"Are you lonely tonight?" - Elvis Presley
"Well, yes, and thank you for asking."
Loneliness: solitary, without company; lacking sympathetic or friendly companionship or relationships. If not you, do you know anyone who fits that description? There is the old man who shuffles down the sidewalk every morning, and your Aunt Mabel who recently left her neighborhood of fifty years to live in a nursing home in a different city. There is the latchkey child who spends three hours at home alone each afternoon, and the single dad who moved into your apartment building. There is your coworker who just doesn't fit in to any of the office cliques, and there is the scientist who spends twelve hours every day in an office working at a computer. Loneliness is a condition that crosses all gender, ethnic and socioeconomic barriers.
In this age of astounding medical advancements and technological wizardry, people are falling prey to the ill effects of loneliness at an alarming rate. Just being around other people is not enough to prevent loneliness. Rather, it is the quality of the relationship that will determine whether a person feels lonely.
So what? So, what's a little loneliness? It's not like a fatal disease, right? Wrong. Loneliness is a stress - like pain, injury/loss, grief, fear, fatigue, exhaustion. Loneliness can be traumatic. Physiologically, loneliness can trigger the same stress response as a broken leg. This causes our bodies to alter the production of hormones, which in turn alters the function of many other systems in the body. Ultimately, this can affect every cell in our bodies. Stress like this has been implicated in contributing to the origin or severity of diseases such as cardiovascular disease (including strokes, migraines, heart attacks), gastrointestinal disorders (including ulcers), autoimmune disorders, asthma, and many other illnesses. Stress also may prolong the amount of time it takes our bodies to heal. Loneliness can make us sick, keep us sick, and interfere with our recovery.
In his book, The Broken Heart: the Medical Consequences of Loneliness, Dr. James Lynch explores the importance of sustaining relationships and their effects on physical/emotional health. "Real loneliness," Dr. Lynch says, "begins with an inability to communicate." With considerable research data to support his argument that "the lack of human companionship, the sudden loss of love, and chronic human loneliness are significant contributors to serious disease (including cardiovascular disease) and premature death," Dr. Lynch provides compelling evidence linking the benefits of communication and human interaction to improved health status.
Of particular note are the tests he has performed using patients' heart rates and blood pressures to monitor the body's response to dialogue and human touch. Blood pressure and heart rates were more regulated (normalized) when comfort through touch was provided. Since it is the blood that carries oxygen, nutrition and regulating hormones to every cell in the body (and carries wastes from each cell), the blood, its distribution system (arteries and veins) and its pump (the heart) must be in top working condition to keep our bodies healthy. When the blood pressure is increased (which occurs naturally when we exert ourselves, become stressed - even the simple act of speaking will cause an increase), the flow of blood to the cells is impaired. This is why it is critical to protect the cardiovascular system, to protect the health of all of the body's cells. It is Dr. Lynch's firm belief that the prevention of loneliness will contribute greatly to that protection.
In his second book, The Language of the Heart, Dr. Lynch extends the examination of beneficial interactions on health to include contacts with companion animals. Various investigations concluded that the presence of, and contact with, a companion animal will lower a person's blood pressure. Watching a tank full of fish also reduced blood pressure to a level even lower than when the person sat still and stared at a blank wall. And most startling may be the findings that pet ownership can help a person who has had a heart attack to live longer. Companion animals, then, can help protect the cardiovascular system.
Why is that significant in addressing the issue of loneliness? Lorann Stallones, MPH, Ph.D., examined a population that is popularly associated with having a high degree of loneliness: the elderly. She writes, "As the likelihood of living without human companionship increases, with the death of a spouse, of friends, and of relatives, the need for social interaction becomes very important for maintenance of health and a sense of well-being." Dr. Stallones cites the benefits of increased social interaction with other people when walking a dog, and the accompanying physical activity, as being beneficial to the able owner. If the person has inherited the responsibility of the companion animal from a deceased spouse, the animal may serve as a link to important memories, and the process of caring for it may also serve to ease the sense of loss. Judith M. Siegel also conducted pet ownership studies among people over 65 years of age. Her data suggested that events in the person's life might arouse a need for companionship, which in turn might result in contacts with a doctor. She found that, over a period of a year, those with pets reported less need for the services of a doctor than those without pets. She cites two other studies that have shown that greater emotional attachment to one's pet was associated with better mental health, and, when human companionship was inadequate, to better physical health.
Loneliness can be at the root of many illnesses. Dr. Lynch eloquently relates this as a "broken heart," which is not purely allegorical when its damage to the cardiovascular system is considered. It is easy to relate the consequences of loneliness to the population of adults aged 65 and older, because our culture supports the notion that longevity is likely to be accompanied by infirmity and social changes. We are not as well prepared to identify these same characteristics in younger people, including ourselves. Yet factors that can lead to loneliness or are symptoms of loneliness - disability, loss of employment, diminished financial reserves, change in family structure and family member roles, availability of health care, lack of competitive level of education - are no longer only problems of the aging. The threat of violence, discrimination, substance abuse, social pressure to juggle multiple responsibilities (work, parenting, caretaking, etc.), and frequent moves all contribute to further isolating and insulating people from other people.
Currently, our society does very little to encourage or support the integration of a pet into a person's lifestyle. "No pets allowed" is a recurring message in public places, housing, transportation; when pets are allowed, the rules are sometimes so restrictive that it is impossible for the person to meet them (charges for transporting an animal, damage deposits, size/breed/species restrictions).
The medical community also has done little to incorporate companion animals into the health care planning of their clients. When was the last time you were asked if you had a pet when you were at a doctor's office? The trend within medicine in the recent past has been to compartmentalize our problems into "specialties;" we see one doctor for problems with our eyes, another for problems with our stomachs, another for allergies (and there, because the relationship between animals and allergies has been known for some time, you will be asked if you have a pet), and yet another for emotional problems. This has led to great advancements in treatments and cures for specific ailments, but it has not contributed significantly to our collective comprehension that our lifestyle and environment can affect every aspect of our general health. Embedded within that is the need for humans to be able to have significant interactions and relationships in order to stay healthy.
Companion animals can mitigate the effects of loneliness, and other stresses. You sit in the same room with Rover or Boots or Tweety, and you "feel more peaceful" (unless Rover is chasing Boots who has Tweety . . . never mind). You have a deadline to meet and while you're thinking how little time there is left, you scratch Bubba's tummy and you stop grinding your teeth. What many have known intuitively for years has now begun to be researched and confirmed to the satisfaction of scientific inquiring minds.
Marlene M. Rosenkoetter, Ph.D. RN, writes about the influence of pets on life patterns in the home:
"the pet is...a safe, non-threatening, neutral topic for discussion and one with which nearly everyone is comfortable. By sharing one's feelings with a pet, a person may be able to cope more effectively with emotional pain and distress [in a study by Corson at Ohio State University] it was found that when pets were used to treat patients who had not responded well to more traditional approaches, there was 'improvement in terms of responsiveness, communication, apparent increased self-respect, and independence.' Pets also facilitate learning, and with children, can facilitate the therapeutic process between the patient and the nurse, the pet can furnish an incentive to recover. The animal needs care; the person responds positively to being needed; some structure is added to a life lacking routines. The patient remembers to take an early morning medication at the time the dog goes out, or agrees to have dinner when the cat does."
A recent two-year study was conducted by Victoria H. Raveis, Ph.D., et. al., to examine the effects of cat and dog ownership on the emotional well-being of cancer patients and their family members. This study recognizes the psycho-social burdens of both the spousal caregivers and children who have a seriously ill parent. The findings suggest that having a companion animal in the household may well be associated with better psychological adjustment for the caregiver. Previous observations have noted the integral role that pets have played in the adjustment of children to the illness and loss of a parent.
Children and pets have been studied in other contexts: pets appear to lessen the loneliness that occurs when children provide their own self care, and children with a strong pet bond score higher on empathy for children than young children without pets. This may have significant implications for the future - if these children can reach adulthood and retain their empathy, they may have an easier time coexisting with others and be less apt to suffer from loneliness.
Since pets provide so many benefits, it is time that we more formally address their important roles in our lives. Healthcare and social service providers would be prudent to acknowledge the impact of pets on patients' health and include information on pet ownership in the patient's history. Pets can be incorporated into the overall treatment plans, and may be especially useful in enhancing long-term and rehabilitation strategies. It is also time to reevaluate rules that prevent some people from having pets in their homes. Some of the prohibitions that still exist originated from inaccurate information, archaic sanitation standards, prejudices and ignorance. The low risk factors associated with well-behaved, healthy, vaccinated pets should be carefully weighed before anyone is deprived of the health advantages of a companion animal.
What about people who are unable to care for a pet, but still wish to have contact with pets? Or people who are in hospitals, rehab facilities, extended care and nursing homes? Procedures are performed; medication is given; caregivers ask many specific questions and come and go at all hours through the client's room. This is a very lonely and stressful experience unless the client is supported in using his or her coping skills. For those who wish to interact with a pet, controlled animal visits can provide that therapeutic contact.
The appropriate use of pets in the health care setting can reduce people's stress and improve their response to treatment and recovery. With regard to risk management, it is crucial that visiting animals and handlers are well-trained and reliable. The handlers/program should carry insurance. Many facilities have initiated these programs through the Delta Society Pet Partners Program, and are reporting good results.
Drs. Alan Beck and Aaron Katcher list the benefits we can all reap from pets:
Pets clearly can help protect us from damage done by loneliness. As Dr. Lynch says, "We don't have pets in our lives to be nice. We have pets because we need them."
The effects of pets on humans continues to be a fascinating discovery as research validates what people have "known" intuitively and reported anecdotally for hundreds of years. Further questions to research could include:
Think of all the people who might benefit from contact with companion animals. The man who shuffles down the street. Aunt Mabel. The latchkey child. The coworker and the researcher. You. And so many others. Not having access to pets can be a hazard to your health. Science cannot fix loneliness, and too many people are prevented from being with a pet that could ease their loneliness. Places that prohibit pets:
need to understand how their restrictive policies are contributing to the poor health of the nation. Risk management, including zoonotic issues, has been addressed at many previously pet-free places, to the satisfaction of both management and pet owners. Information on leases and policies that effectively integrate pets into the environment while protecting the property owner can be found in the Companion Animals in the Community section of this web site.
