Social Connectedness and the Right to Belong: Society’s Failure of Older Persons, and How We Can Make it Right

Kim Samuel remarks for UN side event

March 29^th 2021, 1:15 – 2:30 pm

Good afternoon, everyone. Thank you, Bridget, for your kind introduction.

I want to start by telling you about my father, Ernie Samuel.

He was principled and fearless, kind of heart and undaunted by challenge.

At the beginning of 1997, he suffered a severe brain injury and fell into a three-month coma. When he woke up, my family turned to his workplace insurance for help.

We were appalled when the insurance company would not consider rehabilitation because he had reached the age of 65 – in their words, he was in his “sunset years”.

What insurance would happily do was put him in a long-term care facility, a nursing home where he was expected to live out his days in a hospital bed, with no hope of learning to navigate with the disabilities he had acquired, and to regain his independence.

My father’s story prompted a new, powerful image in my mind. I began to see a person sitting all alone at the bottom of a well. This is social isolation. It’s the deprivation of social connectedness, and its hallmarks are a lack of agency and a lack of choice.  

How incredibly lonely it must be to grow old in a society that gives up on you while you’re still here.

I often find myself returning to one foundational question: What do we, as a society value?

And sadly, through my father’s experience and that of countless others, it’s clear that society does not value older people very much at all.

COVID-19 has laid bare our many failings on this front, but the devaluing of older people is not a new phenomenon brought on by this pandemic.

Look at some of the avoidable, overlooked, and persistent risks facing people as they grow older:

Poverty.

Illness.

Inadequate housing.

Food insecurity.

Elder abuse.

Loneliness.

Social isolation.

As people age, providing adequate support does not seem to be a priority.

It’s not just a question of resource allocation.

When we do begrudgingly get around to thinking about older people, we’re so often focused on the idea of protecting them that we strip away their autonomy in the process.

We incorrectly treat these concepts – protection and autonomy – as mutually exclusive, creating this push-pull dichotomy where we can have one or the other, but never both.

This is a violation of older persons’ agency and their right to choose for themselves.

It’s ageism, clear as day, and it’s rampant.

The Global Report on Ageism – released a week and a half ago – tells us that, globally, one in two people are ageist against older persons.[1]

And ageism is known to increase social isolation and loneliness, which HelpAge Canada tells us affects more than one million older Canadians.[2]

This is unacceptable.

We have to course correct, and fast.

Unfortunately, COVID-19 has only deepened some of our worst fissures.

Case in point: the recent horrors in long term care facilities.

Long term care residents account for 67% of Canada’s total COVID deaths[3], and never-ending lockdowns have banned crucial interactions between residents and their loved ones.

As a Canadian, it’s been heartbreaking to see coverage of what’s happening inside these facilities.

But sadly, this failure is not bound by our borders; we’ve seen this happen in many countries.

For example, this past Thursday, Human Rights Watch released a new report on older people titled, “US: Concerns of Neglect in Nursing Homes”.[4] This report reveals how over the course of the Covid-19 pandemic, severe isolation, the absence of family members to provide human connection and support contributed to neglect, including extreme weight loss, dehydration, untreated bedsores, inadequate hygiene, mental and physical decline, and inappropriate use of psychotropic medications among nursing home residents.

This story from the report is as heartbreaking as it is a clarion call for action.

“Blanche”, whose 94-year-old mother, “Kathy”, lived in a nursing facility in the southwest, described how her mother struggled with isolation and was increasingly detached in the months leading up to her death in the fall. “She felt abandoned,” said Blanche. “She would say, I’m just an old piece of junk. Nobody comes to see me.”

The constant devaluation of older persons, both before COVID-19 became a global pandemic, and afterwards, underlines societies’ wider violation of an emerging right.

It’s broader and deeper than most of the individual rights enumerated in the Universal Declaration of Human Rights.

I call it the Right to Belong.

To belong means to be able to contribute; to be respected and represented and to fully participate as part of the social fabric of a community, if you so choose.

I fundamentally believe that all human beings, by simple virtue of the fact that they were born, have the Right to Belong.

Article 29 of the Universal Declaration touches on this idea in broad terms, stating: “Everyone has duties to the community in which alone the free and full development of one’s personality is possible.”[5]

This gives us a powerful starting point for looking at the rights of older persons, through the lens of social connectedness and belonging.

So, what does this mean? What are we being called to do?

Well, at the macro level, it starts with recognizing that all people, including older persons, have a Right to Belong.

Respecting this right means we must fight ageism, combat social isolation, restore agency, and stand firm against inequality. It demands that we uphold the dignity of older persons, and ensure that their rights are finally prioritized.

And recognizing the Right to Belong requires the state to take its responsibilities to its citizens – especially the most vulnerable – seriously.

[Pause]

We must push for international support of a Convention on the Rights of Older Persons, and as we consider its creation, we must keep intersectionality top of mind.

And finally, we should engage in a meaningful discourse on the right to deinstitutionalization.

Article 19 of the Convention on the Rights of Persons with Disabilities, (CRPD) identifies: “the equal right of all persons with disabilities to live in the community, with choices equal to others.” This is equally true for older persons.

When people are allowed to live their lives in their communities – as opposed to being placed in facilities – they retain a sense of social connectedness. They can interact with neighbours, friends, family – and even their medical care team – at will.

Whereas, removing people from the places they call home, strips them of comfort, familiarity, and agency, and often leads to loneliness, depression, and anxiety.

I might add that given our recent failures, investing in deinstitutionalization should be high on our priority list.

Now, there are of course situations where long-term care in a facility is the only option.

And so, to better serve people in those circumstances, nothing short of a total overhaul of our long-term care system must happen immediately.

We should also champion grassroots solutions that foster belonging.

The Friendship Bench is a great example.[6]

Founded by Dr. Dixon Chibanda in Zimbabwe, The Friendship Bench trains older women in evidenced-based talk therapy, and connects them with people seeking mental health support in their communities. Sitting on a park bench, the two parties talk problems through and work together to find solutions.

This simple interaction recognizing the inherent value of both people on the bench, grounding this important social connection in trust and reciprocity.

And as it turns out, these “grandmothers” as they are called, are, on average better at treating depression and related conditions than psychiatrists in the local context.[7] There’s a clear mechanism of action here: It’s belonging.

Friends – tomorrow, Canada’s Ambassador to the UN, Bob Rae, will take part in an international dialogue about the impact of COVID-19 on the human rights of older persons. I hope our talk today can provide important context for that discussion.

To close off, I’ll leave you with this.

In what turned out to be the last few years of his life, I never saw my father as a lesser person. Because he never was a lesser person.

I met him where he was on his life’s journey, and worked to ensure that his dignity, autonomy, and inherent value remained intact.

For too long, society has failed to understand and meet the needs of older people, to respect and recognize their personhood, their right to community, their right to belong.

It’s time for change.

So I ask you again, as a society and as a global community: What do we value?

Thank you very much.

[1] Global report on ageism. World Health Organization. 2021 pg. xvi.

[2] “Canada.” HelpAge Canada. https://helpagecanada.ca/canada/.

[3] Dr. Samir K. Sinha, Dr. Ryan Doherty, Rory McCleave, and Julie Dunning, National Institute on Ageing, Ryerson University. Data curated by the NIA Long-Term Care COVID-19 Tracker Open Data Working Group.

[4] “US: Concerns of Neglect in Nursing Homes.” Human Rights Watch. March 25, 2021.

[5] The United Nations. Universal Declaration of Human Rights. 1948

[6] The Friendship Bench. “What We Do.” www.friendshipbenchzimbabwe.org.

[7] Chibanda D, Weiss HA, Verhey R, et al. Effect of a Primary Care–Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe: A Randomized Clinical Trial. JAMA. 2016;316(24).