Loneliness is the painful feeling of being alone or disconnected; social isolation is having few contacts or little support, whatever the person feels. Older adults can have one without the other, and both are linked to heart disease, depression, dementia and earlier death. If you or someone you care about is thinking about suicide, call or text 988, or call 911 if it is an emergency.
If someone is in crisis right now
Call or text 988, or chat at 988lifeline.org. Per the 988 Suicide & Crisis Lifeline, it is free, confidential and open 24 hours a day, every day. In New York City, NYC 988 answers the same number, with interpreters in more than 200 languages (Spanish speakers press 2; deaf or hard-of-hearing callers can dial 711, then 988). The city’s older NYC Well web address now redirects to that site. For a life-threatening emergency, call 911.
Loneliness and social isolation: what is the difference?
The CDC and the National Academies define them separately:
| Social isolation | Loneliness | |
|---|---|---|
| What it is | Little or no contact with others and little social support; an objective lack of social contact | Feeling alone or disconnected; a subjective feeling |
| How you can tell | Count the visits, calls and outings in a typical week | Only the person can say; it can happen in a full household or a crowded building |
How common is it in older adults?
The National Academies’ 2020 report on social isolation and loneliness in older adults cites about one quarter of community-dwelling adults aged 65 and older as socially isolated, and a 2018 AARP Foundation survey finding that more than one third (35 percent) of adults 45 and older are lonely. The CDC says about 1 in 3 U.S. adults report feeling lonely and that older adults are more at risk for social isolation. Treat these as national figures; neither source gives one for New York City.
The National Academies names the factors that tend to come first: living alone, losing a spouse or friends, chronic illness, hearing or vision loss, and trouble getting around. The CDC lists heart disease and stroke, type 2 diabetes, depression and anxiety, dementia, self-harm and earlier death among the risks of isolation and loneliness. These are associations found in research, not a prediction for any one person.
Depression and anxiety signs versus ordinary ups and downs
Everyone has low days, and grief after a loss is normal. What matters is how long it lasts, how much it covers, and whether it changes the person’s daily life. The National Institute of Mental Health describes major depression as symptoms most of the day, nearly every day, for at least two weeks.
| Often within ordinary ups and downs | Worth raising with a doctor (NIMH list) |
|---|---|
| Sadness after a loss that comes and goes and eases with company | Ongoing sadness, an “empty” feeling, hopelessness, or feeling worthless or helpless |
| Skipping an activity when tired | Losing interest in hobbies and activities; pulling away from others |
| One bad night, one small meal | Insomnia, waking very early or sleeping too much; changes in appetite or weight |
| Forgetting a name when distracted | Trouble concentrating, remembering or making decisions |
| Aches that have a known cause and respond to treatment | Aches, headaches or stomach problems with no clear cause that do not improve with treatment |
| Worry about a specific event, then it passes | Anxiety that, per NIMH, does not go away, is felt in many situations and can get worse over time |
| Dark moods that lift | Thoughts of death or suicide: call or text 988 right away |
NIMH also notes that depression can look different in older adults. It may show up as a lack of feeling rather than low mood, pain and other medical conditions can contribute, and in severe cases memory and thinking problems can be prominent. A change in memory should be checked by a clinician rather than assumed to be either depression or dementia (see dementia care at home).
What helps
- A predictable week. Fixed times for a walk, a meal with someone, a phone call.
- Regular contact that does not depend on one relative. Family, a neighbor, a volunteer, an aide: several points of contact hold up better than one.
- A place to go. Senior centers and adult day programs give a reason to leave the apartment, and a ride there if getting around is the barrier.
- Treating what blocks contact. Hearing or vision loss, pain and mobility problems are practical reasons people stop going out. The National Academies recommends checking for isolation after life events such as a move or the loss of a spouse.
- A primary care visit. NIMH says a primary care provider is a good place to start, and can refer to a psychologist, psychiatrist or clinical social worker.
NYC and New York State resources
| Resource | What it offers | How to reach it |
|---|---|---|
| 988 Suicide & Crisis Lifeline / NYC 988 | Crisis counseling by call, text or chat; follow-up care to check you connected; referrals; 24/7 | Call or text 988 |
| NYC Aging: Aging Connect | Starting point for older-adult services in the city | 212-244-6469 or 311 |
| NYC Aging older adult centers | Free membership for ages 60+; meals, classes, fitness, help with benefits; on-site or virtual mental health services at over 80 centers | “Find a center” on nyc.gov/aging, 311 or Aging Connect |
| NYC Aging Geriatric Mental Health Initiative | Licensed clinicians at older adult centers in all five boroughs: screening, counseling, referrals; in person, virtual or by phone; no center membership needed; ages 60+ | Aging Connect, 212-244-6469 |
| NYC Aging Friendly Visiting | Volunteers visit at home or connect by phone or video; aimed at older adults who are homebound with ongoing health challenges | Aging Connect, 212-244-6469 |
| NYS Office of Mental Health | Customer Relations helps with questions about services and providers; it is not a crisis line | 1-800-597-8481, weekdays 9 am to 6 pm |
Details are on the official pages for older adult centers, the Geriatric Mental Health Initiative (clinicians there speak Cantonese, Mandarin, Italian, Russian and Spanish; the page does not state a fee, so ask when you call) and Friendly Visiting. For anyone in danger, the Geriatric Mental Health page also says to call 911.
If you want someone to talk to who is not a crisis counselor, OMH describes warm lines as non-emergency numbers for support and information on mental health and recovery resources, as opposed to crisis hotlines. Its list of numbers sits in a separate document, so we do not reproduce them here.
Does Medicare or Medicaid cover mental health care?
For people on Original Medicare, Medicare Part B covers outpatient mental health services for conditions such as depression and anxiety, including psychotherapy, psychiatric evaluation, medication management and safety planning for people at risk of suicide. It also covers one depression screening a year in a primary care setting that can provide follow-up, at no cost if the provider accepts assignment. For other visits, after the Part B deductible you pay 20% of the Medicare-approved amount.
Medicaid and managed care plans vary. New York’s Office of Mental Health keeps an adult behavioral health page listing plan enrollment lines, Health and Recovery Plans and clinic services, and says OMH Customer Relations can help. Our pages on what Medicare covers at home and what Medicaid covers at home explain the home care side.
Where paid companionship and adult day programs fit
Home care does not treat depression. What it can do is put a familiar person in the home on a schedule, which matters when days go by without anyone coming through the door. A home health aide can keep someone company at a meal or on a walk, help with bathing and dressing so the person feels ready to go out, and tell the family or care manager when something changes: eating less, sleeping badly, losing interest in things they enjoyed. The aide reports; a clinician decides what it means. Our in-home care and private home care pages explain how hours are arranged and paid.
For people who can leave home, an adult day program adds structured company in a group setting. Families who provide most of the company themselves often need a break too; see respite care, and our guide to choosing a home care agency if you are comparing providers.
Easing loneliness at home: what our nurse director tells aides
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
Small things matter more than people expect: tea together, talking about the news, looking through family photos, a short walk. I remind our home health aides that they are not just working through a task list. They are spending the day with a person who wants company.
When we match an HHA or PCA to a client in Brooklyn or Queens, we look at experience, but also at language, habits and temperament. Hearing their own language at home makes an older person feel safe, so we give it real weight.
The signs that worry me are loss of interest in things the person used to enjoy, refusing food, trouble sleeping, withdrawing and constant sadness. Aides report these to the nurse, and we ask the family to see a doctor. Depression is not a normal part of getting older.
Talk to us
We are a licensed home care agency in Brooklyn and Queens (New York State Department of Health licence #2572L001). We can talk through what regular aide visits would look like. Call (718) 232-2777 or use our contact page. No cost, no obligation.
This is general information, not medical advice; it cannot tell you whether someone has depression or anxiety. Programs, phone numbers and eligibility change. Everything above was checked on 8 October 2026 against the CDC, National Academies, NIMH, 988lifeline.org, NYC 988, NYC Aging, NYS Office of Mental Health and Medicare.gov. If someone is in crisis, call or text 988, or call 911.
Frequently asked questions
What is the difference between loneliness and social isolation?
Social isolation is an objective lack of contact with others and little social support. Loneliness is the subjective feeling of being alone or disconnected, which a person can have even in a crowd.
Is depression a normal part of getting older?
Low days and grief after a loss are common at any age, but persistent symptoms are not something to dismiss. NIMH describes major depression as symptoms most of the day, nearly every day, for at least two weeks, and advises talking to a health care provider if signs do not go away.
What number do I call if an older adult is thinking about suicide?
Call or text 988, or chat at 988lifeline.org, any time of day. If the person is in immediate danger, call 911.
Are NYC senior centers free?
Yes. NYC Aging says membership in its older adult centers is free for adults 60 and older. Programs differ by center; 311 or Aging Connect at 212-244-6469 can help find one.
Can an older adult get mental health counseling through NYC Aging?
Yes. NYC Aging’s Geriatric Mental Health Initiative places licensed clinicians at older adult centers in all five boroughs and is open to New Yorkers 60 and older, whether or not they are center members. Call Aging Connect at 212-244-6469.
Does Medicare cover therapy for depression?
Medicare Part B covers outpatient mental health services such as psychotherapy and psychiatric evaluation, with one depression screening a year in a primary care setting. After the Part B deductible you generally pay 20% of the Medicare-approved amount.
Can a home care aide help with loneliness?
An aide can provide regular, familiar company and everyday help, and can alert the family or care team if mood, eating or sleep seem to change. An aide does not diagnose or treat depression; that is for a doctor or mental health professional.
