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Loneliness and Purpose, Dean Fried | The Future You | Men's Health
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00:00Another topic that you focused on earlier in your career, which again not many people were talking
00:04about, very popular now, is loneliness. Social engagement with your family, friends, community.
00:13When did you first start thinking about that as something that clinically physicians or you
00:18specifically should be aware of when dealing with patients? Welcome to The Future You, a new series
00:24by Men's Health where we talk to the leading experts in health and longevity to help you live
00:28longer and stronger. I'm your host, Rich Dormant. In this episode, we're talking with longevity
00:33expert Dr. Linda Freed about connection and purpose and the relationship with aging.
00:38So I was taught about loneliness and also the need to stay connected and engaged by my patients.
00:46About the same time, maybe a little after, I started being challenged by what I was seeing
00:52in my patients that looked to me to be frailty. That they were losing weight unintentionally,
01:01that they were a little weak, that they were slowing down with less activity and less energy.
01:11That was early frailty. But what I learned from my patients was that everybody, no matter what age
01:19they are, need several things. We all need to have a reason to get up in the morning.
01:25Purpose. Exactly. It doesn't matter if you're 15 or if you're 100. You have to have a reason to get up
01:33in the morning. And people who don't have that reason and don't have a place to go to, it was shown
01:40many years ago, as they get older, they get sick and die. Not the next day, but over time they're more likely
01:49to get sick and die. It's the most deep of human needs. The other deep human need
01:58in the doing of things is that human beings are, you talked about genes, human beings are genetically
02:05encoded to need social connection. Now my wonderful colleague, John Cassioppo, who founded the field of
02:14loneliness science, said, talked a lot about the evolutionary origins of why human beings would need
02:23that. Why should we care? And you know, the evidence is very strong that over human history,
02:31traveling together got more accomplished, more safely, more effectively than traveling alone.
02:39And that you, whether you're worrying about safety or you're worrying about producing the conditions for
02:48better lives, we need each other. And so we're genetically encoded as it turns out to need each
02:55other where we need to feel positive connection with another person, with many other people. And
03:03there, you know, if I was going to get technical, I'd say there are lots of different kinds of
03:08positive connections that have been characterized with people like you, with people not like you,
03:14people older than you, younger than you, but we need a whole, it's all good.
03:18Yeah. And we need something in it. We need to feel like we get positive meaning and that we're
03:26positively valued in that interaction. There are lots of interactions where you walk away wishing you
03:33hadn't had it, but that's not the connections that I'm talking about. And we need those positive
03:40connections, both to feel like others value us as a human being and that the connections are nurturing,
03:48but that we get pleasure and enjoyment. Tell me about the Experience Corps.
03:53My pleasure. Your pleasure, your pride, perhaps? It's one of them. Yeah, for sure. So I learned these
04:00issues from my patients because for many years I saw people in their sixties or seventies or eighties or older
04:07who had retired. And often what I saw was that, and I'll give you one example of a gentleman who I
04:17took care of, who was, he was a youngster. He was 67. He had retired eight weeks before as this, from being
04:26the CEO of a big corporation. And he was ill. He didn't know why he was ill. And he'd been to see a few
04:33other doctors who really didn't see anything. But in talking to him, it was very clear to me that he was
04:40feeling ill because he went from being on top of the world to being invisible as an older person walking
04:47around the streets. Nobody saw him and he had no reason to get up in the morning and no sense of what you
04:55said, Rich, which is meaning and purpose. And he felt like he was in free fall and he couldn't get his
05:03balance. And it really made him feel sick and he was getting sick. And I started out, I was very used
05:12to grading prescriptions for exercise because I have a bit of that background. So I wrote him a
05:18prescription, which I'd never written before to say, go and find, he didn't need a medicine. He
05:25needed to find something that mattered to him and do it. So I wrote him a prescription saying,
05:30please do that and find something that matters and do it and report back. So I realized it's not a
05:37characteristic prescription, but there was no medicine that would have solved this to my judgment.
05:44And he came back to me a couple of months later and he said, Dr. Fried, I went and volunteered
05:50in an organization I care about a lot. And they put me in a corner licking stamps
05:57because they decided I am an old, old volunteer. Nobody asked me about my background. Nobody asked
06:04me what I know. That's what they did. And he said, and I stopped going back because I have limited time
06:11on the earth and that's not how I want to use it. And I wasn't being valued in terms of what I bring to
06:17the table. So I started thinking about that. And then I had many other patients with similar needs.
06:26And what I learned was I, people kept coming back to me without being able to fill their prescription.
06:32And I realized that we have this really important, somewhat novel, really novel situation going on,
06:42which we need to develop new approaches to. We as a society have created long lives.
06:49They didn't just happen. We made investments over the last hundred years,
06:53years, which enabled us to live longer and longer. Sanitation, the ability to breathe clean air and
07:03have safe water, nutrition, the ability to be physically active, the prevention of and treatment
07:11of infectious diseases. More recently, the ability to prevent chronic diseases like heart disease and
07:18stroke. All of those things added up to living longer. But what we haven't done is build the next
07:27stage. This next century's task is to figure out how to live longer with meaning and purpose and the
07:35health that enables people to carry that out. That's the century's task is to add that to longer lives.
07:42And I realized for my patients, we were not prepared for this. So after thinking about a long time and
07:50getting frustrated, quite frankly, that my prescriptions couldn't be filled because I thought they could
07:58make a difference for people, that I decided I wanted to see if it was possible to demonstrate something
08:08I saw in my older patients, which science now supports. This is all a good news story,
08:18which is that as we get older, we actually cumulatively and not miraculously develop skills
08:27and abilities we never had when we were younger. And those skills and abilities are quite astounding.
08:33People, of course, we acquire a lot of knowledge and expertise that we didn't have when we were 15
08:40or 20 or even 25. And we don't lose it the day we retire. If we retire, we acquire the ability to
08:49evaluate that knowledge and think about when it needs to get used. We have a lifetime of problem solving,
08:55both on work-related tasks and on life-related tasks. And as people get older, they bring that all
09:02together and an ability to actually use that with some judgment about what really matters,
09:10because people really think about that a lot. And the ability to handle ambiguity and shades of gray
09:18and make hard decisions in the face of ambiguity. And then as we get older, we get two other attributes.
09:26People become more what scientists would call pro-social. They care more about doing good things for their
09:33neighbor, taking care of their grandkids, making a contribution to an organization they care about,
09:42and they become more generative. Now that's a fancy word for wanting to leave the future better than you
09:50found it and future generations better off. So think about that package. To me, when I realized that in
09:58my late 30s, it took my breath away that we have created a world of people getting to not just live
10:07longer lives, but accrue these capabilities. But every time I gave them a prescription to use them,
10:14they couldn't cash it in. There was nowhere to do it. So I decided I needed to at least try to see if it
10:24was possible to build a new social organization and new kind of social institution that could use these
10:31capabilities and demonstrate how profoundly valuable they could be both for the older person to be able
10:39to use them for things they cared about and for society, because these are assets we've never had
10:46before. And if we have 20% of the population with these generous and generative assets.
10:53And nowhere for them to use it.
10:55I know what, that's, we're leaving, we're, we're leaving a lot on the table.
10:59So I decided I would start with something I deeply care about, which might, this was in the late 80s,
11:07early 90s, that I thought also society might be able to value. And that was public education and
11:15whether our children in this country are succeeding in public education. And so I started learning a lot
11:21about public education and realized that if children are not succeeding by third grade, they're
11:26track to drop out later. And it seemed to me like an easy match in the public eye to place older adults
11:37in roles that supported the success of kids in public education. Fast forward many years of designing
11:45the program, implementing it, carrying it out, evaluating it. We, the design is that we place
11:54whole teams of older people. So they have friends, colleagues, and critical mass to raise up all
12:00kids in public elementary schools and kindergarten through third grade. And we train them in roles
12:08that support the teacher's success, are there for the children's success. And that actually are there,
12:16is there also to improve the health of the older adults, including preventing frailty. And it works.
12:23Tell me how it works. Well, it works in many ways. It's very clear from the data on experience score,
12:30which is now in over 20 U.S. cities in multiple countries, that experience, having a critical mass of older
12:39adults in the school as volunteers with training in roles that the principal and teachers think would
12:47matter to support the kids' success. That they provide an ear for the kids, so that kids who are
12:54floundering in class don't fall behind, don't act out negatively, can stay with the class. The teachers
13:03feel like they are more successful at teaching because the class is in there with them, and you don't
13:09have kids acting out. You see a big improvement in the school climate. When there are several teams of
13:18older adults in a school of kindergarten through third graders, the whole school calms down.
13:24You know, I remember there was one school in Baltimore where a man who used to be a lithographer
13:34and volunteered for Experience Corps, on his own steam, would stand at the front door every morning and
13:44give every single child a high five as they walked in. You know, it changed the school climate. It also
13:51did a lot for his own loneliness. I was going to say, what a great way for him to start the day.
13:56It was right. He was there every morning. He was there every morning. So it had amazing effects for
14:03the students and for the educational community. Tell me about the observed impact that it had on the
14:09older participants. So I'm a public health scientist and I brought together a large team of scientists to
14:18think about how to design something that people wanted to do, that they would be gratified to do,
14:24that they saw made a difference in doing. Because like my CEO who quit because they were giving him
14:33stuff that didn't use his skills well, I needed to fulfill those criteria. But I'm a person who believes
14:42in preventing ill health. And it seemed to me this was a perfect opportunity if we could put this in
14:50every public school in the country to deliver health promotion and prevention to older adults
14:56simultaneously. But it had to be like, I don't know, an Easter egg, which was pretty on the outside
15:02that people wanted to show up for, but had lots of protein inside.
15:05And data, right? And data to tell you that it worked.
15:09And a huge amount of data. So we designed Experience Corps to do a number of things that
15:14people need as they get older. To have a reason to get up in the morning. To have a place to go to
15:22that they cared about building the future through. And older adults deeply care that the next generation
15:30was succeeded. That it would give them a way without signing up for an exercise program
15:37to get a lot of physical activity. And we've shown that it does. You know, think about getting up and
15:42down from those little chairs all day. It's good for you. And walking or taking the bus to school or whatever.
15:49We designed the roles carefully to use your mind. So they use their minds in ways that cognitive
16:01scientists have shown are really good for building memory and maintaining complex thinking. And as one
16:09of our volunteers said to me, who was a 78-year-old African-American woman, she said, you know, I feel
16:17like I'm dusting off the cobwebs in my head doing this. So we designed it for physical activity,
16:24for cognitive activity, and we designed it very carefully to build social activity and connection
16:31at many levels. With the other volunteers thinking about loneliness prevention. And in fact, what we've
16:38seen is that Experience Corps volunteers say that they have new people who they could turn to for help.
16:44And a new social network of people who they're friendly with. They may not be best friends, but,
16:53you know, replacing some of the social networks that people lose as they get older and as they retire.
17:00And we designed it to also create connection with people of different generations. So with the teachers
17:08and the principals for whom they became valued members of the team as volunteers and with the children.
17:14And it had a positive impact on the health and physical and mental health of them.
17:18We have shown over the years that this program, as it was designed, as it was designed,
17:26is effective in maintaining or even improving complex
17:32and maintaining what we call executive function and which is very important for just everyday living
17:45and actually slowing or preventing memory loss.
17:49I think it's important to reflect on what we've learned from the Experience Corps experiment,
17:56which is that what older people bring to the table is unique and can be transformational if the
18:04program is designed to bring out the transformation. And we have also emerged into a different era than we
18:12were in the 90s when people were not willing to see older people in any role.
18:20And but countenance seeing them with young children.
18:24I think we're now ready to build new roles for all of us as we get older that can make a difference in our
18:33communities and for ourselves. Roles that extend to include children's education and the education of
18:43teenagers and and mentoring of older adults. But there is a vast array of roles where the assets and
18:50capabilities of all of us as we get older could make a huge difference.
18:54And we need I think this is a moment for a grand act of imagination
19:00to think about the complex problems we have to solve
19:03and where we need more human capital and social capital and how the assets that older people
19:12would want to bring to that table could be transformational and then build the institutions
19:17that enable people to contribute as they get older. A grand act of imagination.
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