By Judd Matsunaga, Esq.

If you’re feeling lonely this holiday season, you’re not alone. Much of the loneliness that occurs during the holidays can be traced to three major causes.

The first is lack of sunlight, called seasonal affective disorder (SAD). The body responds by producing less melatonin, a hormone tied to sleep, and less serotonin, the feel-good brain chemical that affects mood.

The result of this chemical imbalance is that some people regularly struggle with depression and fatigue during the winter months. You feel low and lethargic. Other common symptoms of SAD include lack of sexual energy, overeating (especially from craving high-calorie comfort food), and social withdrawal. You may feel better if you seek out sunlight on brighter winter days.

Sunlight exposure stimulates the hypothalamus, a part of the brain that helps control your circadian rhythm — the body’s internal 24-hour sleep-wake clock. Lack of light can throw off your circadian rhythm. SAD is also associated with impaired cognitive function, including problems with concentration and working memory — like having trouble recalling just-learned information or finding the right words when speaking.

The second major cause of holiday loneliness is unrealistic expectations. It’s easy to jump to the conclusion that others are having more fun than you. People tend to share their good times more than their down days, especially on social media. If seeing other people’s posts bothers you, then cut back on social media or leave it completely for a while.

Also, don’t compare your current holiday with ones from the past. Keep the present in perspective, as new traditions can be just as fulfilling as fondly remembered old ones.

The third major cause of holiday loneliness is missing family members. If you made it into your mid-80s, 90s and above, there’s a good chance that you’ve outlived most (if not all) of your closest friends. What’s more, some people have to work over the holidays. A few may leave the holiday hustle behind and go somewhere relaxing instead. Try not to take their absence personally.

The sad truth, however, is that it doesn’t have to be the holiday season for people to feel lonely. The May 2021 American Perspectives Survey finds that Americans report having fewer close friendships than they once did, talking to their friends less often, and relying less on their friends for personal support. (Source: https://www.americansurveycenter.org)

The survey found that 12% of Americans say they have no close friends — quadruple the number (3%) who reported no close friends in 1990. Close to half (49%) of Americans report having three or fewer. More than one-third (36%) of Americans report having several close friends — between four and nine. The survey of 2021 found that four or five close friends was the sweet spot for many people to feel satisfied with the state of their social circle.

The number of close friendships Americans have appears to have declined considerably over the past several decades. Trends show less community participation and more people living alone. Religious service attendance has fallen dramatically, and marriage rates are down.

Socializing with friends and family is given less priority than work obligations. As technology has advanced, so too has the pace of our lives, ironically often leaving less time for leisure and social activities. The advent of television (and then cellphones, the Internet, and social media) turned our attention away from one another and toward devices — or at the very least, took us another step away from face-to-face interaction.

Seniors are particularly inclined to feel lonely, not because of their age per se, but because of circumstances such as the loss of a spouse or other close friends, poor health, or the demands of serving as a care giver for someone else. All these factors increase the risk of social isolation and loneliness. (Source: Special Health Report, Harvard Medical School, “Combating Loneliness”).

In his seminal book “Bowling Alone: The Collapse and Revival of American Community,” Harvard political scientist Robert D. Putnam chronicled the decline of civic engagement, church attendance, and union membership in the last third of the 20th century. Participation in bowling leagues, which used to bring people together on a weekly basis, is down, along with membership in service organizations like the Lions Club, Hadassah, and Rotary International.  

At every stage of life, from birth until death, humans need social connections and support. “That need is hard-wired into us,” says Julianne Holt-Lunstad, director of the Social Connection and Health Lab at Brigham Young University in Utah. Holt-Lunstad and her colleagues found that being lonely and socially isolated confers as great a health risk as smoking up to 15 cigarettes a day.

The connections between mind and body have never been as clear as they are today. For instance, research shows that both objective and perceived isolation can lead to the release of stress hormones. While these hormones serve vital roles in the body, they should not remain at high levels on a regular basis. Over time, they can contribute to chronic illnesses such as cardiovascular disease, high blood pressure, diabetes, dementia, anxiety and depression.

“There is something about relationships, social connectedness, community life, that is central to what it is to be human, what it is to flourish,” says Tyler VanderWeele, professor of epidemiology at the Harvard T.H. Chan School of Public Health. Being socially isolated was the more important factor for physical health outcomes, like risk of death. But loneliness was more important for mental health outcomes like depression or happiness, purpose in life, and having a sense of mastery.

Volunteering is a proven buffer against stress and depressive symptoms and can be particularly effective in lessening feelings of isolation. That is because loneliness tends to draw people’s attention inward, while giving back turns it outward, said Dr. Kory Floyd, a professor of communication at the University of Arizona and the author of “The Loneliness Cure.” “You are focusing on the joy and comfort you can bring to others,” he added.

There are plenty of opportunities to volunteer this time of year. Look into your closest Japanese American community center or neighborhood senior center. Informal gestures help ease feelings of isolation, as well. Research shows that performing small acts of kindness toward neighbors — like dropping off groceries, watering their plants or simply chatting for a bit — can also help people feel less solitary. (Source: www.nytimes.com)

Now, some Rafu readers are great at making new friends and staying socially engaged. Some seniors have already moved into a retirement community where social activities abound. However, some Rafu readers are not so lucky. If you’re not able to get around to make new friends, and don’t like the negative health consequences of loneliness, look into companionship care.

Companion care can be as straightforward as having company during the day and keeping your mind active through brain games and conversation. There are several home care agencies that offer elderly companion care services, including a couple that advertise in The Rafu Shimpo. One well known company that offers elderly companion care service is called Visiting Angels. From their website (www.visitingangels.com), the elderly companion care services include:

• Engaging your loved one with favorite activities. Our caregivers offer friendly conversation?and engage in favorite hobbies, such as playing games, listening to music or watching a?favorite TV program. ?
• Accompanying your loved one. We can accompany your loved one on neighborhood walks, attending community events or going shopping.
• Assisting with mealtime. Our assistance includes planning, preparing and serving healthy?meals that ensure your loved one receives the nutrition they need.
• Helping with housekeeping chores. Visiting Angels can help with light cleaning, including?tidying, washing dishes and doing laundry.

“But Judd,” you say, “isn’t home care expensive?” You bet. According to Genworth’s 2024 Cost of Care Survey, the median hourly cost of homemaker services is $30.90, and the median price of home health aide services is $29.50 per hour. In the Los Angeles area, it is $6,873 per month. In addition to location, personal needs and the amount of care time per day are significant factors. (Source: www.seniorliving.org/companion-care/costs/)

“I can’t afford that,” you might further say. Yes, you can if you get help from In-Home-Supportive-Services. IHSS is the only public program that will help pay for home care. Of course, to get IHSS you first have to qualify for Medi-Cal. But since the elimination of Medi-Cal’s Asset Test, you no longer have to “spend down” or transfer assets to qualify. IHSS will pay $4,000-$5,000 per month to help you remain at home.

If you don’t qualify for IHSS (e.g., your income is too high), you can use the equity in your home to pay for home care. Chances are that the equity in your home has increased by several hundred thousands of dollars since you bought it. In fact, the average home in Los Angeles is worth close to $950,000, according to Zillow. So even if you still have an outstanding mortgage, you should still have plenty of equity to pay for companionship care.

“But my children told me to never take out a loan on my house.” Well, it’s your home. What’s better? Developing a medical condition from loneliness and ending up in a nursing home; or using the equity in your home to remain in your own home with companion care? In my legal opinion, based upon my years of education, training and experience, I suggest you use your money to provide yourself the best care possible for the remainder of your life.

Here’s my final thought: Make sure your power-of-attorney allows the agent to refinance your home and/or qualify for a reverse mortgage. Most of you have appointed a spouse or adult child to be your power-of-attorney. If you feel they won’t honor your wishes to remain at home with home care, find another agent. And since some lenders are requesting physician opinion letters as to capacity at the time the POA was executed, that’s not a bad idea to have in the file. In other words, “Hope for the best but prepare for the worst.”

Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.

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