Why Caregiving Never Ends – The Caring Generation®

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The Caring Generation® – Episode 111 November 10, 2021, On this episode, Why Caregiving Never Ends, caregiving expert Pamela D Wilson talks about caregiving responsibilities that begin with children and progress to caring for aging parents, spouses, and ourselves. Guest Dr, Louise Hawkley, from NORC at the University of Chicago shares research about the health effects of loneliness on isolated caregivers. 

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Why Caregiving Never Ends

0:00:04.0 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson, is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.

Family Caregiving is a Life-Long Role for Many

Watch More Videos About Caregiving and Aging on Pamela’s YouTube Channel

0:00:37:24 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, consultant, and guardian of The Caring Generation. The Caring Generation focuses on the conversation of caring. Giving us permission to talk about aging, the challenges of caregiving, and everything in between. It’s no surprise that needing care or becoming a caregiver changes everything. The Caring Generation is here to guide you along the journey to let you know that you’re not alone. 

0:01:01:67 Pamela D Wilson: You are in exactly the right place to share stories, learn about caregiving programs and resources to help you and your loved ones plan for what’s ahead. Invite your aging parents, spouses, family, and friends to listen to the show. If you have a question or an idea for a future program, share your idea with me by responding to my social media posts on Facebook, Instagram, Twitter, YouTube, and Linked In.

0:01:30:87 Pamela D Wilson: Today, we’re talking about the idea of why caregiving never ends. Your first caregiving role may be having a pet or your first child. You may find yourself constantly reacting or responding to emergencies because you are not intentional with your time or daily plan. You might feel dissatisfied with your life because your values do not match your day-to-day or month-to-month activities.

0:02:01:61 Pamela D Wilson: Feeling good about life involves giving attention to the body and mind while balancing family relationships, work, social, and community activities. These are not things we learn in school. We learn through life experiences and quite often by making mistakes. We may be entrenched in our habits or unwilling to consider options, so we miss opportunities to improve life situations.

0:02:32:21 Pamela D Wilson: In a perfect world, our parents would teach us all of the skills we need to succeed in life. But that’s not the way it happens. Our parents are too busy with the day-to-day. There is not enough time to mentor children about life issues that parents may not have fully learned to navigate themselves. Likewise, as parents, there may not be enough time for us to mentor our children. So everyone in the family keeps learning and connecting the dots as they go along.

0:03:06:64 Pamela D Wilson: During this program, I want to help you connect the dots about why caregiving never ends. Then, we’ll talk about making choices to smooth out the turbulence that all of us experience in our lives. It doesn’t matter if you are a caregiver for your children, aging parents, a spouse, a pet, or yourself. You’ll find something in this program that you can use to gain insights into lowering the stress of being a caregiver.

0:03:33:98 Pamela D Wilson: If you are a caregiver, you may notice periods in your life where your focus is more on you and the things you want to do until the next life transition pulls you back into the caregiving role. We often don’t think of ourselves as caregivers, but in many life roles, we are. Parents are caregivers for babies who grow up to be adults. If you are in a relationship, you are a caring person even though you may not perform tasks traditionally considered caregiving.

0:04:09:44 Pamela D Wilson: You may be a 20-year-old caring for a parent in their 50’s who isn’t familiar with being called a caregiver even though you perform caregiving tasks every day.  On the other hand, you may be a young married couple raising children, a 50-year-old working full time and caring for a spouse, a 70-year-old caring for yourself, or in your 70’s taking care of elderly parents in their 90’s.

0:04:37:96 Pamela D Wilson: The younger you are when you realize that caregiving responsibilities repeat throughout life, the more prepared you will be. The quality of your health—even though you may think you are healthy and appearances can be deceiving—will determine whether you will need a caregiver and to what degree later in life. Let’s start with the realities of being a caregiver and where things begin to go off track in our relationships.

0:05:04:72 Pamela D Wilson: You get married and decide to have a child, or two, or three or more. Immediately what happens? The child or children become the focus of your Martial relationship instead of your relationship with a husband or wife. Then all of a sudden, dad or mom need care. You’re spending hours in the evenings and on the weekends at mom or dad’s instead of at your house with your spouse and children.

0:05:32:77 Pamela D Wilson: While having a baby might have been planned, there was no way to understand the impact or change that would occur in your life and in your marriage. And if I had to guess, if you are an adult child—taking care of an aging parent—this was never on your radar as something you would have ever thought you were going to have to do. So today, you find yourself in a situation where caregiving never ends.

0:06:01:72 Pamela D Wilson: You’re trying to keep up with all of your responsibilities. Where do you begin? Caregivers I talk to are at various life stages, from very young to being seniors themselves. The common theme for why caregiving never ends is that the caregiver and other family members experience challenges in four main areas. The first is a general lack of communication about caregiving expectations.

0:06:27:87 Pamela D Wilson: The second is a desire to be helpful, resulting in other parts of life becoming a very low priority—including the caregiver’s life and health. This shift in priorities snowballs over time, placing more stress on the caregiver and everything in the caregiver’s life—work, family relationships, income, and health. The third challenge is the caregiver’s lack of experience to navigate the healthcare system, identify available resources, and discuss this information with the care receiver to make important decisions.

0:07:11:15 Pamela D Wilson: Fourth, but not last in importance, is the emotional turmoil the caregiver and their family experience because of a lack of knowledge of how to prioritize and manage all of the moving parts in the life of the parent and the life of the caregiver and the caregiver’s family.

0:07:31:06 Pamela D Wilson: For these and many other reasons, the effects of caregiving never end and continue from generation to generation. Unless at some point the caregiver decides to make other choices. This is where you, as the caregiver, can change the cycle of caregiving in your family and for future caregiving generations—your children and your grandchildren.

0:07:59:51 Pamela D Wilson: For the benefit of all caregivers, especially caregivers in their twenties caring for parents or grandparents and married couples raising children, we’re going to take a step back, to begin with why communication in the family is essential to managing care situations today and for the rest of your lives. If you’ve been a caregiver for a while, you may have already mastered some of these skills, so think of this as a refresher course.

0:08:28:15 Pamela D Wilson: Regardless of who you are caring for, a dog, cat, baby, child, parents, grandparents, or yourself, there are four questions to ask yourself. The first question, is why are you doing what you are doing? Was caregiving an intentional decision like having a baby? Did you volunteer to help a loved one, or did caregiving responsibilities fall into your lap, and you feel you cannot say no.

0:09:02:47 Pamela D Wilson: What does the person you care for expect of you? If you are caring for children, the question is, what expectations do you have of yourself as a parent? Next, what are your strengths in managing the responsibilities of this caregiving role, and where do you have information or skill gaps? It’s okay. We all have skill gaps. It’s best to acknowledge them so that we recognize opportunities exist to strengthen these skills.  More on this after this break.

0:09:37:05 Pamela D Wilson: This is Pamela Wilson on The Caring Generation. Pay it forward to help others dealing with health, aging, or caregiving issues by sharing information about this show and my website pameladwilson.com. The Caring Generation is available worldwide on your favorite podcast and music apps: Apple, Google, I Heart Radio, JioSaavn, Spreaker, Amazon Music, Breaker, Deezer, Listen Notes,

0:10:05:21 Pamela D Wilson: Pandora, Player FM, Pocket Casts, Podcast Addict, Podchaser, Stitcher, Spotify, Tune In, and Vurbl. You don’t have to do it all alone. I’m here to help. Visit my website or call to schedule a 1:1 telephone or video consultation with me. On my website, click on How I Help, next Family Caregivers, and then Eldercare Consultation. This is Pamela D Wilson on the Caring Generation. Stay with me; I’ll be right back.


0:11:03:74 Pamela D Wilson: This is Pamela D Wilson on the Caring Generation. Tips, articles, videos, this podcast, my book The Caregiving Trap: Solutions for Life’s Unexpected Changes, online webinar courses about becoming a guardian, and things you should know about caring for aging parents or caring for yourself as an aging adult at home are on my website at pameladwilson.com.

why caregiving never ends0:11:28:35 Pamela D Wilson: We’re back to talk about why caregiving never ends. As a caregiver for children, aging parents, or a spouse, you’re probably continually busy. Do you know where your time goes? How much of each day do you spend in activities that are routine or scheduled? Do you have a schedule that you keep to, for example, dropping children and picking up children from school?

0:11:56:46 Pamela D Wilson: Meetings at work that occur each week on the same day or time for which you prepare. Maybe stopping at a parent’s house on the way home to deliver groceries or set up medications? Making dinner, washing clothes, and running errands. Do you spend an entire weekend day running errands after errands? By the end of the week, you feel exhausted and wish you had a single hour to yourself. If this describes your why caregiving never ends life, you’re like many caregivers.

0:12:32:93 Pamela D Wilson: If you were to change parts of your life, what would you change? What is working great or not working at all? There are times in our lives when we feel that our schedules are out of control and we’re going along for the ride. How do we change feeling like we are on a treadmill to nowhere when we may be alone as the caregiver, feel isolated, and not have a trusted friend with whom we can talk?

0:13:03:77 Pamela D Wilson: In the second half of the program, you will meet Dr. Louise Hawkley, a Principal Research Scientist in the Academic Research Centers, NORC at the University of Chicago. Her research contributions are predominantly in perceived social isolation and health during aging, including identifying factors that increase the risk for loneliness and the types of interventions and actions that support lonely people.

0:13:33:93 Pamela D Wilson: We will be talking about the effects of being socially isolated and research from her article called Loneliness Matters. You can find a link to the article in this show’s transcript. Dr. Hawkley’s publications include more than 100 peer-reviewed articles and book chapters. She is a member of the Gerontological Society of America and the American Society on Aging and serves on the editorial board of Research on Aging and Social Science & Medicine.

 0:14:04:63 Pamela D Wilson: In addition, she is an international speaker and a founding member of the International Loneliness and Isolation Research Network (ILINK), and a member of the Scientific Advisory Committee for the Foundation for Social Connection. Having someone to talk with or being part of a social group, even if that group is online, can help caregivers feel less alone to the degree that you choose to participate.

0:14:31:62 Pamela D Wilson: If you are a working caregiver, by nature of going to work or working from home these days, you may have daily contact with other people and work projects that can distract your mind from caregiving responsibilities. I have talked to caregivers on both sides. Those whose main responsibility is limited to caregiving tasks or work in the home and caregivers who work part-time or full time.  Both feel that there are days when caregiving never ends.

0:15:03:96 Pamela D Wilson: Caregivers employed outside of the home feel that going to work is the break they need to distance from the emotional stress of being a caregiver. In either caregiver role, how can you continue to gain the skills to ease the challenges of your situation if you do not have regular contact with someone in a similar situation or a person or group that can inspire and encourage you to continue your self-development?

0:15:33:58 Pamela D Wilson: Because caregiving is an all-encompassing role, six months can pass with so many tasks completed but none that you felt contributed to your life. Caregivers might look back and be unsure if any tasks accomplished were on their priority list. When I talk to caregivers in groups, many ask if there is a framework for prioritizing responsibilities or duties to decide what to focus on.

0:16:05:79 Pamela D Wilson: The answer to this question depends on your stage in life. What is important to you and what aspects of life feel most challenging – essentially the actions that result in your feeling that caregiving never ends. For example, are you raising young children, and by virtue of the children’s age, you have to arrange daytime care if you want to go to work? On the other hand, do you have an aging parent with Alzheimer’s disease so advanced that mom or dad cannot be left alone?

0:16:38:51 Pamela D Wilson: When we are young and growing up toward independence, we may never consider that an aging parent or we will ever need someone to care for us full time again. But this is what happens in some situations when chronic diseases make us sick and need care. Throughout life, we juggle going to college and working, working and raising children, caring for aging parents, and working, and yet we all survive.

0:17:09:42 Pamela D Wilson: When we are in these situations, it can be easy to forget what we did the last time to make it through. When I was young, I worked full time, went to college in the evenings, and did my homework on the weekends. I was my own caregiver. When I was 23 or 24, I could make it through the day with only a few hours of sleep and use the weekends to catch up if needed.

0:17:31:29 Pamela D Wilson: Energy levels and the ability to adapt to change vary with how we manage our time and everything we have to do when caregiving never ends. During these years, my time was very scheduled. I got off work at 5 o’clock and had to be at class by six. I left work, ran home, grabbed a quick meal, and went to the school campus, where I stayed until class ended around 9 pm.  I went home, went to bed, and repeated the same schedule the next day.

0:18:02:07 Pamela D Wilson: On the evenings I did not have class, I went to the gym to exercise. Examining my schedule as a young adult may help you identify priorities in your life or what you are making a priority. I worked to support myself, and I still work. What do you do in the hours you are not at work? If you were to create a 24-hour schedule on a piece of paper, what would it look like? Do you get up at the same time every day? Are you in bed at night at the same hour? What is your morning routine?

0:18:37:09 Pamela D Wilson: When I was young, education was a priority. I was not a person who graduated from high school and went full-time to college. My parents could not afford to send me to college. I wanted to attend and paid my way by working and taking college courses in the evenings. I was fortunate in that some of my employers had tuition reimbursement programs for completing a course. On the hours I was not working, I had errands to run.

0:19:05:20 Pamela D Wilson: I visited my parents every Sunday, exercised to take care of my health, and spent time as I could with friends. But like many of you, I learned as time went by why caregiving never ends. So how can you prioritize and manage your time to include time for you, work, and family and friends? Doing this requires that you know how you spend your time today and have an idea of how you would like to spend your time and the goals you want to accomplish tomorrow and in the future.

0:19:41:66 Pamela D Wilson: We’re off to a break. We’ll be back with more. If you are looking for help making a care plan for a loved one, finding more time in your life, navigating the healthcare system, or helping aging parents make decisions, I can help. Visit my website PamelaDWilson.com and schedule an eldercare consultation by telephone or virtual call. Click on How I Help, then Family Caregivers, and then Eldercare Consultation to complete the form and make a request. Stay with me. I’ll be right back.


0:20:37:47 Pamela D Wilson: This is Pamela Wilson, caregiving expert, author, and speaker on The Caring Generation. If you are a working caregiver, and your company does not currently offer support, resources, or educational programs for caregivers—it’s time. Share my information with your human resources department or your family caregiving workgroup and ask them to contact me. I provide on-site and virtual programs for corporations and groups interested in supporting caregivers.

0:21:04:85 Pamela D Wilson: Let’s continue with the idea of why caregiving never ends, specific to prioritizing and managing your life so that you can feel like you are moving ahead instead of staying stuck where you are or have been for some time. Use the 24-hour clock idea to evaluate how you are spending your time outside of work. You can also use this idea to look at your workday to see where you might be losing time, are becoming distracted, or are not as effective as you would like to be.

0:21:40:00 Pamela D Wilson: For all activities outside of a full or part-time job, ask the question, “Do I want to do this?” Rank your response on a scale of 1 to 10, with one being no and ten being an absolute yes. While we all have things we may not want to do, like take out the garbage, daily activities do support life. The question for these necessary activities is, are you doing things that can be combined to use your time better?

0:22:08:16 Pamela D Wilson: These activities may include caregiving tasks. For other activities, ask yourself, “does this meet my intentions or life goals, or is it a distraction?” The answer to this question focuses on whether you know your priorities and are working toward them. Do these activities inspire and engage me, or are they motions that have no contribution? Are they things that I do out of habit or routine that I enjoy but that might be traded for a more valuable activity?

0:22:41:46 Pamela D Wilson: This exercise is time for you to take ownership of where you place your time and attention. What activities do you value by doing them over other activities that might be more high value? From here, you can create a goal list or a to-do list and a “no” list of activities you may decide to end. When you think of this process, compare it to the idea of changing habits or behaviors.

0:23:07:58 Pamela D Wilson: Your children, an elderly parent, or a spouse may participate in daily activities that are not good for them or don’t contribute to what they say they want. This is where the buck stops. If you want A but instead you are doing B, you may be self-sabotaging your efforts. Why? Is the idea of change too difficult? Not motivated enough? Afraid of change? Are you experiencing fear of missing out?

0:23:40:59 Pamela D Wilson: Why do we act inconsistently with our goals or what we say we want? Answering this for yourself or asking your children, a spouse, or a parent may lead to interesting discussions about why caregiving never ends. These are the discussions that many families should be having about caregiving but do not. If we want A, why are we doing B? If I want E, why am I doing F? All good questions. Part of the answer is to return to look at your habits and where you spend your time.

0:24:17:25 Pamela D Wilson: If you drive through fast-food restaurants instead of cooking meals at home, you may value convenience but be unaware of the effects of fast food on your weight, health, and energy levels. Some of these habits may have been modeled to you by our parents, who didn’t know the importance of being intentional. These gaps between our current life and what we want is a learning curve that could be faster or easier if we had a mentor or someone to guide us and we valued their experience or opinions.

0:24:45:89 Pamela D Wilson: Who might a mentor be in your life? Why caregiving never ends is that we can become unaware of stuck patterns that result in unintended consequences. Unfortunately, this happens to aging parents who miss the opportunity to learn about healthy behaviors early in life. The diseases that make the body sick begin in our 20’s, 30’s and 40’s. We don’t notice them because the changes may only be slight, and at that point, the disease stage is early, so the side effects are not eye-opening.

0:25:22:68 Pamela D Wilson: But, by the time the body ages to 50 or 60, high blood pressure, diabetes, breathing problems, or physical weakness may appear. By this age, the damage has occurred. Motivation and a commitment to change ingrained habits is the only way to avoid having health issues continuing to advance.

0:25:44:91  Pamela D Wilson: As you think about your life today and consider some of the questions we’ve reviewed, how would you respond to your children who ask why caregiving never ends? Is part of the answer that we don’t realize the importance of being intentional in our daily actions instead of running on auto-pilot? Is this a skill that you can learn and model for your children – decreasing their learning curve about how to make life run more smoothly?

0:26:14:50 Pamela D Wilson: What about the idea of being more protective of your time as a caregiver instead of undervaluing your health and well-being? Another reason why caregiving never ends is the idea of being reactive instead of reflective. How many of us are driven by the requests of others? Someone makes a request, and instead of staying the course to complete whatever it is we’re doing; we change gears to fulfill the request.

0:26:43:05  Pamela D Wilson: Responding to requests that are not time-sensitive can shift our value proposition away from the activities we believe to be important to the activities or needs of others. When caregivers value the needs of others more than they value themselves, caregiving relationships go off balance.

0:27:16:09 Pamela D Wilson: To succeed as a caregiver and in many other parts of our lives, if we can learn to be uncompromising about delaying or scheduling non-urgent tasks, we might learn that the tasks don’t need to be done at all or have a low return based on the time involved. We actually may add these tasks to our do not-do list. Prioritizing and managing time more effectively with the idea of eliminating non-essential tasks can help all caregivers find more time in their lives to focus on what is important.

0:27:44:53 Pamela D Wilson: Taking this look into our daily habits and routines can be eye-opening. Many people may not want to do this using the excuse, “I’m too busy I don’t have time.” The only way you learn to manage your time is by looking at how you spend your time and what you might change. Otherwise, for you, caregiving never ends translates to daily thoughts of exhaustion and frustration because you keep doing the same things and hoping for a different outcome.

0:28:15:55 Pamela D Wilson: Positive thinking and conscientious behavior support caregiving situations to become more manageable. Consider these aspects of why caregiving never ends and begin looking at your daily, weekly, and monthly schedule to see where you can take control of the time-wasters and the non-emergency emergencies. Consider that there may be other ways of doing things or that doing things differently might be part of the solution to the challenges of why caregiving never ends.

0:28:48:71 Pamela D Wilson: Up next, Dr. Louise Hawkley talks about the isolation and loneliness that occurs in caregiving situations and with age. Thank you for following and communicating with me on social media – Facebook, Twitter, Instagram, Linked In, and YouTube, where I have hundreds of videos, to answer your questions, and you can also there ask me thoughts about topics for this podcast for future videos and articles on my website.

0:29:19:99 Pamela D Wilson: Our communication is a two-way street. Join my caregiving group called The Caregiving Trap on Facebook. I’ll put a link in this show transcript. I’m Pamela D Wilson on The Caring Generation. Stay with me; I’ll be right back.


0:30:03:25 Pamela D Wilson: This is Pamela D Wilson, caregiving expert, advocate, and speaker. Are there days when you wish you had someone to talk to, someone to reaffirm that you are doing the right things? You’re in the right place here with me on The Caring Generation. Joining me is Dr. Louise Hawkley, a Principal Research Scientist in the Academic Research Centers, NORC at the University of Chicago, to share helpful information about the effects of and tips for managing loneliness and isolation.

0:30:35:19 Pamela D Wilson: Dr. Hawkley, thank you so much for joining me.

0:30:37:70 Dr. Louise Hawkley: My pleasure.

0:32:39:92 Pamela D Wilson:  Dr. Hawkley, is it surprising that older adults are less likely to be lonely than younger adults or that they are less likely intensely lonely than younger adults? Why or why not?

0:30:51:13 Dr. Louise Hawkley: Right, it’s usually an assumption on the part of people. An incorrect assumption that loneliness is a problem of older adults. That you get lonely because you’re losing your close others. And indeed, people do become widowed, their siblings die. Their friends may die, and they do become more alone. But that isn’t the same as feeling lonely.

0:31:14:85 Dr. Louise Hawkley: And what I think we’re beginning to appreciate now is that older adults are much more resilient than we’ve given them credit for and that loneliness serves its purpose, which is to make people connect with others so that they’re not as lonely even if they don’t have as many people around. They’ve learned how to prioritize valuable relationships and focus on those really close relationships and feel quite fine. Younger adults perhaps not as far along the road of acquiring coping skills, so are more seriously affected by losses to their social network or the lack of people in their network.

0:31:58:48 Dr. Louise Hawkley: And that’s partly because it’s their task at this phase in their life to build up a network. So they may be more sensitive to experiencing the pain of isolation. And it’s not like the idea of loneliness being different than being alone. That’s important in this equation as well because people can be alone and not feel lonely. And that’s true for anybody. And people can be around others and feel lonely despite that. So it’s not a synonymous relationship.

0:32:29:13 Pamela D Wilson: Can you describe that difference you just mentioned. Being around other people and still being lonely. What is that? How does that come about?

0:32:37:57 Dr. Louise Hawkley: Yes. This is a key difference when we talk about loneliness we’re talking about a subjective feeling. It’s a perception. It’s a distressing feeling. It usually accompanies a mismatch between what it is we want or would ideally have in our social relationships and what we feel we’re getting. And that can be in terms of the number of people. But more often, it’s related to how close those relationships are. What the quality of the relationships are. So, if those relationships do not fit our idiosyncratic need for the kind of quality we’re needing and wanting, then we’re likely to feel lonely.

0:33:19:44 Pamela D Wilson: Loneliness has this wide range of effects. Can you describe the physical effects on the body of loneliness?

0:33:26:21 Dr. Louise Hawkley: Yes. Loneliness does have a wide range of effects. Excuse me [cleared throat], and when we’re talking about physical effects, my research early on started looking at the physiology. Like what’s happening in the body that might be distinguishing between lonelier people and less lonely people. And one of the things that have come up there is changes in the cardiovascular system.

0:33:52:47 Dr. Louise Hawkley: We saw even in young adults that the lonelier they were, the more resistance their blood vessels exerted against flow of blood. Which in itself doesn’t sound like too much of a thing. It’s like a hose that’s not expanding to accommodate the flow of blood. But on the other hand, they had other physiological mechanisms in their young adult ages to compensate. So, their blood pressure stayed relatively normal.

0:34:24:43 Dr. Louise Hawkley: But when we started looking at older adults, if you think about how loneliness might chronically create a pattern of how the blood vessels react to blood flow, you’d expect that the longer that happens, the more likely blood pressure will be a problem. And in fact, that was the problem. We saw people, older adults, having higher blood pressure and showing faster increases in blood pressure over time. So that was all critical as well.

0:34:57:87 Dr. Louise Hawkley: There are other physiological effects, and a lot of them center upon inflammation—inflammatory processes. So inside the body, we have inflammation serving a useful purpose in, well you can think of it like poison ivy. What do you use, or what do you get given to deal with poison ivy? You get given cortisol to dampen the inflammation. Well, the body has cortisol in it as well. Naturally occurring cortisol.

0:35:27:53 Dr. Louise Hawkley: And if it’s not doing its job, inflammation inside the body in the organs starts running amok, and then that leads to a range of chronic diseases of aging like stroke and heart problems and dementia and diabetes and so that one pathway is potentially that pathway of inflammation is potentially common to a lot of those diseases. And that’s also what then might be used to explain, although we haven’t got strong evidence of this but the fact is lonely people die sooner, they have an earlier mortality. Why is that? Part of it could be the fact that they are more susceptible to these chronic diseases of aging.

0:36:16:79 Pamela D Wilson: It’s amazing the effects that loneliness has on the body. Can you talk about the effects of loneliness on our minds and our emotions?

0:36:25:65 Dr. Louise Hawkley: Yes. And that’s where our research started. In just understanding what it is that makes loneliness so special that way that it has such wide-ranging effect. Well it’s because it’s a central nervous system process. It’s how we think about our world, and everything that happens in the brain is interconnected, and that’s what’s happening in the body. What we see are emotional consequences like depressive symptoms. It wouldn’t surprise anybody to hear that.

0:36:56:77 Dr. Louise Hawkley: I think typically that is even considered synonymous with loneliness, but it isn’t. Depression as a clinical syndrome is typically all-inclusive. It’s—it doesn’t matter what part of your life you’re talking about, you’re going to feel sad. Whereas loneliness is a sadness that’s specifically around your social life. Your social relationships. There is an anxiety that comes with loneliness. In some cases, it’s a blatant social phobia. Other cases, it’s a more diffuse kind of anxiety.

0:37:32:31 Dr. Louise Hawkley: There are also cognitive effects, and these are really quite sobering given the concern we have with Alzheimer’s disease and dementia in late life. Lonely people seem to fall prey to cognitive dysfunction and dementia more easily or more quickly than do non-lonely people. And then there are even more basic effects. Lonely people don’t sleep as well. Its not necessarily that they don’t sleep as much. It’s the sleep that they get that is less salubrious.

0:38:08:74 Dr. Louise Hawkley: They don’t benefit from sleep like a non-lonely person would. They wake up tired from the same amount of sleep. And there are explanations that people have posited for this but, nevertheless, that’s a behavioral outcome as is something like physical activity. It’s so good for us. But lonely people are less likely to start or to stay engaged in any kind of physical activity. And that has a big consequence too because of all of the benefits one can reap from physical activity on emotional and physical health.

0:38:43:02 Pamela D Wilson: And you mentioned kind of the loneliness and the social connection. So isolated individuals might feel, to your point, more threatened or uncomfortable by interacting with people socially. How does that distancing, like we had to do from COVID, you know, affect all of this?

0:39:01:93 Dr. Louise Hawkley: Yes. There, lonely folks especially. Well, let’s put it this way. Loneliness initially, we think of it as an adaptive state of mind. A perception. I mean, why do we feel hunger? It’s not pleasant, but it gets us out to look for food. Why are we thirsty? It’s because it serves a purpose, right? Why are we lonely? It serves a purpose too, and that is to get us out there connecting with other people to satisfy our social need.

0:39:37:23 Dr. Louise Hawkley: But what happens is if you do not succeed in connecting socially, you start questioning your place in your social network. You might feel as though people are out to get you. That you’re not being—people aren’t opening up to you. They’re not trusting you. And even that perception may be inaccurate but even simply thinking that leads a person to behave as though they have to protect themselves. They have to be careful because this other person might not be accepting me as much as I would like.

0:40:18:96 Dr. Louise Hawkley: So I’m going to put up some barriers here. Make sure that I don’t get sucked in too far. Well that tends to elicit exactly the kind of behavior they think that they’re protecting themselves against. And so, it becomes a loop of self-fulfilling prophecy. Let’s call it that. It’s just this loop of continuing uncertainty about the people around them and the behaviors that they emit because of that makes them even more distant from their interaction partner.

0:40:51:88 Pamela D Wilson: How has the mental health, including loneliness of older adults versus younger adults, kind of fared during this whole COVID episode that seems to never end?

0:41:03:42 Dr. Louise Hawkley: [laughter] This is one thing, and I started out talking about how loneliness is not as big a problem in older age. You have some of the quotes originally, which was it’s more prevalent among younger than older adults. Well, the same thing happened during COVID. We have had some data from a study of older adults well adults all ages across the country. We were looking at loneliness and anxiety, and depressive feelings.

0:41:37:09 Dr. Louise Hawkley: And consistently the older adults, even though they were at greater physical risk from COVID complications, let’s say even from infection, to begin with. They were not more susceptible to the mental health impact. They did not get as lonely. As depressed. As anxious as the younger adults did. And that’s perhaps a healthy thing because they—well, it is definitely a healthy thing. But it is an expected thing in the sense that they had a repository of coping skills, as I was mentioning earlier, to be able to handle that.

0:42:18:25 Dr. Louise Hawkley: That all the stresses that came with it. Now I’m talking specifically about people living in the community. Not people who lived in assisted living or long-term care facilities, or nursing homes. That’s a different kettle of fish. But the persons, the older adults living in the community, had relatively positive outcomes compared to younger adults.

0:42:41:14 Pamela D Wilson: I found you from your article, it’s called Loneliness Matters. I’m going to put the link in this show. But can you talk about technology and any type of evidence that video calls can compensate for less social contact or reduced social contact.

0:42:58:72 Dr. Louise Hawkley: Right. We did study that explicitly when we followed up the older adults in the National Social Life Health and Aging Project. And I’m an investigator on that project. It’s an NIA-funded study. What we did is ask people how frequently they interacted with friends or family members in person, by phone, by text, which we included email and text messaging and even social media messaging or video calls.

0:43:32:87 Dr. Louise Hawkley: And all of them reported the frequencies in which they did those things. They reported whether they increased or decreased their frequency of using those modes of interaction with other people. And when we looked at how that related to how much their mental health had changed since 2015—because we had data on these folks that went back five years. The changes that we would normally see were exaggerated when they were in a negative direction.

0:44:04:71 Dr. Louise Hawkley: People who would normally get lonely got even more lonely during COVID and those that were protected got less lonely during COVID. More importantly, those people who decreased their in-person interactions had experienced or exhibited these changes. These increases in loneliness. But if they at the same time increased other modes of contact, which we’ve all been encouraged to do.

0:44:33:39 Dr. Louise Hawkley: Whether that was phone calls or texting or video calls, that had no residual remediating effect on mental health. So there’s nothing in our data that suggest that there’s any compensation going on. I wouldn’t say that that meant don’t do those things. It didn’t harm anything. But it does make me wonder whether we’re not quite there yet in terms of how people use this technology.

0:45:06:48 Dr. Louise Hawkley: Maybe they didn’t use it in the right way. Like you can use video calls for interactions with sort of superficial partners, or you can use it to develop close relationships. Or nurture family relationships. I don’t know how people used it. But the take-home is still we  really don’t have a good handle on whether technology has any capacity to compensate for in person. It might supplement, but it’s not seemingly compensating.

0:45:37:46 Pamela D Wilson: Yes. I would agree there’s no substitute for in-person contact. Dr. Hawkley, thank you so much for joining me today.

0:45:45:59 Dr. Louise Hawkley: You’re very welcome.

0:45:47:15 Pamela D Wilson: The information Dr. Louise Hawkley shared mirrors what we are talking about, specifically why caregiving never ends and the ongoing experiences and lessons that benefit us as we age. How does life experience affect loneliness over time? We’ve heard that exercise improves the coping skills of adults who are more physically and socially active and mitigates the effects of chronic disease.

0:46:14:62 Pamela D Wilson: Also, according to the research, lonely people are less likely to engage in regular physical exercise that is protective of health. If you are experiencing loneliness, consider a habit and a lifestyle change to begin exercising regularly and keep it up. According to the research, this will positively affect your mood and your health over the years of your life. Additionally, setting an example of regular exercise for your children and your grandchildren can have long-lasting positive effects on their lives. It’s time to start passing down and sharing positive habits to each generation in our families – after all, we are The Caring Generation.

0:47:01:21  Pamela D Wilson: This is Pamela D Wilson on The Caring Generation, available worldwide on your favorite music and podcast apps. Listen and follow the program for proven, reliable caregiving tips, information, caregiving resources, and research about caregiving, aging, health, and everything in between. Add the podcast or the music app to the cellphones and computers of family members and aging parents. We’re off to a break. I’m Pamela D Wison on The Caring Generation. Stay with me; I’ll be right back.


0:48:01:66  Pamela D Wilson: This is Pamela D Wilson on The Caring Generation, where we talk about aging, health, and everything in between to support caregivers of all ages. Caregiving is not limited to caring for aging loved ones. Parents raising young children are also caregivers who may eventually care for parents and spouses. We’re here creating The Caring Generation.  Add the podcast or music app to the cell phone of your family members or friends and show them how to listen.

0:48:28:73 Pamela D Wilson: Earlier in the program, we talked about options to reduce or manage the time component of the caregivers’ tasks and the importance of having ongoing caregiving conversations within families. Let’s talk about the benefit of setting boundaries with young children and young adults. Learning to teach your children how to help themselves, rather than doing everything for them or giving them everything they ask for, goes a long way in adulthood—theirs and yours.

0:49:03:35 Pamela D Wilson: If you learn boundary setting—when to say yes and when to say no—you will experience less turbulence in your life. You will feel less pulled to place the priorities and needs of others over your needs. To identify how you are at setting boundaries, ask yourself. Are you a reactor? Do you jump to respond to requests from people before thinking about the time consequences?

0:49:31:86 Pamela D Wilson: Part of boundary setting is to learn how to say no by being kind but honest. For example, rather than saying no because you don’t have time, be more specific and say you have other commitments. I have other commitments. Be honest. Don’t allow family members to pressure you with their timelines unless there was a prior agreement with you about the timetable and you committed to a deadline.

0:49: 59: 01 Pamela D Wilson: If so, keep your word. Family members can make assumptions about availability without asking about your schedule. Look at your work life. How many people steal your time?  Do co-workers stop by your desk or your office to chat while you are up against a deadline? While you may have an open-door policy, if you are working toward a deadline and you have an office door—shut it. Do the same if you work from home.

0:50:27:00 Pamela D Wilson: Shut the door and tape a “do not disturb” sign on the doorknob. If you want to have an important conversation rather than beginning the topic during an evening meal, schedule a family meeting or a time to meet separately with your family, spouse, or aging parent. There are so many positive habits from the workplace that can translate to respectful behaviors our families.

0:50:53:07 Pamela D Wilson: While scheduling a meeting with a spouse may seem a bit formal, it’s a great way to schedule a focused time to talk about what’s important. Scheduling time for important conversations links back to why caregiving never ends and the opportunity to learn and model behaviors for everyone in the family. Remember, ask yourself who and what you value and follow those guidelines. But know that priorities can change based on unexpected situations.

0:51:24: 41 Pamela D Wilson: An aging parent may have experienced a fall, and you have to have safety equipment installed in their home or interview and schedule in-home caregivers. This can be a time-intensive task that takes a couple of weeks of your time. Taking you off track from the routine of your regular plan. Or, your children may need extra support with homework or to complete a big school project. These scheduling glitches will happen.

0:51:52:64 Pamela D Wilson: But you can easily get back on track. This brings us to the idea of reciprocity. Reciprocity is the idea of exchanging things with others. In the family, it could be making dinner in return for your children washing and putting away the dishes. Establishing ongoing participation for family household tasks when children are part of the family is another modeling behavior that teaches responsibility for owning things.

0:52:23:08 Pamela D Wilson: Talking to children about your work life as a parent can help them understand the effort required to earn an income, to maintain a household, buy groceries, pay the bills, and everything else that goes into homeownership. Establishing positive values in young families ensures more positive relationships when parents grow older and may need help. It’s also good to involve children in the care situations of their grandparents.

0:52:53:72 Pamela D Wilson: Shielding children from life and caregiving responsibilities only makes the issues more shocking as they occur later in life. Talking as a family about the importance of working together to help each other as needed supports teamwork and reciprocity. These are skills that follow children into school and the workforce.

0:53:18: 00 Pamela D Wilson: Even aging parents can support the idea of reciprocity by using their skills. If you help aging parents and mom is a great cook, can you deliver groceries and ask her occasionally to make meals that serve as quick evening meals for your family during the week so that you don’t have to run home and cook?. Can your dad run an errand for you that can only be completed during working hours? Parents of all ages want to feel needed even if they need a little help from their children.

0:53:50: 48 Pamela D Wilson: Help your aging parents maintain their independence, self-esteem, and confidence by supporting them to do things that they can continue to do. Occasionally ask for reciprocity with something you need. Conclusion: this is a good path toward maintaining balance and setting boundaries so that you don’t go down the path of being too helpful and wondering why caregiving never ends.

0:54:19:47 Pamela D Wilson: Let’s look at what we’ve discussed in this program. Caregiving is a generational issue that begins with having children and progresses all the way to the end of life. You might care for children, elderly parents, a spouse, other family members, or yourself. The sooner caregivers master interpersonal communication, social skills, planning, and other practical skills in life and model these behaviors for other family members; the more solid family relationships will be.

0:54:50:86 Pamela D Wilson: If it’s too late and your parents were not good role models, I suggest finding a role model. What about your grandparents if they are still living? Find a mentor in school or at work who is willing to share positive habits. Hire an expert in any of the life skill areas that are not your strengths yet. Experts can shortcut your learning curve and help you avoid making common and costly mistakes.

0:55:20:86 Pamela D Wilson: Possessing a wide variety of skills reduces the stress involved in caregiving relationships. In addition, as we talked about with Dr. Hawkley, you now have tips to reduce loneliness and isolation if you choose to change habits and lifestyles. The choice of what we value in life and what we choose to set as priorities shows by where and how we spend our time. This week think about your priorities and if you feel a bit off track, use the tools and suggestions offered during this program.

why caregiving never ends0:55:57:20 Pamela D Wilson: Pamela D Wilson: If you are an aging adult or a caregiver not sure what to do or how to plan for care, or how to get your time and your life back, my website PamelaDWilson.com offers resources for caregivers. Check out my caregiving library, my Caring for Aging Parents blog, listen to all of The Caring Generation podcasts—there are over 100. Read the show transcripts that include links to research by program guests, and check out my online caregiver courses in webinar format. They’re like binge-watching your favorite television shows.  You can also watch hundreds of videos on my Facebook and YouTube channels

0:56:33:35 Pamela D Wilson: There’s something for everyone at PamelaDWilson.com. This is Pamela D Wilson, caregiving expert, advocate, and speaker. I look forward to being with you again soon. God bless you all. Love to everyone. Sleep well tonight and have a fabulous week until we are here together again.

0:56:54:17 Announcer: Tune in each week for The Caring Generation with host Pamela D Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone here on Pamela D Wilson’s The Caring Generation.

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About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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