Friends sitting around a table, talking and laughing. A touch on the arm, as one of them leans over to make a confiding comment. A round of hugs before walking out the door.

For years, Carole Leskin, 78, enjoyed this close camaraderie with five women in Moorestown, New Jersey, a group that took classes together, gathered for lunch several times a week, celebrated holidays with one another, and socialized frequently at their local synagogue.

Leskin was different from the other women — unmarried, living alone, several years younger — but they welcomed her warmly, and she basked in the feeling of belonging. Although she met people easily, Leskin had always been something of a loner and her intense involvement with this group was something new.

Then, just before the COVID-19 pandemic struck, it was over. Within two years, Marlene died of cancer. Lena had a fatal heart attack. Elaine succumbed to injuries after a car accident. Margie died of sepsis after an infection. Ruth passed away after an illness.

Leskin was on her own again, without anyone to commiserate or share her worries with as pandemic restrictions went into effect and waves of fear swept through her community. “The loss, the isolation; it was horrible,” she told me.

What can older adults who have lost their closest friends and family members do as they contemplate the future without them? If, as research has found, good relationships are essential to health and well-being in later life, what happens when connections forged over the years end?

It would be foolish to suggest these relationships can easily be replaced: They can’t. There’s no substitute for people who’ve known you a long time, who understand you deeply, who’ve been there for you reliably in times of need, and who give you a sense of being anchored in the world.

Still, opportunities to create bonds with other people exist, and “it’s never too late to develop meaningful relationships,” said Robert Waldinger, a clinical professor of psychiatry at Harvard Medical School and director of the Harvard Study of Adult Development.

That study, now in its 85th year, has shown that people with strong connections to family, friends, and their communities are “happier, physically healthier, and live longer than people who are less well connected,” according to The Good Life: Lessons From the World’s Longest Scientific Study of Happiness, a new book describing its findings, co-written by Waldinger and Marc Schulz, the Harvard study’s associate director.

Waldinger’s message of hope involves recognizing that relationships aren’t only about emotional closeness, though that’s important. They’re also a source of social support, practical help, valuable information, and ongoing engagement with the world around us. And all these benefits remain possible, even when cherished family and friends pass on.

Say you’ve joined a gym and you enjoy the back-and-forth chatter among people you’ve met there. “That can be nourishing and stimulating,” Waldinger said. Or, say, a woman from your neighborhood has volunteered to give you rides to the doctor. “Maybe you don’t know each other well or confide in each other, but that person is providing practical help you really need,” he said.

Even casual contacts — the person you chat with in the coffee shop or a cashier you see regularly at the local supermarket — “can give us a significant hit of well-being,” Waldinger said. Sometimes, the friend of a friend is the person who points you to an important resource in your community you wouldn’t otherwise know about.

After losing her group of friends, Leskin suffered several health setbacks — a mild stroke, heart failure, and, recently, a nonmalignant brain tumor — that left her unable to leave the house most of the time. About 4.2 million people 70 and older are similarly “homebound” — a figure that has risen dramatically in recent years, according to a study released in December 2021.

Determined to escape what she called “solitary confinement,” Leskin devoted time to writing a blog about aging and reaching out to readers who got in touch with her. She joined a virtual travel site and found a community of people with common interests, including five (two in Australia, one in Ecuador, one in Amsterdam and one in New York) who’ve become treasured friends.

“Between [Facebook] Messenger and email, we write like old-fashioned pen pals, talking about the places we’ve visited,” she told me. “It has been lifesaving.”

Still, Leskin can’t call on these long-distance virtual friends to come over if she needs help, to share a meal, or to provide the warmth of a physical presence. “I miss that terribly,” she said.

Research confirms that virtual connections yield mixed results. On one hand, older adults who routinely connect with other people via cellphones and computers are less likely to be socially isolated than those who don’t, several studies suggest. Shifting activities for older adults such as exercise classes, social hours, and writing groups online has helped many people remain engaged while staying safe during the pandemic, noted Kasley Killam, executive director of Social Health Labs, an organization focused on reducing loneliness and fostering social connections.

But when face-to-face contact with other people diminishes significantly — or disappears altogether, as was true for millions of older adults in the past three years — seniors are more likely to be lonely and depressed, other studies have found.

“If you’re in the same physical location as a friend or family member, you don’t have to be talking all the time: You can just sit together and feel comfortable. These low-pressure social interactions can mean a lot to older adults and that can’t be replicated in a virtual environment,” said Ashwin Kotwal, an assistant professor of medicine in the division of geriatrics at the University of California-San Francisco who has studied the effects of engaging with people virtually.

Meanwhile, millions of seniors — disproportionately those who are low-income, represent racial and ethnic minorities, or are older than 80 — can’t afford computers or broadband access or aren’t comfortable using anything but the phone to reach out to others.

Liz Blunt, 76, of Arlington, Texas, is among them. She hasn’t recovered from her husband’s death in September 2021 from non-Hodgkin lymphoma, a blood cancer. Several years earlier, Blunt’s closest friend, Janet, died suddenly on a cruise to Southeast Asia, and two other close friends, Vicky and Susan, moved to other parts of the country.

“I have no one,” said Blunt, who doesn’t have a cellphone and admitted to being “technologically unsavvy.”

When we first spoke in mid-March, Blunt had seen only one person she knows fairly well in the past 4½ months. Because she has several serious health issues, she has been extremely cautious about catching COVID and hardly goes out. “I’m not sure where to turn to make friends,” she said. “I’m not going to go somewhere and take my mask off.”

But Blunt hadn’t given up altogether. In 2016, she’d started a local group for “elder orphans” (people without spouses or children to depend on). Though it sputtered out during the pandemic, Blunt thought she might reconnect with some of those people, and she sent out an email inviting them to lunch.

On March 25, eight women met outside at a restaurant and talked for 2½ hours. “They want to get together again,” Blunt told me when I called again, with a note of eagerness in her voice. “Looking in the mirror, I can see the relief in my face. There are people who care about me and are concerned about me. We’re all in the same situation of being alone at this stage of life — and we can help each other.”

This story was published by KFF Health News on April 28, 2023. It is republished with permission.