In the box were the front pages of greeting cards with pictures of flowers, wheat fields, and open prairies; the other half that would have contained a greeting or signature was cut off in a jagged path by sharp scissors. Hidden inside the bottom of the box, were a wrinkled handkerchief embroidered with the initials SH and a pink crystal rosary. Absent from the box was a ring of purely sentimental value that was on her hand the last time I saw her, but not with her at the time the funeral home staff arrived to pick up her body. The missing ring was never found. An employee of the nursing home likely slipped the ring off her finger just prior to or after her death. These few belongings were all that remained of Sarah’s life, and I was the only interested party available to collect them.

Sarah’s death struck me as significant and melancholy. Sarah lived to the age of eighty-seven. There was no one except me to mourn her passing or to shed a tear, no one except me to know or care where Sarah was buried or to visit her burial place to acknowledge the life she had lived. Cemeteries are filled with stones bearing the names of people who no one visits. My clients tell me that their greatest fear is not dying but the fear of dying alone. It disturbed me that Sarah’s presence on earth was memorialized by material belongings in a solitary cardboard box that now belonged to me. I wanted to believe that life---that all of our lives---offer some legacy to a world that we may no longer inhabit.

Holding the cardboard box of belongings gave me a better understanding of the isolation that many individuals experience in the latter years of life. While many of us take for granted frequent emails or phone calls from friends or the ease of going shopping or joining groups of friends, for many older adults advancing age and poor health prohibit participation in these activities. “People with stronger social relationships have a fifty percent increased likelihood of survival than those with weaker social relationships.” Having friends and participating in social activities has a positive impact on quality of life. Older adults become isolated due to loss of friends or family, limited physical mobility, and reduced income that restricts participation in activities like going out for dinner with a friend or joining an interest group. Social isolation and loneliness negatively impact quality of life in many ways that include poorer health, increased medical expenses and moving to a community of care much earlier than expected.

Today, families are spread across great distances. When older family members age and become isolated, family is many times unaware or uninvolved of daily struggles or health challenges. I know this to be personally true. This past holiday season I learned of the passing of an uncle who lived at a distance. Because contact with my uncle and aunt consisted of written cards and visits every several years I had no idea my uncle’s health had declined and would have not known of his passing if his niece had failed to respond to my holiday card. As a result of receiving a note in the mail, I had a wonderful telephone conversation sharing memories of my uncle with his niece, who knew of me but whom I had never met in person.

Sometimes it takes great loss before we are fully able to understand the value of human connection. Life passes with time and we age. Remaining connected to family is important even if contact is by email or phone. If you doubt the human desire for connection, look at the popularity of Facebook and social media and the way these allow connection to those in our present and in our past. We seek to connect even if the connection is through the convenience of a computer and the Internet.