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San Francisco (Catholic San Francisco) - More than half of the senior population has a chronic illness, defined as a permanently altered state of health that significantly affects daily living. Examples include arthritis, osteoporosis, diabetes, heart disease and neurological diseases such as Parkinson’s disease.

There can be many difficulties with progressive diseases, including altered appearance, strength, coordination, energy, communication, mobility, roles and responsibilities (including, perhaps, employment), previously enjoyed pastimes and plans for the future. Increased dependence on others can strain relationships and threaten identity and negatively affect self-esteem.

Common emotions include anger, frustration, fear, anxiety, sadness and embarrassment. If not resolved, they can result in a negative attitude characterized by bitterness, self-pity, self-loathing or hopelessness, alienating others or prompting voluntary withdrawal from social situations.

Such separation from others fosters loneliness and may precipitate depression. While sustaining all relationships may be impossible, close relationships – a vital source of pleasure, validation and practical support – need to be nurtured or, if need be, new connections forged.

If you or a loved one is living with a chronic health condition, here are some ways to prevent or overcome isolation.

Recognize that, like you, your family and friends will need time to adjust to the reality of your illness and the lifestyle changes it necessitates, and may not know what to say or do. Let them know how you wish to be treated, and keep the lines of communication open.

Accept offers of help and ask for assistance if necessary. Give loved ones the opportunity to support you in practical ways.

Take the initiative in calling friends and relatives to talk or arrange get-togethers. Instead of waiting for invitations, extend them.

Make it easy for people to get in touch with you. Get an answering machine and perhaps also a portable phone.

Keep in touch with out-of-area loved ones through regular phone calls (find a good long-distance savings plan), letters or e-mail.

Find at least one person you can talk to openly, who will really listen and empathize.

Consider joining a community support group for people challenged with a similar illness. Information on groups can be obtained from your local hospital, community social workers and your local office on aging. Online message boards and chat rooms, and electronic mailing lists or discussion forums are some alternatives if it’s hard to get out or you prefer anonymity.

Sign up for an adult education course or lessons that interest you—for example, gourmet cooking, pottery or creative writing. (Check out the programs available at the local senior center or community center as well as educational institutions.) Learning something new can be energizing and confidence boosting, and in the process you might make new friends.

Get involved in your community by volunteering–perhaps with a neighborhood association, church group, charitable cause, political campaign or environmental issue.

If mobility issues prevent you from accessing the community, rent or buy a walker, scooter or wheelchair.

Investigate available resources in your community, which might include telephone reassurance services; friendly visiting services; volunteer driver programs; accessible transportation; therapeutic day programs; outreach services such as foot care and seniors’ dental clinics; home health services involving personal care, homemaking and therapy services; and supportive housing. Such information can be obtained from the area agency on aging.

Do nice things for others, especially those who are going through a difficult time. This takes your mind off your own situation, boosts your self-esteem and strengthens relationships.

Get a pet. Cats and dogs provide companionship and affection, and give you a sense of purpose. Owning a dog also ensures you get out of the house and get regular exercise, facilitates socialization and offers security. Just make sure you can properly care for the type of pet you’d prefer to own.

If you live alone and don’t like it, consider taking in a boarder, sharing accommodation with a relative or friend, relocating to a condominium or apartment in a senior living community or moving into a retirement home.

Seek help from your family doctor or a counselor if you continually feel sad, angry or overwhelmed. There is no need to suffer, because depression is highly treatable. The sooner you seek professional help, the sooner you will once again be able to experience enjoyment in your day-to-day life.

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Lisa M. Petsche is a clinical social worker and a freelance writer specializing in spirituality and health matters.