The loneliness epidemic is now known to be a major public health issue, impacting both
​mental and physical health.  But there are ways to protect ourselves. Angela Mathews explains

After a lifetime spent caring for the poorest of the poor and looking after people suffering from sicknesses diverse as leprosy, tuberculosis, cholera and HIV/AIDS  Mother Teresa famously said, “Of all the diseases I have known, loneliness is the worst”.
 
Several decades later US Surgeon General, Vivek Murthy, identified the “epidemic of loneliness’ as a public health issue.  In 2023 he described mental health as the defining public health crisis of our time but identified loneliness as being at the heart of that crisis (Murthy 2023).
 
Loneliness is the state of distress or discomfort which results from the perceived gap between one’s desire for social connection, and their experiences of social connection. (Psychologytoday.com. 2025).  While loneliness can affect anyone, those aged 65 and over are particularly vulnerable.  In fact the General Social Survey carried out by Statistics NZ showed the percentage of people aged 65 had over who felt only increased form 27% in 2018 to 36% in 2021, a massive 9% increase in only three years!
 
In November 2024, Age Concern Auckland, in conjunction with the CHT Aged Care Fund,    published a report examining loneliness and social isolation among older adults in Auckland and the Bay of Plenty.  Their research found that 59% of  participants had recently felt lonely or socially isolated, and 30% felt that way often or all for the time (Breaking Barriers: Understanding the Socal Connection Challenges of Older Adults, Age Concern Auckland).

Among the report’s findings were some surprising insights. For example, 63% of those who reported feeling lonely could still drive, proving that it is not so much your driving status which is important but rather having a meaningful destination to drive to where you can meet others and connect over common in interests. And 42% of married older adults reported feeling lonely or isolated, showing that marriage alone is not a protection against loneliness.
 
The problem with loneliness is that it is not only diminishes joy and quality of life but also impacts physical health. Beyond the obvious correlation between loneliness and mental health  challenges, it has also been linked to an increased risk of cardiovascular disease, hypertension, diabetes and a host of other health issues. Put simply, for the sake of your mental and physical health it is wise to do your utmost to come up with a plan to try and avoid loneliness and           social isolation.  This like many other things in life is more easily said than done.  Whilst the 20th century saw rapid urbanisation in New Zealand, the 21st century has brought a new wave of globalisation for the New Zealand population. Over the last century people have become increasingly mobile which means families are less likely to live in the same town, city or even country.  At the time of the 2023 census an estimated one million New Zealand citizens lived abroad, this represents an astonishing 19% of the population.  That same census showed that over 28% of New Zealand’s resident population were born overseas.  The result of all this mobility is an increasing number of older adults living in different countries or cities than their adult children, and their grandchildren. Visits have changed from regular  pop-ins from children and grandchildren to catch ups online punctuated by occasional in-person visits.
 
The Age Concern study also highlighted that particularly in Auckland, there is a growing group of older migrants who feel isolated due to language barriers and their adult children being unable to support them during the day as they are out at work.
 
The Age Concern study found that the health system also contributed to the rise in loneliness and social isolation.  Delays in accessing non-urgent medical treatment affected some participants mobility, making it harder for them to get out into the community and participate in activities and connect with others.  This was especially true for those who were less financially secure as they didn’t have the option to pay for private medical care and extra support.
 
 
 
 
 
 
Ironically, while technology and social media have made us more connected than ever, many people feel more alone. Age Concern found that an astonishing 75% of survey participants who reported feeling lonely were social media users. However older New Zealanders are also rightly wary of scams which can make us feel insecure and hesitant about connecting online.  I think we can all conclude after living through covid lockdowns, that nothing is quite as good as catching up in person and connecting over a cup of tea or shared interest.
 
So what can we do to protect ourselves from loneliness?  The Age Concern study suggested that retirement planning needs to be more than financial but should also include a plan to live life with purpose and remain socially connected, whether that be through part time employment, volunteering or developing a new hobby.  Of course retirement villages often come with a huge   plethora of activities or clubs to get involved in which offer plenty of options to connect socially but for those people who aren’t living in a village and whose social life was tied up with work there may be a need to plan ahead for your post-work social life!! If possible, make sure that plan doesn’t hinge around one person or group but has lots of variety and options. As well as developing existing friendships this could include joining a new club or interest group.  To find local clubs and groups in your area check out www.seniors.org.nz/clubs.
 
Lesley who lives in Christchurch found that her life was a bit more lonely when her husband  moved into care.  She said while it was easy to stay busy and connected during the day it was at the ‘bookends’ of the day, the mornings and evenings, that she really noticed the change.  One thing she really missed was having someone to discuss problems with so she didn’t feel like she was carrying the load alone, and it was at these times she really appreciated being connected to the community around her and having neighbours and friends to talk things through with over a cup of tea or a glass of wine.  Fortunately Lesley is someone who has spent years helping others out in the neighbourhood so those community connections were already well established when she needed them.
 
Vivek Murthy, the US Surgeon General who identified the epidemic of loneliness, would agree with Lesley’s approach.  He encourages us to focus on building caring and supportive relationships and community networks to strengthen our social connections.  He also encourages each person to take 15 minutes a day to reach to someone and to support them in some way, in doing so we forge a connection with another human and we remind ourselves of our own value. What a great way to reduce loneliness!!
​ 
Ref:  NZ”s Best - Seniors Org NZ Edition 2026
 
 

Keeping fit when older is important and takes more effort the older we get.  Fifty per cent of those over 75 are sedentary (sit most of the time) and 25% of those over 85 aren’t active at all.  Habitual activity makes up a large part of all activity.  Housework makes up more than half of an older woman’s activity.
 
As we get older, fitness is more Important than weight, so relax about your shape and concentrate on fitness.
 
So how fit are you? 
 
What walking distances can you comfortably do?
 

• walk across the road
• walk around the house
• walk in your garden

• walk in the street – one block
• walk in the street – two blocks
• walk more than four blocks

 
Being unable to walk round the block is one indicator you have an increased risk of falling.
 
Test your fitness with the “Get up and go test” – using a dining chair.  
Record how long it takes you to stand; walk three metres (10 feet); turn; walk back; sit down again.
 
After a month of exercising, test yourself again. A change more than four seconds can indicate a change in the level of mobility eg six seconds slower indicates slower/less confident mobility or six seconds faster indicates stronger/more confident mobility.
 
Below are some moderate intensity realistic exercise ideas for you to improve your fitness: 

In 1987 Clare O’Hagan, the founder of Therapy Professionals Ltd attended the World Congress of Physical Therapy and heard a lecture by Carol Davis on Transdisciplinary Teamwork.  From that moment Clare wanted to develop such a team.  It wasn’t until 1997 when she got the opportunity.  It was a slow process to start with as the disciplines were struggling to work in a multidisciplinary way.  By the early 2000’s the team was humming and her dream was realised.
 
Below is Carol Davis’s article on transdisciplinary teamwork.
 
 
Philosophical Foundations of Interdisciplinarity in caring for the Elderly:  or, the willingness to change your mind.
 
Carol M Davis, Ed. D Associate Professor
Department of Physical Therapy, Sargent College, Boston University, Boston, MA 02215, USA.
 
INTRODUCTION
 
Medicine alone rarely, if ever, meets all of most patients’ needs. Other health professionals assume the responsibility of caring for patients’ multiple other needs with a common goal of the highest level of independent function, thus the greatest quality of life possible, for each person.
 
When health professionals from many disciplines attempt to work together in caring for the elderly patient, the end product of this effort can have various characteristics.  This paper examines the characteristics of various outcomes, and describes what factors enhance the process.  Finally the suggestion is made that the processes of interdisciplinary or transdisciplinary result in the best possible outcome of care for the patient.
 
THE CONTINUUM TOWARD TRANSDISCIPLINARITY
 
Few health care professional students in the United States receive adequate training in learning how to work well with others for the good of patients.  Indeed, young beginning practitioners often feel more than stressed in simply maintaining access to their own professional knowledge and skill.  Learning to work with others takes place on a continuum of growth that can be described in the following model:
 
Unidisciplinary
Feeling confident and competent in one’s own discipline
 
Intradisciplinary
Believing that you and other fellow professionals in your own discipline can make an important contribution in care
 
 
Multidisciplinary
Recognising that other disciplines also have important contributions to make
 
Interdisciplinary
Willing and able to work with others in the joint evaluation, planning and care of the patient
 
Transdisciplinary
Making the commitment to teach and practice with other disciplines across traditional disciplinary boundaries for the benefit of the patient’s immediate needs. (United Cerebral Palsy 1.)
 
The increasing effectiveness of each of these processes can be illustrated with the help of the following case example.
 
An 85-year-old patient is admitted to the geriatric evaluation unit with a cerebral vascular accident with right hemiplegia, hemianopsia, and aphasia.  He is accompanied by his 78-year-old wife.  They had been living together at home prior to his stroke one month ago.  Since that time the patient was in the hospital for resolution of his acute problem, then transferred to a nursing home for careful nursing care until he stabilised.
 
Mr Walker was a tailor and lives on a modest social security income.  His wife receives no social security.  Their finances are assisted by monthly cheques from their son who lives in another state 1000 miles away.  Mr Walker is diabetic.  Mrs Waker is quite well but very lonely without her husband of 60 years.  They were active in the Methodist church but were driven to church each Sunday before Mr Walker’s stroke, as neither could drive any longer.
 
Mr Walker’s physician illustrates unidisciplinarity and intradisciplinarity as he evaluates the patient upon admission to the hospital. He believes that his discipline of internal medicine is very suited to the care of this patient, but his area of expertise in gastrointestinal cancer restricts his confidence that he can uncover and treat Mr Walker’s circulatory problem to resolve it adequately.  Thus, he requests his colleague in internal medicine who is a cardiac specialist to see the patient as well.
 
Multidisciplinarity occurs as he writes the order for the patient to be seen by the physical therapist, occupational therapist, speech therapist, the psychologist, the social worker and the nutritionist.
 
When this group of practitioners evaluate the patient and plan their care, all separate from each other, communicating only by way of the patient’s record, they are practicing multidisciplinarity.  Just as in a ‘jar of jelly’ beans, the end product of care is no more than the sum total of all the parts.
 
Patients complain about multidisciplinary care when they say, “I’m not answering that question one more time!”.  Or, “I’ll only give blood once today – you people get together and figure out which one of you is going to stick me and when.”
 
Practitioners complain about multidisciplinary care when the goal of the physical therapist to increase Mr Walker’s endurance in ambulation is thwarted by the nurse who ties him in bed so he cannot get up and walk around for he might fall.
 
Interdisciplinarity can be recognised as superior to the aforementioned when it’s working well.  In the Journal of Medicine and Philosophy Maurice de Wachter offers five steps to interdisciplinarity (De Wachter 2):
 
1)        One starts by accepting the “methodological epoch”.
Each person agrees to abstain from approaching the topic along the lines of his  or her       monodisciplinary method alone.
 
2)        The entire team tries to formulate, in an interdisciplinary way, the global question, acknowledging all aspects of the patient’s problem and all disciplines required to solve it.
 
3)        One translates the global question into the specific language of each participating discipline.
 
4)        Answers to this global question (translated to each discipline) are constantly  checked for relevance with regard to the overall global question.
 
5)        One agrees upon a global answer, which must not be produced by any one  particular discipline but rather integrates all particular answers available.
 
Thus, interdisciplinary process is composed of more than just several health professionals gathered around a table to discuss Mr Walker.  Each sits down and, in essence, brackets his or her professional-discipline identity, places it to the side and assumes the new identity of “team member.”

This act of bracketing is critical to the success of interdisciplinarity.  Just as in algebra or language analysis, brackets serve the purpose of setting aside, without destroying, what is bracketed.  In other words, identity as a physical therapist, for example, is available to me and, indeed, informs my contribution to the team, but I do not allow it to keep me from hearing the reports of other team members and helping to decide on a team goal and plan of care for this patient.  In short, each of us sits down at the table and listens to the others with a willingness to allow others to change our minds.  In this way the very best of all possible plans is agreed upon.  Unlike the “jar of jelly beans”, the product of this effort is larger than the sum of all the parts.  Indeed, ideally professional boundaries are transcended and flow into each other with ease, much like the colours of a rainbow.

Finally, transdisciplinarity represents the highest progression in the process of patient care.  Hospice care illustrates this process quite adequately.  Health professionals teach each other, the patient and the patient’s family how to perform aspects of care reaching beyond professional boundaries with the immediate need of the patient being foremost.  If the physical therapists arrives to work with a patient at home and learns she has not yet taken her pain medication, she doesn’t wait for the nurse to arrive to give it, nor the husband to make the toast to take with it. She does it herself.  Likewise she teachers the nurse, husband and volunteers how to help the patient move about in bed and walk to the bathroom.
 
Integrated, smooth, coordinated congruent care with the patient’s immediate needs at the centre of the effort marks transdisciplinary care.  Individuals come together without territorial professional boundary needs to guide their role and responsibilities.  This is what makes it the highest form of care.
 
Transdisciplinary care is a mature and humble way of being in the world.  Factors which interfere with interdisciplinary and transdisciplinary care include:
 
·         lack of personal commitment in the process
·         lack of personal commitment to accepting the risk of bracketing one’s professional role
·         feelings of insecurity that are revealed in the need for clear territorial boundary roles
·         lack of shared values
·         lack of skill in interpersonal interaction
·         perception of threat from other team members (Darling 3)
 
Factors that enhance interdisciplinarity and transdisciplinarity are the opposite of these limiting factors.  Central to these two processes is a mature, secure, self-confident practitioner with excellent skills in communication and teaching who primarily values that the patient’s needs be met regardless of who meets them.  The making of such persons takes time and commitment to the beauty and value of the rainbow.