As we learned more about the COVID-19 virus and its devastating qualities, the message became clear that older people were among the most susceptible to negative consequences. So, to prevent the spread to this vulnerable population, society entered a global lockdown.
And while social distancing did help as best it could, it left many older adults stranded in isolation. They couldn’t see their families, visit their friends, or share a room with anyone. The results were devastating.
But societal isolation of older adults has been a global problem even before the virus. And on April 12, 2023, Fordham GSS’s Ravazzin Center on Aging and Intergenerational Studies held a conference at the Westchester Campus to discuss this issue and find possible solutions. The conference was also co-sponsored by the State Society on Aging of New York and the Westchester County Department of Senior Programs and Services.
A Global Problem
The US prides itself on individualism. We grow up, become adults, move away from our hometowns, and strike out on our own. While this can be great for personal development, it often leaves families at a distance, sometimes over 3,000 miles away.
The generations before us often end up at home isolated, in assisted living homes and other settings. And while these facilities are extremely helpful, they aren’t always older adults’ preferred modality of living.
“Older adults want to stay at home in the community,” said James O’Neal, New York State AARP President, in his opening keynote speech of the conference. “If you talk to people about what they need, you’re bound to think of more effective programs.”
O’Neal explained that we should all reframe the issue as one of inclusion rather than isolation. And while he recognized that the US government’s view of older adults has not always been favorable, “the government often says how older adults cost society funds, not realizing what they give back,” he cited the New York State Master Plan for Aging, a program signed into executive order by Governor Hochul last November—and which AARP is helping initiate—as a positive step.
O’Neal also has his sights set on a global mindset shift. He noted that two of the United Nations’ 17 Sustainable Development Goals are indirectly related to this issue (#3 and #11, respectively). This all starts, O’Neal said, with inclusion.
“If we include people, we are able to provide services they need to stay at home and in the community,” he said.
Social Isolation and Health
According to the Office of Disease Prevention and Health Promotion, social determinants of health (SDOH) “are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” The social work profession relies on the knowledge of the SDOH to advocate effectively for vulnerable populations.
So, when Janna Heyman, Ph.D., GSS professor and Ravazzin Center chair, framed isolation and loneliness through the lens of their relationships to SDOH, it became clear how detrimental this situation can get.
“Social isolation has been associated with a significantly increased risk of premature mortality from all causes… [and]an approximately 50% increased risk of developing dementia,” she said. “And poor social relationships have been associated with a 29% increased risk of incident coronary heart disease and a 32% increased risk of stroke.”
Making in-person and virtual connections can help mitigate the impacts of loneliness and social isolation. These can be familial- and friend-related, Heyman said, but one important “touchpoint” for socially isolated older adults is through their health care providers.
“We always think of families,” she said, “but context outside of family and friends can be equally important.”
Heyman also cited Gerontechnology, the interdisciplinary field linking existing and developing technologies to the aspirations and needs of aging and aged adults, as another important step forward in society’s solution. As technology becomes more refined, it seems as though the possibilities are boundless.
“We are fortunate today to hear from innovative leaders who have developed programs to help shape the future,” Heyman said.
Dozene Guishard, director of health and wellness initiatives at the Carter Burden Network, served as the event’s following speaker. Guishard, who featured art from a local older artist on her slide deck (“talk about inclusion”), said technology has long been a catalyst in the effectiveness of her older adult programs. She explained CBN’s four methods of communication to reduce social isolation among the older adults it serves: Wellness Calls, Technology Virtual Classes, Telephonic Broadcast Messaging, and Virtual Case Management.
Guishard introduced CBN’s Broadcast Communication System in January 2020. The system communicated updates on voting, COVID and flu vaccine information, and even pre-recorded messages from CBN staff to the program members. Until December 2022, over 73,000 calls were made.
“Sometimes, it was the only call they received that day,” Guishard said. “We’d see people in the community and they would thank us for calling them.”
On Roosevelt Island, where CBN has the only older adults programs in the area, Guishard’s team implemented a “Tech Educator” to help its members with all the advancements. These educators are on-call to provide technological assistance members need. Reducing this digital divide, Guishard said, is one of the major steps in enhancing the future of aging services.
“It’s one thing to give someone a tablet,” Guishard said, “it’s another for that tablet to be used.”
Social Isolation as a Human Rights Violation
Older adults who are forced into isolation can turn to alcohol or other mood-altering substances. Substance use and misuse have increased in the older adult population over the last three years, said Fordham GSS Associate Dean Linda White-Ryan, Ph.D., LCSW, RN.
However, sometimes, this behavior is not intentional. White-Ryan’s recent research on older adults’ concomitant use of substances and medication cited unclear communication with health care providers as a fundamental cause of older adults’ alcohol misuse alongside prescription and over-the-counter medications.
White-Ryan detailed the story of her mother, who has since passed, and her struggles with health care communication in the final years of her life. She often couldn’t hear the doctors properly or was too intimidated to ask questions about her health. This is, unfortunately, a common occurrence.
“A good health care team is so important,” White-Ryan said. “Visiting them can be like visiting family.”
The day’s closing speaker was Fordham GSS adjunct and director of program development at the Westchester County Department of Senior Programs and Services, Colette Phipps, LMSW, who framed social isolation as a human rights violation.
“It conflicts with equality of opportunity and the inability to effectively participate in politics,” she said.
Phipps spoke at length about the Department of Senior Programs and Services’ Telehealth Intervention Programs for Seniors (TIPS) program, a program that sends trained student technicians, often GSS students, to take seniors’ vitals at community centers, nutrition sites, housing authorities, and independent living facilities for seniors.
TIPS’ success expanded it into four states. However, when the pandemic struck, home visits weren’t an option. Phipps and her team were agile and formed the TIPS in Touch program, where students made phone calls to the older adults to check in and provide a familiar voice.
“We had over 1,200 older adults in the TIPS program when the pandemic started,” Phipps said. “We needed to keep them connected.”
Phipps said TIPS and TIPS in Touch have resulted in a 30% decrease in hospital visits and a 35% decrease in emergency room visits among participants. Her team makes real changes for older adults and the community, one call at a time.
Commitment to Intergenerational Studies
If we’re lucky, we’re getting older. And while age can come with some challenges, isolation does not have to be one of them.
The Fordham GSS Ravazzin Center on Aging and Intergenerational Studies has dedicated its mission to improving the aging process and the quality of life for older adults since 1995. Conferences like these gather top minds in this field for a cause that truly affects all of us.
“The time is now to make a difference in the lives of older adults,” Heyman said. “We need to explore ways to address the challenges and the opportunities to advanced evidence-informed and evidence-based practices that reduces older adults’ social isolation.”