Isolation = Depression and Dementia.

As a couple, my parents did not have very many friends. My Dad had a few, from work and his church. My mom had a few more, her most special group being several women who went through the Master's of Library Sciences program at the UW with my mom. These women, and my mom, got together on a monthly basis. I remember occasional dinners with my parents' "couple friends" but on the whole, my parents were introverted and preferred it to be just family.

I don't know much more about their relationship than what I observed and can remember now, and what I remember seems fairly dysfunctional, however, they were definitely each other's best friends, and each other's main social outlet; especially as my sister and I grew up and left the house more and more. When my mother died, my father was devastated - his main companion just gone, leaving him alone with his thoughts and grief.

At first, he carried on with his own life. He continued to go to work and go out. He kept skiing - usually a solitary pursuit. He did have a girlfriend for a few years, but they eventually broke up, and then it was just him - alone in his house. Neither my sister nor I had the best relationship with him, and our visits were infrequent, although I did try to see him once a month or so, with my then husband, and then by myself after my divorce.

He spent the bulk of his time alone, talking to nobody, eschewing social opportunities with what few friends he had left. He continued to go to Church - his one social outlet for two hours once a week. Eventually, he became something of a hermit, in his disintegrating house filled with recycling and old memories of his life with my mother. My father also suffered from undiagnosed depression, something we all knew from an early age but never spoke about. He could go into black moods for weeks, and it affected all of us.

I firmly believe that one of the main causes of his dementia was the fact that he totally, eventually shut down. I think he gave up a little bit after my mom died, but we didn't really see the effects until years later. Her death accelerated his already antisocial tendencies since there didn't seem to be a reason anymore to see their friends. And I'm sure his grief and depression weighed on him and crippled any ability to reach out, as did his stoic nature.

By the time we stepped in to take over, horrified by what his life had become, I imagine that he went weeks without interacting with another human being. By that time, the dementia was firmly entrenched, no doubt fostered by his complete detachment from the world.

This is why I argue for the validity of placing our loved ones in a facility if we no longer feel able to provide care. It has been statistically shown that many care receivers are starved for interaction and socialization at home, even if they have a full-time member of the family with them. Usually, that caregiver is busy doing all the things they need to do and don't have a lot of time to spend socializing with their care receiver.

Facilities have been shown to increase and foster interaction and socialization for care receivers; providing them with people to talk to, activities to perform, things to watch, and just straight companionship. Companionship and interaction are so important to keeping the brain going, and keeping one's heart from giving up. I saw what having an in-home care aide did for Dad - someone to talk to who was focused solely on him - I think it really helped, although by that time it was too late.

Don't underestimate the value of other people in your care receiver's life - or in yours! Try to get friends involved in their life, and yours. Arrange visits by whomever will visit. Hire or arrange for an aide a few times a week to spend time with your care receiver, or hire a local teenager to come in and babysit, so to speak. Find an adult daycare - Dad liked his, I think - or a respite program so they can go socialize and you can have a break. We really do need people around us, someone to talk to and maybe care about. Someone to whom we can tell our story and feel that we're not alone.