Social frailty is a community challenge

Photo: Freysteinn G. Jonsson/Unsplash

Social frailty is defined by an inability to safely and smoothly live from day to day with ease, free of physical, emotional, mental and financial burdens. Very often elderly persons with one or more health challenges that impact daily living don’t have the community resources necessary to enrich their lives to relieve the isolation of home alone solitary living.

                                                                                                

Many in my world might consider me socially frail because I don’t move about easily within the community, relying on a few mobility aids, a wheelchair or crutches when spending time in the city for shopping, and a mobility scooter for ‘running the roads’ where I live, just outside, Fredericton, NB. My involvement/presence within the community is, for the most part, functional – to get things done – like health care appointments, grocery shopping, the occasional mall crawling and dog grooming appointments. 

Often, with no close relationships and little or no opportunity to rely on others for help, the socially frail may risk becoming more mired in the muck of isolation. They’re not always active in community groups or religious organizations or live in neighborhoods may not be safe. Here’s the thing, though. Many, if asked, would like to be. Would love to be.

According to a 2014 Japanese study, “men with social frailty were more vulnerable than women to a decline in their psychological function and cognition domains. Therefore, the advanced management of social frailty is necessary to facilitate healthy aging.”

Perhaps a community cooking class for men followed by a shared meal with their dinner date. Activities such as this are ideal ways to opening doors to other community/social opportunities which enhance quality of life.

Closer to home, our aging population, regardless of gender, may benefit from an ongoing daily plan to counter the effects of social frailty. That is not to say that we who are aging need to be looked after/sat with, interacted with on a daily basis. Many people, myself included, are creatures of solitary habits. That’s not a bad thing, but with the passage of time, as more peers are passing away due to implications of illness or old age, it’s important to do wellness checks on those who really are more on their own than is safe, based on medical standards of care.

COVID shone a light on manifold inequalities experienced by the aged and those living with since birth/long term disability and those plagued by bare minimum classroom education and minimum wage work life employment. Being ‘confined to quarters’ was a challenge to millions of people who had a lifetime of being used to coming and going, socially connecting on their own initiative or being included by others, individuals and groups.

Establishing a network of social connectedness goes a long way to reducing social frailty and reducing health care costs. The engaged person is a happier person, a more physically healthy person. It reasons that communities across the country would be well served by stepping up programs and services of outreach to those who are rarely seen or heard from.

Inequalities in health care continue to put the socially frail at risk as they lack the resources to reach out and touch, to coin that popular television advertisement phrase. We who can must do the reaching out. One day we may find ourselves in need of similar networking supports and to fully appreciate what it means while we are young allows us to strategize with like minded men and women in the community to ensure that the ‘least among us’ have their needs met.

Financial stress, transportation problems, concerns about affordable housing are uppermost in the minds of older persons as they get close to the typical retirement age. Are they ready for what that means. Will an often reduced income allow them to continue living in the manner to which they’ve been accustomed?  Having to give up the family home because it’s too expensive is a worry that impacts seniors who never had a solid plan over the decades before they ‘aged into’ the 60s-70s zone. Panic exacerbates dementia, compounding the problem.        

Social frailty is the enemy of many senior, elderly and advanced geriatric men and women, but it doesn’t have to diminish quality of life if systems of support are put in place to cover all the bases. 

Nursing home care is expensive and wait times for beds can be long; some patients actually expire while waiting for admission. Quality of life for the socially frail could be significantly enhanced if community school systems, as example, incorporated studies in home ‘friendly visiting’ care with seniors as part of course credit. Match students with seniors in the community to ensure an enriched mutually beneficial relationships. School boards, school administrators, provincial departments of labour, health and education could collaborate on a range of schemes that engage two populations with different needs and different skills. 

Independent living requires a high degree of mental acuity; from self care, to meal planning and preparing, to home care, pet care and friends care. Inviting people in if you cannot go out is a great way to connect and engage. 

It’s been my experience that being mentally engaged allows the older, isolated person to stave off the angst of home alone living, staying alert and aware -- both tools to ward off dementia. Scrabble, anyone?

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with Miss Lexie, a rambunctious Maltese and Mr. Malcolm, a boisterous Havanese. She can be reached via email at  Carla MacInnis Rockwell

You can say no, I promise!

 

Almost immediately, as I started ‘penning’ this piece, a tune from a favourite musical popped into my head. Now I can’t get it out; the words of Richard Rodgers as delivered in the production of Oklahoma for both stage and screen resonate.

   “I'm just a girl who cain't say no

   I'm in a terrible fix

   I always say "come on, let's go!"

   Jist when I orta say nix…”

I and others are of similar mind with regard to volunteerism; getting ‘sucked in’ and not being able to say no, or fearing that if we do say no, we won’t be well regarded and that people won’t like us. We should be able to be comfortable saying no without being pressured to alter our position, or have our decision dissected by those seeking our help.

It is, indeed, a pervasive concern for many who do want to be involved but have so much other ‘stuff’ going on in their lives they don’t want to spread themselves too thin.

Not long ago, I had a conversation with a friend who volunteers across a wide platform — church suppers, food bank, various functions at the elementary school where she’s taught for years and now functions within a few hours a week, along with other volunteering in and around where she lives. She’s good at what she does and she enjoys it but she’s agreed that sometimes she does take on too much, not wanting to say no; not wanting to disappoint, etc.

Just because we said no to being available to bake pies for a church supper doesn’t mean we won’t be available to serve at that same supper. The one asking shouldn’t get her knickers in a knot because we said no to one component of the event.

The fellow you had to turn down seeking your help to load winter stove wood shouldn’t be annoyed if he sees you helping another neighbour remove yard debris. 

At the time we said no, we really needed to do so. But when we say yes to another request, especially if the parties know each other, it has potential to create ill will. “Why did he help him but wouldn’t give me a hand?”  Save yourself the stress. Don’t ask. Just accept that our lives take many twists and turns and there was no intent of personal slight. 

Unfortunately, there are some who will immediately feel that they weren’t valued enough to be considered. Others will think that previous behaviour on their part has offended the person they asked for help so it has soured the relationship. All those damned if you do, damned if you don’t scenarios. The bottom line is that we can’t be all things to all people all the time, and sometimes we just need to say no for our own benefit. That is not being selfish. That’s self care.

Sadly,  year after year after year, the same people seeming to be doing it all are YES people when they may want to coast along in the NO lane. If they say no, they fear the whole process of organising that church supper will fall apart.  That the school play just can’t get along without them.

What seems to be overlooked by so many others is that they enjoy all the benefits of those church suppers, and fall fairs, and craft shows without much thought to how it all comes together? There are no gremlins or dancing bears scampering around in the middle of the night  making pies and soups and salads and setting up tables. Real live men and women are doing it — the same real live men and women, year after year. They’re tired. Some of them are in their mid 80s. Did you know that? 

While you were helping yourself to another roll and pat of butter at the table in the church hall enjoying a roast beef dinner, did you know that a 74 year old woman in the kitchen at the sink doing dishes was having chest pain? She’s okay, but maybe one of you 40 year olds could step in and do your part. Become a volunteer — for the next 30 years! Invite your children and a few of your friends to join you. Show them that caring about your community means giving to your community. According to a dog training book I read years ago, nothing in life is free. The same is true for us humans. When we receive, we must be aware that giving, though not expected, is a reward in itself. 

Summer outings and gatherings will soon be in full swing, so now’s your chance to find your niche. COVID fears are still present for many and being a good neighbour, especially to those whose situations isolate them from community is the perfect way to reach out. Older men and women who had to limit their participation still have talents to share. Call them. Drop in for a meet and greet. They can be included in other ways.

The COVID experience, across the province and across the country, has opened our eyes to huge gaps in care with regard to service provision to those who are less able, less physically and financially healthy. 

In crack filling with our service, we actually reduce stressors across the board, fostering inclusion. Always a good thing.

 Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with Miss Lexie, a rambunctious Maltese and Mr. Malcolm, a boisterous Havanese. She can be reached via email at Carla MacInnis Rockwell