Loneliness, helplessness and boredom are silent problems plaguing the elderly, experts say, and aged-care providers face a growing hurdle as the New Zealand population gets older.
By 2030, New Zealand will have 1.2 million seniors. Six years later it is anticipated one in four people will be 65 years or older.
The number of people living alone is projected to rise to 600,000 by 2038.
Of the 355,000 New Zealanders who lived alone in 2013 at the last Census, more than 60 per cent were widowed, divorced or separated.
Studies have linked loneliness to a range of serious conditions like cardiovascular disease, cognitive loss, depression as well as to an increased use of healthcare services.
The number of lonely baby boomers turning to sex workers for comfort has increased.
And New Zealanders aren't the only ones getting lonely. The United Kingdom recognised social isolation as a key issue facing its population and appointed a Minister for Loneliness this year.
Next month Age Concern is holding a national conference to discuss wellbeing, social connection and loneliness among older people.
More than 15,000 frail elderly identified as being lonely according to a world-first Otago University study of 72,000 older New Zealanders. That equates to one in five older people.
The study was completed using a survey during assessments of elderly people who needed home services or were being considered for entry into care.
Researcher Dr Hamish Jamieson thought the high prevalence of loneliness reflected the increasing fragmentation of society.
"Many people are working long hours and travelling more. Anecdotally, there is a reduction in community networks and neighbourhoods. This is contributing to the high levels of loneliness reported in vulnerable older people.
"It is important to understand there are thousands of frail elderly in the community who are lonely."
Asian seniors were the most likely to be lonely, at 23 per cent, while Pacific Islanders were the least lonely group: 17 per cent reported loneliness.
Loss of mobility, health issues, sight or hearing loss, bereavement, grief, social disruption, lost ability to drive, mental health issues and a lack of social confidence were some of the reasons elderly people became socially isolated.
Minister for Seniors Tracey Martin said the Government had been running on the outdated Positive Ageing Strategy since it ended in 2010 and needed to recalibrate to the diverse ethnicities of seniors.
From May, she will conduct 40 feedback sessions around the country before pulling together targets for a new strategy.
"We have a newer group of people of New Zealand Asian descent. Their language might not be at a level that makes it easy to interact. We need to talk about how can we help more.
"If you've eaten a certain type of diet for 86 years you should be able to eat the same diet in a rest home and not change to a Western diet. It's a little thing but it's a big thing when you're 86 years old."
Martin wanted to emphasise the quality of interactions was crucial, it wasn't just about getting elderly out of the house.
"A young woman left a violent relationship and the first thing she did on her own was a sewing class at night school. The tutor was an older woman in her 70s who had just had her husband pass away.
"They found friendship in their two different circumstances, they found support. Quality is just as important."
Elder abuse was another area Martin wanted to look at. Currently, as many as 70,000 seniors are victims of abuse each year. Recently widowed, Māori women were some of the most likely to be victimised. It is estimated only about a quarter of cases are reported.
Projections indicate the number of seniors experiencing elder abuse and neglect will increase significantly in the next 20 years, alongside a doubling of the 65 and over population.
Aged-care services are bracing themselves for an increase in demand.
Age Concern social connection adviser Louise Rees hoped the sector would get more funding. During the 2016-2017 financial year DHBs spent $1.7 billion on Health of Older People support services, including residential care, support in the home, support for carers, hospital-based rehabilitation and assessment.
"The ageing population is a success story because we're living longer," Rees told the Herald.
"We expect to see demand go up and there's only so far we can go in terms of using our resources efficiently.
"It just needs to be acknowledged that some things are changing and we need to adjust our priorities and do things differently in response to that."
Origami, themed houses, pen pal schemes and Māori tikanga are some of the ways New Zealand aged-care providers are trying to solve the loneliness crisis.
Rotorua pilot programme The Care Village kicked off late last year to provide care services to the elderly. The village resembles a small New Zealand town and people live with others in one of 13 homes that each have a different style - like country, minimalist or contemporary - to reflect the lives people are familiar with.
It's the second programme of its kind in the world after Holland pioneered the idea.
Chief executive Therese Jeffs believed loneliness, helplessness and boredom were plagues that killed people. The Care Village was an antidote to that.
Dementia patients often regressed to an earlier stage of their life and mirroring that made them feel more comfortable and aided their memory, Jeffs explained. In the minimalist household they might have boil-up for dinner, while an excursion with the contemporary household could include high tea.
Residents help choose what they're eating, do the shopping and dishes.
Jeffs had seen a huge improvement in their residents.
"It requires a whole paradigm shift. You can't think about an institution, you have to think 'how do we live at home?'.
"People are not bored here, they are not lonely and they are not feeling helpless because they are participating in the running of their life and their house … It's palpable, you can feel it, you can see it.
"One lady hadn't recognised her husband for 18 months. She recognises him now she's moved in here."
Diversional therapist Orquidea Mortera works for the Selwyn Foundation charity, which has won multiple awards for its innovative solutions.
Its Baby Buddies programme - in which new mums bring in their babies for a play date with the elderly - won last year's New Zealand Aged Care Association's community connections award.
"We didn't realise how many mums in the community also feel lonely. It has given the mums and residents hope and a huge boost for their self esteem," Mortera said.
There is also Cycling Without Age, where volunteers offer free bike rides to elderly people, and an origami pen pal project, where Japanese seniors send origami to New Zealand seniors and in return the Kiwis send them handmade cards.
Last year a group of seniors knitted a huge jumper for cold elephants struggling with climate change and also learned and performed a flash mob dance at Motat to celebrate Christmas.
"We're constantly developing things that are meaningful for them," Mortera said.
"It keeps them doing something for other people. It's a lovely way to combat the loneliness and in spite of life and abilities they still get to do things they enjoy."
Solutions didn't have to be groundbreaking, Age Concern's Louise Rees said.
One example was giving lessons in Skype and texting to help seniors stay connected with family living elsewhere.
Another was community-driven outreach programmes, like the one Age Concern started when it consulted with elders in a deprived Napier suburb. They were told the elderly people there wanted a safe place to meet, share food and bring their mokopuna. Eight months later, the Kai and Korero group, where seniors met to share morning tea, was very popular and members brought guitars and sang together, Rees said.
"It's not rocket science, but it is working."
Depression Helpline – 0800 111 757 or free text 4202
Seniorline, a free information service for older people – 0800 725 463
Elder Abuse Helpline - 0800 326 6865
Healthline, for free arvice from a nurse – 0800 611 116
Samaritans, support for anyone feeling depressed, lonely or contemplating suicide - 0800 726 666