LeadingAge Magazine · July/August 2014 • Volume 04 • Number 04

Fighting Isolation With Technology

June 24, 2014 | by Linda Barbarotta

It’s well documented that social isolation can lead to depression, decreased quality of life and other related issues for older adults. Today’s ever-more-sophisticated communications technologies can go a long way toward alleviating isolation and boosting well-being.

Isolation is too often a part of older adults’ lives and can have serious consequences. A 2012 U.S. Department of Health and Human Services (HHS) report on aging services technology defined social isolation as occurring “…when an individual has limited contact with others, and perceives that level of contact as inadequate.” The report linked social isolation with depression, considering it both a risk factor and a result of depression, which needs to be addressed when preventing and treating this mental health issue.

The severity of depression is strongly associated with decreased quality of life, decline in physical and mental functioning over time and decreased disability. Depression can also enhance symptoms of arthritis, heart disease, hypertension and diabetes.

The number of older persons with major depression is significant. Researchers estimate that 1-4% of those 60 and older living in the community and 13-25% of nursing home residents are affected, and 35% of assisted living residents are socially isolated.

Fortunately, the use of technology can help reduce isolation and depression. A study in the Journals of Gerontology found that Internet use among retired older adults reduces the probability of depression by 33%, with the largest reduction in people who live alone.

Internet use can build social networks, reducing feelings of loneliness and alienation. One study, cited in the HHS report, found Internet use enhances older adults’ overall well-being, while another showed that older adults who use the Internet felt self-empowered and engaged in better self-management of their health.

LeadingAge members have increasingly adopted technology to reduce isolation among their residents and members. A 2013 survey of LeadingAge Ziegler 100 members found that nearly 92% provide their residents with Internet access, a community Internet portal and senior networking sites. Smaller proportions provide email (34.5%) and video conferencing (5%).

Two LeadingAge members have launched successful programs using technology to connect their community members to the outside world and providing them with the care they need.

Selfhelp Community Services, Inc., has been offering services and programs to low-income seniors and Holocaust survivors for over 75 years in the New York City area. They currently serve more than 20,000 through senior housing complexes, senior centers, adult day care, case management and naturally occurring retirement communities (NORCs).

But it’s their Virtual Senior Center that has been receiving a lot of attention. It’s a senior center without walls, using technology to connect home-bound and socially isolated seniors to the outside world.

According to David Dring, executive director of Selfhelp Innovations, the Virtual Senior Center was designed to help alleviate the isolation and loneliness homebound seniors often face. Dring explains, “Most of these clients were in great need of human contact and socialization, especially those who didn’t have family members who regularly visit. The damage prison inmates face when put in isolation is not much different from what alone and home-bound seniors suffer.”

Using their technical expertise and experience providing services, Selfhelp launched a small demonstration project with six homebound seniors aged 67-103, in 2008. Two New York City departments and Microsoft provided the original funding.

Participants received new all-in-one, touch-screen computers in their home, with video capability, broadband Internet service and technical assistance, connecting them with live classes from a local senior center. It soon became clear that those with little or no computer experience needed more streamlined computer operations. The software was simplified, an all-inclusive interface was developed and most computer operations were put behind the scenes.

Now, the first screen participants see is the Virtual Senior Center main menu. From there, users easily access classes and services offered by Selfhelp and connect online to family and friends, entertainment, online grocery shopping and more.

The large number and variety of classes offered is the heart of the program. Volunteer facilitators teach classes of 10-15 people. Most important, the classes are live and interactive. During the class, the video screen focuses on whomever is speaking while smaller images of the other participants are shown at the bottom of the screen. They can all see and hear each other and contribute to the discussion.

Anyone can be a facilitator who has a passion and a wish to share it with others. Facilitators include community partners such as museums, historical societies, libraries and hospitals, as well as the participants themselves. Subjects include tai chi, armchair yoga, current events, history and virtual tours of museums, such as the Guggenheim. A Selfhelp intern from Spain started a class on conversational Spanish and it was so popular that when she returned to Spain, she continued the class. A participant who has a lifelong love of Shakespeare is now teaching a class on Shakespeare’s plays.

One of the most transformed seniors was Milton Greidinger (see a great Wall Street Journal video about him here). When Greidinger started the program at 87, he was, he says, waiting to die. Once he learned the technology, he began taking classes and his life began to change. He created videos to share with others and became involved with Selfhelp, attending their board meetings and testifying at a U.S. Senate hearing about the program’s rewards. As he put it, “I consider myself reborn.”

The Virtual Senior Center classes have shown significant improvements in the lives of the participants, who report reduced isolation and increased social interactions.

A formal research study is underway to measure the effects of the Virtual Senior Center on participants, comparing 100 participants with 100 non-participants.

Selfhelp’s Virtual Senior Center is now operating beyond the New York City area—in Baltimore, Chicago and San Diego. Additional expansion is planned.

Dring credits his three main funders, United Jewish Federation of New York, the Consumer Electronics Association Foundation and the AARP Foundation. “Without them, we would not have been able to demonstrate the program’s effectiveness nor expand it.”

Can technology help older adults to remain in their homes as they age? Lynne Giacobbe, executive director of Kendal at Home in the greater Cleveland area, believes it can.

Giacobbe has directed Kendal at Home since it began with a grant from Kendal at Oberlin, The Kendal Corporation and the Cleveland Foundation in 2002.

Healthy and independent adults aged 50 and older join Kendal at Home by paying an entry fee and a monthly premium. In return, the organization assigns them a care coordinator and covers all the care they receive at their homes, and if needed, in assisted living or nursing home settings, for the rest of their lives.

While Kendal at Home integrated technology into the homes of members, the members themselves pushed Kendal to go further to upgrade that technology.

For example, Kendal first offered a traditional PERS (personal emergency response system) to its members but it didn’t go over well. “Our members didn’t like the stigma of this device nor the fact that it couldn’t be used outside the home. They wanted Kendal to find something that better fit their lifestyles,” says Giacobbe.

“We’re just trying to get people [who are] afraid they’ll mess up something, to get them to have fun with technology.”

So says Floyd Brandt, a resident at Westminster, Austin, TX, who chairs the CCRC’s in-house technology committee. The committee, launched a few months ago, recently surveyed residents about their use of computer equipment.

The survey garnered 107 replies and showed that:

  • 32% of Westminster residents use cell phones
  • 48% use a [desktop] computer
  • 19% use a tablet or iPad
  • 86% use Google

The survey data did not show how much overlap there was between devices—i.e., how many desktop users also use a tablet or vice-versa—but Brandt says, “My feeling is that about 50 percent of the people are using something. And every new group that comes in is using more than older residents.”

Westminster is helping residents get up to speed on computer use and social media. The community is offering in-house classes to help residents navigate Facebook and improve their social media skills through hands-on seminars.

The first Social Media 101 seminar was held in April, with more than 25 residents in attendance. “Mostly we talked about Facebook, covered how to set up a profile, how to do simple tasks like leave comments and add friends, the concept of a news feed and how it works, and other functions,” says Keith Fields, Westminster’s community relations coordinator and the leader of the seminar.

“Based on feedback, there is room to cover other things,” says Fields. “I was able to show them videos on YouTube—they were really interested in that. Our activities director also has University of Texas students come to work [with residents] on basic computer skills as well.”

Brandt, a retired professor of business, says his committee is motivated by the potential of computer technology to dramatically boost the quality of life of older people.

“Our feeling is that when mobility starts declining, there are a bunch of windows available, via iPads or computers,” for people to stay engaged with the world. The committee was organizing a computer fair for late June, a venue for users and non-users to mingle and share information face-to-face.

Westminster’s website has earned awards for its user-friendliness, including a recent “Website of the Year” award from LeadingAge Texas.

The first device Kendal offered its members was an improved PERS with GPS capability. Members can now contact emergency response services from anywhere. One member used the PERS device to connect directly with her care coordinator while en route to the hospital, getting the support she needed right away.

Giacobbe began searching for other technologies and found mostly products that seemed invasive or were technically overwhelming. In 2012, she learned about Independa’s technology solutions for independent living at a conference and discussed how it could work for Kendal at Home.

The result was a groundbreaking Independa-developed TV embedded with cloud-based care services, requiring no previous computer experience or training. The software integrates multiple devices, including PERS.

The TV is the first to offer integrated telecare monitoring, telehealth and social engagement tools. Members can set up medication schedules and reminders and set appointments with the calendar. Adult children can also use the calendar to remind their parents of upcoming family events.

A video chat function connects members with family, friends and their care coordinators. One home-bound member’s grandson was able to give his home-bound grandmother a tour of his college dorm.

With its caregiver application and other features, the system enables Kendal at Home to be portable and allows its members, who currently live in 10 different states, to stay connected with both Kendal and each other, no matter where they are living.

In the 10 years since Kendal at Home began, not one of its members has lived or is living in a nursing home permanently.

The program is available in 10 northern Ohio counties with over 200 members ranging in age from their late 50s to late 90s. Members, excited to be pioneers and groundbreakers, have formed their own community, with book groups, bird walks, social events and educational programs. Those who are more experienced help new members learn the technology in user groups hosted by Kendal.

Giacobbe says part of what makes Kendal at Home work is that its employees are so in tune with, and have such respect for, members’ needs.