Geography can create additional barriers.
Adult children may live in another city or country.
Neighbors may be unfamiliar with the couple’s daily circumstances.
Friends may have their own medical concerns or mobility limitations.
Consequently, an older household can become increasingly isolated without anyone deliberately choosing isolation.
A friend might occasionally call and hear the familiar response that everything is fine.
A relative may visit for an afternoon and notice that the house appears orderly.
But those brief interactions cannot always reveal the reality of daily life.
A caregiver may be sleeping only a few hours each night.
A seriously ill spouse may require far more assistance than visitors realize.
Medical bills may be accumulating.
Both individuals may be frightened about what will happen next.
And neither may feel comfortable asking for help.
The absence of visible conflict does not necessarily mean the absence of distress.
Sometimes, the people who appear most determined to manage everything privately are those who would benefit most from additional support.
