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--from The Daffodils. William Wordsworth (1909-14.)

A new study suggests social isolation may harm physical health, even hasten death. People who lived alone were found to have a 32% higher risk of an early death than those who lived with another person. (What is meant by early is not defined, however.)

Lisa Jaremka, University of Delaware in Newark assistant professor of psychological and brain sciences, agrees. People have a very basic and fundamental need to feel connected to and cared for by other people… lonely people are lacking in this area. They aren't fulfilling this basic need, and thus, negative things happen as a result. 

According to the U.S. Census Bureau, 59.2% of women and 21.6% of men over age 75 are widowed. Many older adults are geographically isolated from their relatives. Others may not have had any children or have actually outlived them. Starting in one’s seventies, friends will die faster than new ones can be made. Still others will move out of town to be with family or to go to a nursing home. Finding new interests is tough for people who have poor hearing and vision, arthritis, urinary incontinence, no car, and or a limited budget. 

Yet another new study contends that loneliness may be as much a threat to longevity as obesity. These findings are based on a review of data from studies involving more than 3 million people, co-authored by Timothy B. Smith, a professor in the department of psychology at Brigham Young University in Provo, Utah. "We think of things like exercise, blood pressure and taking cholesterol medication. But it turns out that social isolation is actually more predictive of death than any of those three things." Smith and his colleagues’ findings are published in Perspectives on Psychological Science. Specifically, their team calculated that social isolation -- having few or no social contacts or activities -- upped the risk for dying sooner by 29%. (What is meant by sooner is not defined, however.) 

Even if you live alone but don't feel lonely, these researchers contend that you may still experience a negative impact on your health… that we are wired to be social beings, and our immune system and our stress response just function better when we are in a collective. We are basically healthier when we are social. 

Filmmakers and reviewers often see comedy in the lives of lonely old people. In her review of In the Courtyard, New York Times (April 10, 2015) reviewer Jeannette Catsoulis, labels “a neurotic retiree.” Dans la cour is a 2014 awards-winning, French comedy-drama film written and directed by Pierre Salvadori. It stars Catherine Deneuve (would you believe 72 years old?) and Gustave Kervern age 53.  

Antoine, played by Kervern, is too depressed to go on playing in his rock band. After wandering in the streets, he decides to seek an occupation. Unskilled as he is, he is lucky to be hired as the caretaker of an old Parisian apartment building. He soon proves good at his job, even if he performs it a little eccentrically. Everybody grows fond of him. He also develops a friendship with Mathilde, a recently retired woman who lives in the block and whose mental balance is deteriorating, played by Deneuve.  

OK, these guys and gals have made their point (conclusion) about (some) old people vis a vis loneliness. This is where the geriatricians and gerontologists should look over their respective fences, at least ask, so what? What’s next? Are there do-able solutions? What do they have to offer Ms and Mr Aged Lonely? Senior center conviviality, hearing aids and eye glasses, PC technology, transportation (taxi scrip), volunteer “opportunities,” holiday food “baskets,” pets… 

I recommend The Real Truth about Aging (2009) by Neil Shulman, MD., et al. They declare, and I agree: Books that highlight ‘healthy aging’ focus on older adults who are healthy and active… the real truth is that for millions, the ‘golden years’ are a time of loneliness. Depression can be a real bummer.  

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My primary care physician (PCP) has retired. Good for her. Not good for me though. I had been her patient since she began her practice. Her buoyant youth and long flowing hair hadn’t been off-putting. She was an internist and later, sub-specialized in geriatrics as well. Thirty plus years on, and my choice is limited for several reasons. Actually, it’s restricted-- I’m back at square one.  

For Medi-Medi senior citizens, “not accepting new patients” is an almost automatic response. It’s. Medi-Medi is a term that refers to Medicare as the primary insurer with Medicaid as the secondary insurer. California’s Medicaid is called Medi-Cal. (Related reading: Harry Brill’s Public Comment, “No birthday celebration for Medicaid?” in April 14^th’s Planet.) 

For powerless seniors, it has become very difficult, often impossible, to identify a physician who accepts new patients and Medicaid. Many turn to non-specialists when they need a specialist, or attempt to get help at Over 60 or a hospital Emergency Department.  

Physicians who in the past may have accepted Medi-Medi patients now eschew both them and Medi-Medi. Their chirpy interceptors may explain “Medi-Cal cancels out Medicare”! This is especially true of medical specialists, dermatologists and orthopedists, for examples, who are turning away long-time Medi-Medi patients. Medicare’s website lists physicians who accept Medicare, which does not mean that they accept Medicare’s payment as payment in full (called Medicare Assignment.) It means that they accept Medicare provided the patient has a secondary insurer other than Medi-Cal. Medicare’s website provider information is based on physician-input. Numerous physicians apparently report that they currently accept new patients and or Medicare Assignment.  

What can one do? Very little, but in behalf of yourself and other senior citizens, you should try to effectuate change locally. Start at the top while working your senior powerful way down. Urge your city council, senior services department, commission on aging (in Berkeley, charged with “identifying the needs of the aging, creating awareness of these needs, and encouraging improved standards of services to the aging”), and community senior center management and advisors to survey physicians (other than pediatricians) doing business in the community, and share the results.  

Or, suggest a safe alternative— volunteers compile a list of physicians who accept new patients and Medi-Medi, and make available the free (predictably, one page or less) list at community senior centers. Here are a few simple yes/no survey questions: 

Is Dr. Xyz currently accepting new patients? 

Does Dr. Xyz accept new patients without referral from another physician? 

Does Dr. Xyz currently accept Medi-Cal (California’s Medicaid) as all or part payment? 

Does Dr. Yyz accept so-called Medi-Medi as payment?
Has Dr. Xyz ever accepted Medi-Cal as payment? 

Does Dr. Xyz ever turn away a patient who has Medicare with no acceptable secondary insurer? 

Has Dr. Xyz instructed her/his office staff to respond negatively (turn away) to patients whose 

Medi-Medi has in the past sufficed? 

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NEWS 

"State, L.A. County set to overhaul nursing home oversight procedure," by Abby Sewell (Los Angeles Times, April 28, 2015).  

Older Adult Services of the Alameda County Library has announced Fabulous Fashion for Women Over 50, a free program at the Albany branch library, 1247 Marin Avenue, on Wednesday, May 13, 2015, from 1:30 to 2:30 P.M.. Telephone: 510-745-1474. TTY: 888-663-0660. seniors@aclibrary.org 

CALIFORNIA NEWS: "Crisis line for seniors struggling for survival as grant ends," by Steve Rubenstein (San Francisco Chronicle, May 3, 2015).