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Posted: October 13th, 2022

Social Isolation in Older Adults”

Trabajo Social con Seminario y Práctica de Campo II

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Social Isolation in Older Adults”
Social work is a profession in the social sciences, actively involved in the care process of cases in which the human rights, health, and well-being of each person are violated. It includes a discipline that must be put into practice in the search for balance and professional competence; students of this career must prepare themselves by carrying out practical activities and internships in specialized mental health centers, such as the Golden Phoenix Mental Health LLC. I had the pleasant opportunity to carry out my second practice, supervised by the clinical director Carina De Diez.
Golden Phoenix is a mental health clinic in Hialeah, Florida, specializing in psychosocial rehabilitation, founded in 2020. Directed by Mrxxxxxxxxxxxxxx updated in 2021, professional taxonomy code is xxxxx. It has been providing its services in the diagnosis, treatment, and prescription of mental and behavioral disorders for two years; it does not have a predefined age range to provide its services; however, a large part of its clients are older adults. His exact address is 8051 W 24th Av. Unit. 11, Hialeah, FL 30165, contact phone , email: admgoldenphoenixmh@goldenphoenixmh.com, Website: golden phoenix-communityhealthcenter.business.site
Mission
Our goal is to help the individual to face, manage and prevent psychiatric problems, treat symptoms that affect daily functioning, and holistically build a quality of life, seeing the individual as a whole composed of emotional, physiological, intellectual, and environmental factors. In its sociocultural and spiritual dimensions, to minimize or prevent recurring events of mental illness/substance abuse and return the individual to a maximum level of rehabilitation, independence, recovery, and functioning.
Vision
To be a therapy center at the forefront of customer needs, developing quality services to promote health and well-being and making society aware of the importance of family participation in the spheres of social life, and prioritizing the importance of human relations using programs and activities as a means to promote personal autonomy and dynamics that lead to the improvement of the quality of life of clients. Thus, with our unique strategies, we achieve the relief or reduction of psychiatric symptoms, that clients learn to cope with their illness, reduce the adverse consequences of their condition, promote drug/alcohol abstinence in the community, promote self-esteem, improve their level of functioning, promote recovery, restore skills, and develop adaptive behaviors.
Services provided by the Golden Phoenix Mental Health LLC center
* Individual therapy
* Group and family therapy
* Behavioral Health
*Mental Health
* Psychosocial Rehabilitation Services
One of the treatment methods most used by the institution is PSR. Psychosocial rehabilitation encompasses techniques and strategies for treating mental illnesses, drug abuse problems, and chronic patients to improve their quality of life and integrate them into the community and work.
To the population with which we work the most in this mental health clinic, I have chosen the research topic " Social Isolation in Older Adults” since it is one of the most frequent symptoms in older adults who face mental illnesses such as anxiety and depression among others, which is one of the requirements to finish my professional practice.

Social Isolation in Older Adults
INTRODUCTION
This research proposal is to study social isolation in Miami's older adults (over 65 years). Social isolation is related to multiple physical and cognitive illnesses, causing feelings of loneliness and depression. This qualitative research aims to identify the impact of social isolation in this population group, the problem, and its possible causes or solutions.

Problem Statement
The human being is biopsychosocial. Therefore, he needs the company of others and social integration; various studies dictate that social isolation at any stage of life generates deregulation in the organism psychologically and physiologically. Social isolation produces high levels of stress and anxiety; it is also linked to feelings of loneliness and depression, lack of interest in activities, and apathy; all this leads to a depreciation of the body that can seriously affect health.
Older adults are people whose rights are vulnerable due to physical and cognitive deterioration and, in some cases, health problems. These people live amid prejudice and stigma, being neglected by their own families in their own homes. This type of person is exposed to social isolation; during old age, there is a reduction in interpersonal interactions, and there is a disengagement from the central roles (work life and fatherhood); this generates a change in the relationships in the remaining social parts (Cumming and Henry, 1961); advanced adulthood is marked by events that modify the reality of the ego, retirement, widowhood, death, the empty nest, the certainty that one is in the terminal stage of life, generates high levels of stress. "The loss of roles, the death of relatives, partners and friends and the empty nest effect led to isolation and the deterioration of social relationships" (Portet, 2016). Disengagement comes with retirement; the abrupt break from the work routine and the ability to develop economically produces feelings of anxiety and despair.
Social isolation can produce loneliness, depression, and anxiety and is one of the possible causes of suicide. In addition, they were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke (CDC, n.d.). The impact of social isolation occurs in an incremental process and produces a growing depression and withdrawal that diminishes the individual's social skills, stagnating them. The motivation for social interaction is lost, so the socially isolated person needs the help of others to be able to relate to others again. Being a point of focus for social workers, “Studies for these populations are scarce and more research needs to be done to determine what the risks are, the impacts, and the appropriate measures that are needed.” (CDC, s.f.).
General objectives
* Know the realities to which an elderly adult living alone is exposed.
* Understand risk factors for social isolation in older adults
* Identify the relationship between feelings of depression and loneliness in older adults.

Specific objectives
1) Know the realities to which an elderly adult living alone is exposed.
a) Assess the living conditions of the elderly living alone: housing, community, geographical sector, medical services, access to public and health services, recreational areas, commerce, food, clothing, and religious worship.
b) See how you access services and meet your needs.
2) Understand the risk factors in social isolation in older adults
a) Study the motivations that lead the person to isolate himself socially
b) Understand how the relationship between the family and the elderly influences social isolation.
Research questions
* What are your living conditions as an older adult living alone: housing, community, geographical sector, medical services, access to public services, health and hygiene, access to recreational areas, internet, commerce, food, clothing, and religious worship??
* How does an adult age 65 and older access services and meet their needs: on their own, with assistance, through family members?
* Where does the economic income of the elderly come from: through retirement pension, government aid, salary for work, income from shares in the stock market, income from property rental, own business, family aid, multiple payments?
* What motivates the person to isolate himself socially?
* How does the family’s relationship with the older adult influence social isolation?
Justification
This study is feasible given that there is a large number of the population in the necessary age range within the geographic scope of the city of Miami, for whom, as social workers, it is essential to identify the problems and life situations, as well as the environmental conditions in which they live. They are living and how it affects their physical and mental health.
Theoretical Bases
L. Maddox's continuity theory assumes that people maintain the same personality, beliefs, and habits throughout life. When they reach old age, they seek to maintain and strengthen the closest ties, focusing on family relationships and those that they created in the first years of life. This allows them to maintain the integrity of their personality and focus on the present; however, when there are frustrations from the past, or these ties cannot be strengthened, a mismatch occurs. The aging process is a succession of losses, which occur quickly and require adaptive and compensation strategies. “For the person to overcome her losses, she must continue acting in life, maintaining constant and intense communication with other people and participating in activities with significant objectives.” (Portet, 2016).
The solution is understood as a distancing between people or objects; In simpler terms, to isolate yourself means to be distant and separated from others. Social isolation is prolonged distancing in social activities, interaction with others, and a withdrawal from interpersonal relationships that occurs when a person partially or continuously withdraws emotionally or physically from others within various social settings. This distancing produces feelings of hopelessness and sadness. “Emotional pain can activate the same stress responses in the body as physical pain. When this goes on for a long time, it can lead to chronic inflammation and reduced immunity” (NIH, s.f.) It can be detrimental to brain health, linked to poor cognitive function and risk of dementia, especially Alzheimer's disease.

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Methodology
The method for data collection will be the semi-structured interview, participant observation, and group work. The semi-structured interview allows knowing the experiences and feelings of the elderly, following a guide to carry out the study’s objectives without losing sight of the spontaneous contributions that may arise since open questions will be used—and maybe readjusted according to the specific needs of each case in this research project. The participant observation will allow knowing personally the house, the environment, and the community where the subject of study develops, seeing their reality from a primary point of view. Through group work, it will be possible to verify what the social dynamics are like in socially isolated people. If there is a deterioration in social skills, this technique also allows testing the benefits of interaction with others.
The method of information analysis will be the phenomenological hermeneutic. Understanding hermeneutics as the art of interpretation, we will seek to interpret the realities of the subject, the transcripts of the interviews, the recordings, and the observations made to understand the existence of the elderly as their actors live it. . Aware that the phenomenological method is the study of the perception of phenomena, it is proposed to study how older adults perceive their lives, their motivations, and their social and affective needs.

References
Arranz, L., Giménez-Llort, L., de Castro, N. M., Baeza, I., & de la Fuente, M. (2009). El aislamiento social durante la vejez empeora el deterioro cognitivo, conductual e inmunitario. Revista Española de Geriatría y Gerontología, 44(3), 137–142. https://doi.org/10.1016/j.regg.2008.12.001
Chávez-Negrete, L. A., Olivares-Luna, A. M., Rivera-Rodríguez, J. M., & Pedraza-Avilés, A. G. (2021). Relación entre depresión y ansiedad con el aislamiento social debido al confinamiento en adultos mayores. Revista Peruana de Investigación en Salud, 5(4), 273–278. https://doi.org/10.35839/repis.5.4.1067
Cigna. (s. f.). Signos y síntomas de la soledad crónica. Cigna. https://www.cigna.com/es-us/individuals-families/health-wellness/chronic-loneliness
González De Gago, J. (2010). Teorías del Envejecimiento. Tribunal del Investigador. https://www.tribunadelinvestigador.com/ediciones/2010/1-2/art-13/Portet, L. (2016). El envejecimiento a nivel psicosocial. Geriatricarea. https://www.geriatricarea.com/2016/05/27/envejecimiento-nivel-psicosocial/

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