is that a circumstance?

STEPTOE: Well, that's difficult. I mean, as you said in your introduction, some people are quite self-sufficient, and so don't necessarily want a whole range of social contacts, whereas other people are very gregarious and have many types of contacts. So there's going to be, in part, a kind of preference about these things.

But also, as we know, when people get older, their social networks tend to diminish, either because children move away, or the contemporaries of the individual pass away. And so social networks tend to become reduced as people get older.

CONAN: Here's an email we have from Ruth in Wyoming: I am 59 years old and live in a town of 5,000 in Wyoming. I've lived here for 11 years. My husband works on the north slope of Alaska and is gone 16 days every month. I have tried volunteering, taking classes at the junior college, etc., and have not found a lasting support group of any kind. I really don't like this isolation, and my drinking has increased over time.

And you would think that, at least statistically, Ruth is not alone. Alcohol may prove to be more of a problem for those who are isolated or lonely.

STEPTOE: Yes. I mean, Ruth is doing all the right things there, by trying to make the social contacts, by, you know, trying to go out and about and use what resources there are. But clearly, in a small town like that, there are limited possibilities, and I guess you might soon run through those.

And, of course, people do turn to alcohol and maybe to overeating when they're trying to cope with these sort of situations. So that's very distressing.

CONAN: Let's see if we can get a caller in on the conversation. And, again, we want to hear from those of you, let's say over 60, and talking about isolation and loneliness, your lifestyle, how does that affect your life? And give us a call: 800-989-8255. Email: talk@npr.org. Paul's with us from Spokane in Washington.

PAUL: Hi. How are you?

CONAN: Good, thanks.

PAUL: I retired in December of 2011, and I was 65, and I worked in a warehouse for 41 years with about seven to 800 people. And before I retired, I thought about just what you're talking about. I'm going to be - I lived out in the country, so I'm going to be basically isolated, because my wife is still working. And what can I do?

And so a neighbor said, hey, we need to walk every day. And so we do that. And then in the summertime and spring, I go golfing and stuff like that. But it's not like interacting with the people I did at work, which is a little tough, but, you know, just trying to figure out what to do after you retire, because when you work with that many people, it's, you know, kind of tough just waking up in the morning and there's nobody around.

(LAUGHTER)

CONAN: It's a lot of stimulation, and all of a sudden, there's a lot less.

PAUL: Right.

CONAN: And I wonder, Andrew Steptoe, if that proves out in your studies.

STEPTOE: Yes. I mean, I think that's a big problem. When people retire, they have a - many people have quite an elaborate social network at work, even if they don't like everyone at work. They still have a lot of companionship of various levels, and suddenly, that is taken away.

On the other hand, your caller is, again, doing the right things, because he's not only trying to make contact with people, but also doing some healthful things at the same time. And that's one way that social connections work. They work not only to give us companionship, but maybe to help us keep our habits good and, you know, things like physical activity are very good.

And social contacts can also help us, for example, in advising us about whether we should go to the doctor with a symptom or something like that, which you might not do if you're on your own.

CONAN: Paul, you still see your friends regularly, though.

PAUL: Yes, I do. I go out to work and go out to lunch with people at work, oh, maybe once every three weeks or so. And I supervised a bunch of mechanics in a truck shop, and, you know, they're emailing me all the time. So I keep in contact. But, you know, I do miss the day-to-day interaction with the people at work.

CONAN: I can understand your situation. Paul, thanks very much. Good luck.

PAUL: OK.

CONAN: And the other question, Andrew Steptoe, is: Are we - and obviously, you're studying people there in Britain, but I suspect it's not so different. Are we living more in isolation than we used to?

STEPTOE: Yes, I think there's good evidence for that. The most striking facts about that are to do with the proportion of people who are living alone, which has really increased a lot in the U.S. and in Europe over the last couple of decades. And I think the most recent figures from the U.S. show that in people over 65, 37 percent, that's more than one in three women are living on their own, and about 19, 20 percent of men are living on their own. And that is a big increase from earlier times.

CONAN: And does that increase with age?

STEPTOE: Yes, it does. The most obvious reason, of course, is that people who've been married become widowed, and so they tend to end up living on their own, and so that does increase, I must say.

CONAN: Here's an email we have from George in St. Louis: Arthritis somewhat limits my mobility, but I maintain daily Internet contacts and interaction with interesting people in show business, music, theater and films, as well as friends. In a physical sense, some say I may be a bit reclusive, but I feel that I have a full and satisfying social life. Am I fooling myself?

And that's been a change, even over the period of your measurements, Andrew Steptoe: the social media.

STEPTOE: Yes, it has, indeed, and it's a very interesting change that we don't really understand very well. There's clearly a great deal more electronic communication. It used to be the telephone, but now it's email. And then we also have social networks and social networking sites. And we don't really know very much about how that operates as far as these sort of social connections are concerned, whether it's as good as face-to-face or telephone contact, or whether it's not quite so good.

And that's really - it's quite difficult, actually, to assess these things, particularly among older people. But it's something that we and others in the U.S. are determined to do to try to find out whether people are compensating for, you know, living on their own with these kind of means of communicating.

CONAN: Well, it's evening there in London. We thank you for your time. We know you've got elsewhere to be. Appreciate it.

STEPTOE: Not at all. Thanks very much.

CONAN: Andrew Steptoe is a professor of epidemiology and public health at the University College London, one of the authors of the study "Social Isolation, Loneliness and All-Cause Mortality in Older Men and Women," with us from the BBC Studios there in London. After a short break, NPR's Jon Hamilton will join us to talk more about this research and others. Stay with us. This is NPR News.

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CONAN: This is TALK OF THE NATION, from NPR News. I'm Neal Conan. If you're just joining us, we're talking about a recent study by a team at University College London in which they studied the effects of loneliness and isolation on mortality. It's not the first attempt to draw links between socializing and longevity.

For example, last June, a study published in the Archives of Internal Medicine made another important distinction: While well-being has long been connected to friendships, it focused specifically on older people who said they were lonely, no matter how well-connected they might be socially.

If you're getting on in years - let's say 60-plus - do you go solo, or prefer the company of others? And what's the effect of your choice on your life? 800-989-8255. Email us: talk@npr.org. You can find us on Twitter @totn. And death - here to tell us some more about research on isolation, loneliness and death is Jon Hamilton - I didn't mean to draw that immediate distinction there - correspondent for NPR's science desk. He did a report last week on the UCL isolation study for MORNING EDITION. He's here with us in Studio 3A. Nice to have you with us, Jon.

JON HAMILTON, BYLINE: Great to be here.

CONAN: And what does being socially isolated have to do with dying sooner? Is there cause and effect?

HAMILTON: Well, you know, it's interesting, because there have been sort of two strands of research that have happened. People have been studying loneliness and its connection with health problems and mortality. But they've also been studying isolation. And I was particularly interested in this study from a few days ago, because it was trying to break down those two things and look specifically at isolation and say: Is the problem the isolation? Or is the problem the loneliness? And this study concluded, of course, that it was the isolation.

CONAN: Ah. So loneliness, as Andrew Steptoe told us, a more difficult, subjective measurement.

HAMILTON: It's tricky, and, of course, isolation and loneliness often go together. So teasing them apart is not the easiest thing. But he tried to do that in his study. And when I talked to other researchers about what he'd found, they were all very interested in it. He's highly respected, and they thought it was a good study. However, the people who had done the loneliness studies - and there are a number of them - say they still think that loneliness by itself is also a health risk factor and also contributes to earlier death.

CONAN: And does anybody say why? Is it a kind of stress? Is it, well, you're not there to tell somebody, you know, I've got a twinge, maybe I should go to the doctor?

HAMILTON: Well, I mean, obviously, isolation is easier to talk about, because you can think about things like that. You don't have somebody to tell you that you need to see the doctor or lose weight or stop drinking or stop smoking. And if you happen to collapse, say, you don't have somebody there to call and get you some help.

So, isolation you can kind of connect to obvious things. It's much less obvious with loneliness. And the kind of things people talk about are you can see some subtle changes in the immune system. You see some changes in brain function. But there isn't - it's not like there is one single thing that kills people who are lonely. They talk about increase in heart disease and stress and all of these things, and together, they seem to affect your chance of dying.

CONAN: And, again, we are talking about averages. Individuals vary. Some people prefer to live alone. Some people make other choices. It's not something we're prescribing that covers everybody. But let's get some callers in on the conversation. We'll go to - this is Judy. Judy's on the line with us from San Antonio.

JUDY: Hi. How are you?

CONAN: Good, thanks.

JUDY: I live alone and pretty much isolated, and I'm 71 years old. And I'm the last of my family to survive. And I do have my days of loneliness, but as far as the isolation goes, I like it in that I'm a farmer now, and I came from a farming family, and it's very rewarding for me. And when I found myself getting lonely - and I do have days that way - I found that getting involved in the farm, and I decided to go back to college, I went back to college for another degree, and I'm about to graduate in another two semesters. And it didn't take away the loneliness, but it gave me options, because my children tended to want to run my life. Because you seem to get at a certain age, and suddenly, society and your children and your family seems to know what you need most.

CONAN: Yeah, they - it's called infantilization.

JUDY: Exactly. And so I found, as strong-willed as I am, that I was going to have to take some risks if I wanted to live my life out the way I wanted to live it, or I was going to have to do like - and I think I came to this realization. As a nurse, I saw so many people in the nursing home who looked like they had - that could have had a life, but had no life and gave up.

And I decided I was not going to go out of this world without having a life. Good or bad, I was going to live it to the very fullest. And it has its bad side, and it has its good. But if I had to say would I prefer to be alone, yeah, I guess I would.

CONAN: That's interesting, and it sounds like you're a determined person.

JUDY: Very.

CONAN: And you graduate, what you're new degree going to be in?

JUDY: It's - I'll be an RN instead of an LBN.

CONAN: And are you going to be pursuing work in that field?

JUDY: Yes, I - well, my goal is, and I've wanted to for a long time, and I've got held back because some of the colleges - or not some, but one in particular - didn't like older students being there. But I wanted to go to work with Doctors Without Borders. I like the - I'm a very - what's the word? I can't think of the word right now, senior moment. But I like to do things beyond the norm. You know what I'm saying? Go places where somebody else may not want to go.

CONAN: That's an interesting - and by the way, what are you farming?

JUDY: I have cattle, and I have horses. I used to have goats, and I cut down on that. With the drought, it has been so hard to make it. It's been really a struggle. We got our first great rain last night, and I am thanking Jesus, because everything was just dried up. But I've got some rain now. My tanks are full again, and I have some horses, and just the routine things of a farm. I plow the field, and I bring in the hay. I do what I have to do.

CONAN: If you've got animals, you've got to do it.

JUDY: Well, you know what? Believe it or not, and some people find this hard to believe, but your animals can be some of the greatest friends you've ever had. I can go to a sale to buy some more cattle, and because of my ability to deal with animals, I can get a whole lot more done with my stock than people there that are having to hire people to handle their stock. I mean, it's just - I guess it's just part of the life. But I love it. I do.

CONAN: Well, Judy, it sounds like you've got that full life. Good luck.

JUDY: Thank you so much.

CONAN: Appreciate the phone call. Here's an email. This is from Patsy(ph) in Rochester, New York: I am 62. I live a very small life working at home and with my husband. He's gone all day. I rarely talk to anyone, yet, of course, I am friendly when I encounter people. I talk to my family and children every now and then. I try not to let anyone know that I spend so much time alone, as people tend to wonder about stuff like that.

Truly, I do not wish to be out in the world much, as I don't want to have to interact much. Life has just gotten too difficult and hurtful, and I do know there are a lot of us like this. Thank you for your show. And she adds: I will miss you a lot. I will miss you, too. Thank you very much for the kind words.

And Jon Hamilton, there are a lot of people like that who prefer to live a quiet life, not like Judy, who's going off with Doctors Without Borders, but...

HAMILTON: Right. I mean, and it's one of the interesting things in the research on this, is you really have to distinguish people who are alone and people who are lonely, because they are not necessarily the same thing. You have a lot of people like your caller who choose to be alone and are quite happy with that situation.

And you have other people who, like your previous caller, who was not so happy with it, but did the things that put you in touch with other people: You go back to school. You get involved in organizations. And so each of them seems to have found a great accommodation for that they want to do.

CONAN: Let's go next to Susan, Susan with us from Santa Rosa, California.

SUSAN: Hi. Thank you. Well, I'm 71, and to follow up what Judy was saying, you know, connecting with nature is really very gratifying for me. I live alone in the country, and there's a lot you can get from gardening, I get, and nature. So, for me, I'm - living alone is somewhat of a challenge, because I'm naturally introverted, and I have to force myself to get out and connect, which I need to do so I don't feel lonely.

But I feel it's also a privilege, and I think my - because of the independence. And I think my health has improved, because I just have to take care of myself. And I can go where I want, when I want, and rest when I want and so forth. And also it's, you know, you can just - my creativity is even higher, because I don't have to answer to anybody. Nobody's here to criticize, and so forth. So I feel, on balance, it's been good for me.

CONAN: And gardening, do you feel like you're eating better?

SUSAN: Oh, yeah. Well, I've always been a kind of a health nut. But yes, gardening is the answer. It's wonderful.

CONAN: The truth, the light and the way.

SUSAN: Yes.

CONAN: All right, thanks very much for the call, Susan. Good luck.

SUSAN: Thank you.

CONAN: Appreciate it. Here's another email, and this one we have from Donald in Hayward, California: I'm only 46, but my wife passed away last year. I live alone and work from home. This morning, I verbally commented as a reaction to something and startled myself. I realized it was the first time I'd heard my own voice in a day and a half. I have a plethora of feelings. Loneliness is one. I just assume it is a process.

And that was one of the things, Jon Hamilton, that Andrew Steptoe was talking about. People, as they get older, even as young as 46, if you lose your spouse and the circle of friends tends to contract.

HAMILTON: Yeah, and especially in a time where people tend to have smaller families. So if you lose a spouse, the chance that you'll have many children - we're a more mobile society. People often have children who have moved away. So, yeah, social connections can be a real problem.

CONAN: Let's go next to - this is Fran, Fran with us from Francis(ph), Michigan.

FRAN: Hello.

CONAN: Hi. You're on the air.

FRAN: Hey, Neal. No, it's Fran from Birmingham, Alabama.

CONAN: Birmingham, Alabama. I apologize.

(LAUGHTER)

FRAN: That's quite a ride, and I enjoy your show tremendously.

CONAN: Thank you.

FRAN: And in listening to the past couple of ladies speaking, they sound like they've got it all together, ladies in their - both 70, and just seem to have found happiness and a contentment, noted in their voices, of nature and of animals. And, yes, that is part of where I find contentment. I was blessed to have been able to retire early at 62, and I thought to myself, well, what am I going to do? You know, when you've worked for 40 years, you wonder.

What you do is you find new routines, and you keep active, and you stay - if you stay on routine, it seems to help, and I find the day just flies by. I am married. Actually, we got married, it will be two years ago. He was a widower and I was divorced. And it's just like - we call it a new chapter in life. I do find great satisfaction in the friendships I found in church, community and physical activity and nature and pets.

CONAN: Hmm, nature and pets.

FRAN: Animals can bring such - a pet can bring so much love and contentment and help even lower blood pressure, they have said. So - and not everybody who lives alone is lonely, as witnessed by your past couple of ladies. They just sound perfectly content.

CONAN: And you said you were blessed to retire early at the age of 62. You were...

FRAN: Yes.

CONAN: ...working in the salt mines there in Alabama?

FRAN: No. No.

(LAUGHTER)

FRAN: No, I was working in an office atmosphere and - but - and corporate. And after many years - it's quite a difference. It's a slower pace, but it's - you find your - you have to find your tick. You have to find your rhythm in a different mindset. And - but waking up and being grateful to be alive and being thankful for what you have and acting grateful and smiling and just reaching out to others.

CONAN: Well, Fran...

FRAN: So there's just many ways and many different personalities and - but, yes, loneliness, it's been there, here and there, but you keep moving on, keep moving forward.

CONAN: Fran, thank you very much. We appreciate it.

FRAN: Thank you so much, Neal. Bye.

CONAN: And here's another email. This is from Marcia(ph): I am 63 years old. I live alone and have for many years. Generally, I've been pretty content. This past year, however, I had a detached retina and needed to find rides to numerous medical appointments, as well as assistance at home. This turned out to be a real challenge. The importance of a broader social network was made clear to me. I do feel lonely at times, but it's been very difficult to forge new friendships.

You're listening to TALK OF THE NATION from NPR News.

And, Jon Hamilton, interesting remark in Marcia's email: difficult to forge new friendships a lot of people find as they get older. Nice to have that caller who connected with somebody else and got remarried after she and her husband - her new husband both lost their spouses. But a lot of people find it hard to make new friends.

HAMILTON: Yeah. And, I mean, if you think about the pattern of our lives, we make so many friends, you know, early on in life and in college, and then we make friends through our work environment. But if you retire and you're alone for that reason, or if you lose a spouse you're alone for that reason, the means to make friends is not necessarily there, which, again, gets back to why, for some people, joining groups or becoming involved in organizations and obviously the church - all of these things are ways that people can connect.

CONAN: Let's go next to Richard, Richard on the line with us from Nashville.

RICHARD: Good afternoon, gentlemen. How are you?

CONAN: Good. Thanks.

RICHARD: On topic of growing older and loneliness, I'm speaking from a child's perspective on my father. He retired at 49. And over the years - he's now 70 - over the years he has - chose to isolate himself more and more and more, to the point where my siblings and I feel that he's almost lost touch with reality. He no longer has accountability in his life, meaning when he was working, he had a boss he had to answer to.

But he is - it's disturbing to see the choice that he has made, that he would rather be on the farm, around his animals, than to spend time socializing and interacting with his children and his grandchildren. My parents are still married. Just a very sad progression in life that we've all witnessed in. I wanted to stay on topic. I hope I'm not getting off the topic, but the isolation, I think, has driven him to become less social and unhappy generally.

CONAN: And that can happen, Jon Hamilton, at least as we look at the statistics.

HAMILTON: Yeah. In fact, the researchers often talk about a phenomena where being alone and isolated will lead to changes in the brain, things like changes in the reward circuit where we don't get the same kind of pleasure out of things, including being with people that we used to. So people get depressed. They become less social. And it's a self-perpetuating problem, right? And sometimes you wonder whether it wouldn't be a good idea to help break somebody out of that particular cycle.

CONAN: Intervention, almost.

HAMILTON: Yes.

CONAN: Have you thought about that, Richard?

RICHARD: Yes, we have. We've tried to speak with him. We've tried many tactics, from casual conversations to the tough love approach. And there seems to be not teaching an old dog new tricks, so to say. He's very set in his ways and says he's happy to be alone, out on the farm working with his animals, yet it doesn't reflect in his attitude when you see him. He's very unhappy, very disgruntled. In fact, once again, has lost touch with reality and I think it's because of the lack of interaction with people and accountability.

CONAN: Well, Richard, we're sorry to hear about that and hope maybe there could be a change before it's too late.

RICHARD: Thank you very much. Gentlemen, have a nice day.

CONAN: And thanks very much for the phone call, we appreciate it. We're talking about social isolation and loneliness. Statistically, they could lead to shorter lives, at least that's what we're learning. Of course, those are averages. Everybody, individually is different. Some prefer to live alone, everybody has their own reasons. Jon Hamilton, thanks very much for being with us today.

HAMILTON: It's been a pleasure.

CONAN: Jon Hamilton, correspondent for NPR science desk. He focuses on neuroscience, health risks and extreme weather. Here's a job description for you. When we come back, we're going to talk about strategies to help elderly people with isolation and feelings of loneliness. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

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CONAN: Today, we're talking about connection between social isolation, loneliness and mortality. Joining us now is Mary "Yogi" Wess, the executive director of Little Brothers - Friends of the Elderly in Cincinnati. Little Brothers is a national network of volunteer organizations that tries to relieve isolation and loneliness amongst the elderly. She joins us from her office in Cincinnati. Nice to have you on the program with us today.

MARY YOGI WESS: Oh. Hi, Neal. Thank you. It's very nice to be on your program and thank you for bringing the attention to this topic and also thank you for all of your years of interesting topics, and you will be missed.

CONAN: Well, thank you very much. Thanks for the kind words. Your slogan: Flowers before bread - tell us what that means.

WESS: That means that we believe in honoring the elderly with dignity and respect, and it also means that we believe in providing the nice things in life. Like when we host a party, we always serve meals on china. We always have flowers on the tables. We use tablecloth. We always remember our elderly on their birthday, not the day before or the day after but on their birthday. And we do those things to, again, honor the elderly and provide some of the things that they might not be able to afford or not be able to get to, let's say, a special event that's going on in the community. So it is traced back to our founder - was a wealthy Frenchman, and Little Brothers was founded in Paris in 1946, and he believed in always honoring the elderly. And that's what we do in all of the programs that we offer to our elderly friends.

CONAN: And I assume most of your workers are volunteers.

WESS: Yes. We have in Cincinnati wonderful volunteers. We have about 350 that are the heart and soul of what we do. They provide a lot of the direct service to the elderly. We have visiting volunteer program where they're matched one on one with the elderly and they provide friendship and a lot of other direct service that the elderly person may have difficulty in getting, you know, on their own.

CONAN: Medical appointments, that's what I think. But I wonder whether a lot of those volunteers aren't older people themselves.

WESS: We do. We do have a lot of older volunteers. I'd say every day just probably, you know, mid-50s but we do have a lot of younger volunteers also. We have a lot of families that do volunteer with us that involve, you know, entire families that, well, volunteer with us on major holidays, and it kind of becomes a tradition in the volunteer family to be involved with us on a ongoing basis on all the major holidays.

CONAN: And I understand that your services are provided to people 65 and older, but I gather you get requests form people younger than that.

WESS: Yes, we do. We do get a lot of calls from people like in that 55 to early 60 range that, you know, slips through the cracks because there aren't a lot of services available for people in that age range, and we lately even getting a lot of calls, especially from like Vietnam veterans that fall into that early 60 age range.

CONAN: And as you look at the kinds of services you provide, is the demand increasing? As we're told, more and more people live alone.

WESS: You know, we get referrals constantly, and it's interesting that the more we get there is the more of a recognition of the isolation of people, that people that, you know, don't have anybody, that don't have any immediate family in the area, that don't have a social network that they can rely on. So, yeah. We do continue to get referrals of people that are, you know, living, you know, without a lot of support.

CONAN: Thanks very much for being with us today. It's an organization I had not heard of before. We did some research on this program and obviously, service is greatly needed, appreciate it.

WESS: Well, thank you very much and come and visit us any time and you can volunteer with us.

CONAN: All right. Thanks very much.

WESS: Thank you, Neal.

CONAN: Let see if we can get one more call on this subject. This is Kirsten(ph), Kirsten with us from Naples, Florida.

KIRSTEN: Hi. Thanks for having me on the show. I...

CONAN: Thanks for calling.

KIRSTEN: It's been a good and informative show.

CONAN: What's your situation? What are your choices?

KIRSTEN: I had - have sort of a different background from many of your callers. But I seem to be sharing the component of being 71 and a woman, living alone. But my professional life was very isolated. I was a wildlife biologist. I work primarily in national forests and state forests. So I was alone, and from many, many years. And now I'm retired to Naples, Florida which is a pretty much retirement everywhere. You know, there's many different types of communities, and there - my greatest comfort and solace is being in the wilderness and being out of doors and hiking, and the Everglades don't really provide that kind of experience. And there aren't many outdoor places that they were in California where I could experience the kind of isolation that is coming for me now.

CONAN: I understand. But surely, there's a lot of social groups there.

KIRSTEN: The social groups are - and I attended them and gone to meetings and done a bit of volunteer work. But I have to say that I have never seen a community that is so oriented towards promoting couples and the lifestyle of tennis and golf, and with each other. You know, that kind of - put together, a different category, I think.

CONAN: Then why did you decide to go to Naples as suppose to some place that spoke more to your soul?

KIRSTEN: That's a wonderful question, part of it was economics and part of it was I have family here. I have also family that lived in the North, and I just wasn't ready to face winters again.

CONAN: No, I can understand that. I could understand that. Well, I'm sorry there's no - not much in the way of elevation and not what's in the way of the - the Everglades doesn't answer your particular needs.

KIRSTEN: But that's the challenge. So I will find the answer somewhere.

CONAN: Good luck. Thank you so much for the call.

KIRSTEN: Thank you. Bye-bye.

CONAN: And thanks to everybody who called and wrote. We're sorry we couldn't get to your calls, but the life of the belly button coming up. Stay with us.

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