About five years ago, Liz Sabo and her husband, Bob, sold their two-story home in New Jersey and moved to Brickstone by St. John's Living, an independent senior housing complex in Brighton.
They came to the Rochester area to be closer to their son and grandson.
Liz Sabo, who is now 76, said there was another factor that went into that housing choice.
"I realized that as much as I am a person who can be alone and entertain myself, so to speak, that was the thing I needed: to be around people," Sabo said shortly before joining dozens of other residents in a chair exercise class in a sunlit room on the main floor of their building.
Getting exercise and socializing — two things Sabo values and enjoys — were hard to come by in the last years of her husband's life.
In 2016, she became his full-time caretaker when he was diagnosed with dementia. Sabo said he used to love to cook and travel but he started losing interest in those things.
"He really wasn't my husband anymore," she explained. "He really was not my mate anymore. He was my child."
Sabo was constantly worried about his safety, afraid to leave him alone for a moment, even to go to the grocery store. Her world started shrinking quickly.
"My life became inside those four walls," she said.
Loneliness is a serious threat to people's physical and mental well-being. It has about the same chance of increasing the risk for premature death as a daily smoking habit.
Earlier this month, U.S. Surgeon General Dr. Vivek Murthy sounded the alarm about the epidemic of loneliness, citing a study showing that it was experienced by half of Americans even before the COVID-19 pandemic.
In Murthy's advisory on the healing effects of social connection and community, he stated that he didn't realize loneliness was a public health concern when he first took office in 2014.
Then, on a cross-country listening tour, Murthy said he experienced a "light-bulb moment" after people of all ages and socioeconomic backgrounds from every corner of the country began to talk about feeling isolated, invisible, and insignificant.
"Even when they couldn’t put their finger on the word 'lonely,' they would tell me, 'I have to shoulder all of life’s burdens by myself,' or 'if I disappear tomorrow, no one will even notice,'" he said.
According to researchers at the University of Michigan, about a third of people between the ages of 50 and 80 sometimes or often experience loneliness or isolation.
"If we can address loneliness and isolation, we can prevent all kinds of downstream negative effects,” said clinical psychologist Kim Van Orden, an associate professor at the University of Rochester Medical Center.
Older adults do have built-in advantages for avoiding loneliness, Van Orden said. For instance, as we age, we get better at managing our emotions and prioritizing relationships.
But for some, like Liz Sabo, barriers get in the way. Things like health problems for themselves or their spouses from limited mobility to cognitive decline to depression and anxiety.
"And when they start to accumulate, someone can then really, really struggle," Van Orden added.
Van Orden is the principal investigator for a National Institute of Mental Health funded study looking at how social engagement coaching can help residents of senior living communities feel more connected in ways that are meaningful to them.
The university is recruiting up to 30 adults aged 60 or older who live in such communities in the Rochester area and report feeling lonely. For eight weeks, participants will get weekly 30-minute, one-on-one coaching sessions where they will learn how to respond differently in social situations in which they experience loneliness.
Let's say, for example, they aren't finding friends in their community. They may feel isolated in a crowd when they visit the dining hall and have trouble making connections.
The coach will give the participant specific goals for the next week. They might suggest sitting with a group of different people at meal time.
If that strategy doesn't work, the coach tries to figure out why.
"It could be something like, 'That person laughed at me,' or 'Gosh, I wish my husband was here.' Whatever kind of barriers pop up for that person, we would try to address them," Van Orden explained.
The researchers are specifically working with senior living community residents simply because they have so many opportunities to make social connections where they live.
At St. John's Meadows and Brickstone by St. John's, an assisted living community and independent senior living community in Brighton, social worker Hannah DeGeorge is an elder advocate. Her job is to support residents in a number of ways, including keeping an eye out for anyone showing signs of social isolation.
DeGeorge said that can present itself in various ways from mood and appetite changes to avoidance of social activities.
She thinks many older adults, especially men, are wary of admitting they are lonely because of the stigma attached to the word. No one wants to be seen as someone who doesn't belong.
In some cases, she said residents aren't even aware that their lack of social connection is the problem. They might report back pain, weight loss, or other physical symptoms as the reason for a loss of enjoyment in activities that once interested them.
"It's a lot easier to blame it on medical than to blame it on something more emotional, something more complex," DeGeorge said.
Even though some may not associate their health problems with loneliness, it can pose serious physical threats.
The U.S. Department of Health and Human Services says poor and insufficient social connection leads to a 29% increased risk of heart disease, a 32% increased risk of stroke, and a 50% increased risk of developing dementia for older adults.
DeGeorge's prescription for loneliness includes encouraging people to engage in social activities or to get a pet, even a robotic one.
When it comes to relationships , Van Orden stresses the importance of reciprocity.
"If you feel like people are only taking care of you, it often doesn't feel as meaningful as if you can give back," she said. "Sometimes people feel like that's missing."
Sabo understands how privileged she is to live at St. John's where social opportunities are always available. Since her husband's death in July 2022, she has had more time to socialize. She got a membership at the JCC and joined a book club on the Brickstone campus, which she now leads.
"Many people are just right outside my door, so you know, right away, my life became, like, 200% better," she said.
But many people cannot afford to live in a senior living community.
According to GenCost, the monthly median cost at Rochester area assisted living facilities was $3,775 in 2021.
"I'm fortunate because I could afford to come to a community like this," Sabo said. "Many people out there don't have the resources that can help."
We're making a special effort to report on loneliness and older adults. In the next part of our series, we'll hear how a Webster woman living on her own finds ways to connect.
