Roles of Social Isolation and Rurality on Functional Limitations in Older Adults Living in the US

Abstract Social isolation is a growing problem among adults aged ≥65. Using 2019 data from the National Health and Aging Trends Study (NHATS) (n=4,603), we examined the associations of social isolation and rurality with functional limitations in US older adults. We hypothesized that rural older adults would report social isolation more than non-rural adults, and social isolation and rurality would have an interaction effect on difficulty in performing activities of daily living (ADLs). Stress buffering theory guided this research suggesting individuals who have greater social connections also have greater coping skills to buffer against health-related stress. We assessed rural and non-rural older adults’ social isolation (measured by a composite score of engagement in community activities and social connections) and difficulty in completing ADLs (e.g., difficulty in dressing, bathing, and eating in the past month). Our results supported one of the hypotheses that there were differing levels of social isolation among both rural and non-rural older adults. In both rural and non-rural groups, oldest-old (85+), non-White adults, those with poor health or had multiple comorbidities were significantly isolated or experienced severe isolation. These results support (1) the premise that specific demographic characteristics are associated with social isolation as well as (2) a growing body of research showing rural adults have unique characteristics that are protective against social isolation. Our findings are related to demographic predictors which could help target interventions toward specific at-risk groups. Policymakers and healthcare practitioners should be aware of risks for social isolation and prepare to discuss these issues.

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SOCIAL ISOLATION AND OLDER ADULTS: UNDERSTANDING THEIR EXPERIENCE

Innovation in Aging ◽

10.1093/geroni/igz038.1346 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S368-S369

Author(s):

Bonnie Jeffery ◽

Tom McIntosh ◽

Nuelle Novik

Keyword(s):

Older Adults ◽

Social Isolation ◽

Well Being ◽

Community Dwelling ◽

Community Activities ◽

Rural And Urban ◽

Isolation Index ◽

Key Variables ◽

Services And Supports ◽

Community Dwelling Older Adults

Abstract This presentation will focus on a unique undertaking where three provincial organizations in Saskatchewan, Canada implemented nine projects to address social isolation for rural and urban older adults across a geography that encompasses one-half of the province. A survey of older adults was conducted to assess their level of social isolation in order to gain a more thorough understanding of the experiences of social isolation among community dwelling older adults. Key variables of interest included: older adult access to services and supports, participation in activities, feelings of being valued by others, barriers to supports and services, and the overall isolation experienced by older adults. The responses from 1,719 urban and rural older adults indicate that 24.1% of respondents felt that they lack support, 17.2% feel less connected to family and friends, and 16.8% of respondents do not feel valued by their friends and family. Overall, almost one-quarter (23.9%) of the survey respondents score ‘high’ or ‘medium’ on a Social Isolation Index. One-third of respondents report they experience barriers to participation in activities outside the home. Several key categories of barriers were identified: health, personal, environmental, social, transportation and systemic. Respondents identified accommodation, services, practices, and activities as areas where their community could assist in participation of community activities outside of the home. Social isolation can have serious health consequences for older adults. The results of this survey highlight several key areas that older adults identify as important for reducing their feelings of isolation and enhancing their overall health and well-being.

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VA Connection Plans: A Whole Health Intervention to Promote Social Connections for Older Veterans

Innovation in Aging ◽

10.1093/geroni/igab046.786 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 205-205

Author(s):

Samantha Hack ◽

Anjana Muralidharan ◽

Amanda Peeples

Keyword(s):

Older Adults ◽

Mental Illness ◽

Social Isolation ◽

Older Adult ◽

Brief Intervention ◽

Social Engagement ◽

Behavioral Therapy ◽

Social Connections ◽

Key Stakeholders ◽

Negative Thoughts

Abstract The Connection Plan intervention was created as a brief intervention to assist older adults experiencing social isolation during COVID-19. Based in Cognitive Behavioral Therapy (CBT), it is designed to help older adults create a “Connection Plan” to cope with distress related to social isolation. In 1-2 sessions, interventionists work with the older adult to create a Connection Plan with three parts: Mind (ways to change negative thoughts), Body (ways to change unpleasant body sensations), and Connections (ways to increase social engagement). Through soliciting feedback from key stakeholders (Veterans and VA clinicians), the Connection Plan intervention was adapted for the VA context. This paper will present this process of creating the VA Connection Plans manual, as well as associated efforts to disseminate the intervention to 900 VA staff and deliver it to 600 older Veterans with (age 50+) and without (age 65+) serious mental illness.

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Advancing the Study of Loneliness and Health in Older Adults Through the Use of Integrative Data Analysis

Innovation in Aging ◽

10.1093/geroni/igab046.818 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 213-214

Author(s):

Eileen Graham ◽

Kathryn Jackson ◽

Emorie Beck ◽

Jing Luo ◽

Olivia Atherton ◽

...

Keyword(s):

Older Adults ◽

Data Analysis ◽

Social Isolation ◽

Young Adulthood ◽

Healthy Aging ◽

Growth Models ◽

Functional Limitations ◽

Evidence Based ◽

Social Disparities ◽

Three Samples

Abstract Recent work has shown the importance of studying loneliness and social isolation across adulthood for understanding healthy aging. This project explored loneliness trajectories across multiple independent samples. Using coordinated IDA, we estimated and meta-analyzed identical multilevel growth models in loneliness using three samples (ELSA, SHARE, HRS). We found u-shaped change, suggesting that loneliness may decline from young adulthood to midlife, then increase after midlife. These trajectories were significant across all three datasets and not fully explained by demographics or depression. We found that divorce, widowhood, social isolation, and functional limitations were associated with higher overall loneliness. Additionally, divorce and functional limitations, and sex (being male) were associated with deeper dips in loneliness in midlife and steeper increases in old age. These findings suggest that loneliness increases across the second half of life and point to the need for evidence-based strategies for addressing social disparities in midlife and later adulthood.

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The Social Context of Disablement among Older Adults

Journal of Health and Social Behavior ◽

10.1177/0022146512439540 ◽

2012 ◽

Vol 53 (1) ◽

pp. 50-66 ◽

Cited By ~ 42

Author(s):

David F. Warner ◽

Jessica Kelley-Moore

Keyword(s):

Older Adults ◽

Social Context ◽

Life Course ◽

Marital Quality ◽

Social Life ◽

Functional Limitations ◽

Stress Buffering ◽

The Social ◽

Buffering Hypothesis ◽

Using Data

Prior research has not adequately considered that disablement occurs within a web of relationships that provides socioemotional resources to and/or places demands on older adults. Drawing on the stress process and life course perspectives, we considered the social context of disablement by examining the influence of marital quality on the association between disability and loneliness among married older adults. Using data from the National Social Life, Health, and Aging Project, we found (1) functional limitations were associated with higher levels of loneliness; (2) neither positive nor negative marital quality mediated this association, contrary to the stress-deterioration hypothesis; and (3) positive (but not negative) marital quality moderated this association, consistent with the stress-buffering hypothesis. These associations were similar for women and men. Our findings indicate the importance of the social context of disablement, as interpersonal resources offer protection from the deleterious socioemotional consequences of disability.

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Preferred Communication Channels Among Older Adults During COVID-19

Innovation in Aging ◽

10.1093/geroni/igab046.842 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 220-220

Author(s):

Cheryl Der Ananian ◽

Brad Doebbeling ◽

G Mauricio Mejía ◽

Hallie Wine ◽

Haley Harelson ◽

...

Keyword(s):

Older Adults ◽

Social Isolation ◽

Communication Technology ◽

Communication Channels ◽

Work And Family ◽

Social Connections ◽

Social Distancing ◽

Communication Techniques ◽

Phone Calls ◽

Family Demands

Abstract Social distancing measures put in place during the COVID-19 pandemic limited in-person interactions and may have increased the risk for social isolation and loneliness in older adults. Purpose The purpose of this study was to understand the communication channels used by older adults (age 50+) during the COVID-19 pandemic to mitigate social isolation and loneliness. Methods Older adults (n=22) who were selected from a longitudinal study, ‘Aging in the time of COVID,’ and who had self-reported they successfully avoided loneliness, participated in a semi-structured online interview. Participants were asked to describe the communication techniques and efforts they used to stay connected to family and friends during the pandemic. All interviews were recorded and transcribed verbatim. A thematic analysis approach was used to identify common approaches. Results Participants were primarily female and white (100%) with a mean age of 64.7 years. Preliminary findings (n=5) suggest older adults relied heavily on technology to facilitate communication with family and friends including texting, phone calls, email, video calls or conferences (e.g., Zoom), WhatsApp and social media, primarily Facebook. In-person communication strategies, including one-on-one and small group gatherings following social distancing guidelines, were preferred, but used less often than technology-based approaches. Living close to friends and family, and previous experience with technology were facilitators. Competing work and family demands, distance, and technology challenges limited communication. Conclusions While older adults may adopt technology at a lower pace, they relied on digital communication technology to maintain social connections during COVID.

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Trends across 20 years in multiple indicators of functioning among older adults in the Netherlands

European Journal of Public Health ◽

10.1093/eurpub/ckz065 ◽

2019 ◽

Vol 29 (6) ◽

pp. 1096-1102 ◽

Cited By ~ 9

Author(s):

Erik J Timmermans ◽

Emiel O Hoogendijk ◽

Marjolein I Broese van Groenou ◽

Hannie C Comijs ◽

Natasja M van Schoor ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Social Isolation ◽

Physical Inactivity ◽

Health Care Policy ◽

Functional Limitations ◽

Age Groups ◽

The Other ◽

Multiple Indicators ◽

Over Time

Abstract Background Monitoring of trends in functioning of older adults provides indispensable information for health care policy. This study examined trends in multiple indicators of functioning among Dutch older adults across a period of 20 years. Methods Data from the Longitudinal Aging Study Amsterdam were used. We included 10 870 observations of 3803 respondents aged 64–84 years across seven waves (1992–12) and 931 observations of 603 respondents aged 85–94 years across four waves (2001–12). At each wave, 8 indicators of functioning were measured: multimorbidity, severe functional limitations, depression, anxiety, cognitive impairment, physical inactivity, loneliness and social isolation. In addition, a sum score (range: 0–8) of these indicators was calculated, with a score of ≥5 indicating ‘multiple problems.’ Trends in functioning over time were assessed using Generalized Estimating Equation analyses. Results In the 64-84-years-olds, the prevalence of multimorbidity increased over time [OR(year) = 1.06, 95% CI = 1.05–1.06], whereas the prevalence of the other indicators decreased [i.e. cognitive impairment, physical inactivity (in women) and loneliness (in women)] or remained stable [i.e. severe functional limitations, depression, anxiety, physical inactivity (in men), loneliness (in men) and social isolation]. In the 85-94-year-olds, the prevalence of severe functional limitations increased over time [OR(year) = 1.08, 95% CI = 1.02–1.13], whereas the prevalence of the other indicators remained stable. In both age groups, the prevalence of ‘multiple problems’ remained stable. Conclusion Unfavorable trends were observed in multimorbidity among 64-84-years-olds and in severe functional limitations among 85-94-year-olds. Favorable trends were found in cognitive impairment, physical inactivity (in women) and loneliness (in women) among 64–84-years-olds.

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Dance Intervention Affects Social Connections and Body Appreciation Among Older Adults in the Long Term Despite COVID-19 Social Isolation: A Mixed Methods Pilot Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.635938 ◽

2021 ◽

Vol 12 ◽

Author(s):

Pil Hansen ◽

Caitlin Main ◽

Liza Hartling

Keyword(s):

Older Adults ◽

Mixed Methods ◽

Pilot Study ◽

Social Isolation ◽

Qualitative Data ◽

The Body ◽

Social Connections ◽

Body Appreciation ◽

Relational Capacity

The ability of dance to address social isolation is argued, but there is a lack of both evidence of such an effect and interventions designed for the purpose. An interdisciplinary research team at University of Calgary partnered with Kaeja d’Dance to pilot test the effects of an intervention designed to facilitate embodied social connections among older adults. Within a mixed methods study design, pre and post behavioral tests and qualitative surveys about experiences of the body and connecting were administered to thirteen participants along with test instruments of loneliness and body appreciation. In the short-term, no significant changes were found on quantitative tests. Exploratory analysis revealed intervention improvements on individual body appreciation questions only. This indication of change was strongly supported by converging qualitative data and identified as relating to: increased connection through task-based collaboration, increased awareness of interpersonal boundaries, and a shift to experiencing the body as responsive. These indications of increased relational capacity were deemed likely to cause further impact in the long term. Examining this possibility and the subsequently arisen factor of COVID-19 risks and restrictions, test instruments were administered again to 10 participants 4 and 5 months after the intervention. A significant increase in loneliness was found. Despite this negative impact of COVID-19 isolation, several positive intervention changes remained detectable and some continued to increase over time. Seventy percent of the participants, who made new social contacts during the intervention and later sought continued contact, improved significantly across all body appreciation measures over the full study. The qualitative data from the last two time-points revealed both consistent values and new, negative changes. While these preliminary findings speak to the durability of intervention changes, they also identify areas of urgent priority to help older adults restore embodied relational capacity that has declined during COVID-19. Within the limitations of a small-sample pilot study, converging mixed methods results support the hypothesis that dance interventions designed for the purpose can positively affect the social inclusion of older adults. Although we recommend further study, these promising results also indicate that dance interventions can help older adults recover from pandemic isolation.

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Promoting Social Connection and Deepening Relations Among Older Adults: Design and Qualitative Evaluation of Media Parcels

Journal of Medical Internet Research ◽

10.2196/14112 ◽

2019 ◽

Vol 21 (10) ◽

pp. e14112 ◽

Cited By ~ 3

Author(s):

Isabela Zaine ◽

David Mark Frohlich ◽

Kamila Rios Da Hora Rodrigues ◽

Bruna Carolina Rodrigues Cunha ◽

Alex Fernando Orlando ◽

...

Keyword(s):

Older Adults ◽

Social Networking ◽

Social Isolation ◽

Qualitative Evaluation ◽

Well Being ◽

The Other ◽

Social Connections ◽

Social Connection ◽

Friendship Group ◽

Short Period

Background Being socially connected is related to well-being, and one way of avoiding social isolation is to deepen existing relationships. Even though existing relationships can be reinforced by regular and meaningful communication, state-of-the-art communication technologies alone do not increase the quality of social connections. Thus, there is a need for the involvement of a trained human facilitator in a network of older adults, preferably for a short period, to promote the deepening of their relationships. Objective This study aimed to evaluate the hypothesis that a human-facilitated, media-sharing social networking system can improve social connection in a small group of older people, who are more vulnerable to social isolation than most, and deepen their relationships over a period of a few weeks. Methods We conducted the design and evaluation of Media Parcels, a novel human-facilitated social networking system. Media Parcels is based on the metaphor of a facilitator collecting and delivering parcels in the physical mail. Extending the metaphor, the system supports a facilitator in designing time-based dialogue requesting parcels from participants that bring out their memories and feelings, in collecting the parcels, wrapping them in annotations that communicate the corresponding requests, and delivering the wrapped parcel to a target person. Qualitative evaluation was carried out in two trials with a group of three people each, one with family members (children and father; aged 55, 56, and 82 years old) and the other with a group of friends (aged 72, 72, and 74 years old), over two weeks. In each trial, data were collected in three interviews (pre-, mid-, and posttrial) and via system logging. Results Collected data indicate positive social effects for deepening and developing relationships. The parcel metaphor was easily understood and the computational system was readily adopted. Preferences with regard to media production or consumption varied among participants. In the family group, children preferred receiving media parcels (because of their sentimental value) to producing them, whereas the father enjoyed both. In the friendship group, preferences varied: one friend enjoyed both producing and receiving, while the other two preferred one over the other. In general, participants reported a preference for the production of items of a certain type depending on the associated content. Apart from having a strong engagement with the system, participants reported feeling closer to each other than usual. Conclusions For both groups, Media Parcels was effective in promoting media sharing and social connections, resulting in the deepening of existing relationships. Its design informs researchers who are attempting to promote social connection in older adults.

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Promoting Social Connection and Deepening Relations Among Older Adults: Design and Qualitative Evaluation of Media Parcels (Preprint)

10.2196/preprints.14112 ◽

2019 ◽

Author(s):

Isabela Zaine ◽

David Mark Frohlich ◽

Kamila Rios Da Hora Rodrigues ◽

Bruna Carolina Rodrigues Cunha ◽

Alex Fernando Orlando ◽

...

Keyword(s):

Older Adults ◽

Social Networking ◽

Social Isolation ◽

Qualitative Evaluation ◽

Well Being ◽

The Other ◽

Social Connections ◽

Social Connection ◽

Friendship Group ◽

Short Period

BACKGROUND Being socially connected is related to well-being, and one way of avoiding social isolation is to deepen existing relationships. Even though existing relationships can be reinforced by regular and meaningful communication, state-of-the-art communication technologies alone do not increase the quality of social connections. Thus, there is a need for the involvement of a trained human facilitator in a network of older adults, preferably for a short period, to promote the deepening of their relationships. OBJECTIVE This study aimed to evaluate the hypothesis that a human-facilitated, media-sharing social networking system can improve social connection in a small group of older people, who are more vulnerable to social isolation than most, and deepen their relationships over a period of a few weeks. METHODS We conducted the design and evaluation of <italic>Media Parcels</italic>, a novel human-facilitated social networking system. <italic>Media Parcels</italic> is based on the metaphor of a facilitator collecting and delivering parcels in the physical mail. Extending the metaphor, the system supports a facilitator in designing time-based dialogue requesting parcels from participants that bring out their memories and feelings, in collecting the parcels, wrapping them in annotations that communicate the corresponding requests, and delivering the wrapped parcel to a target person. Qualitative evaluation was carried out in two trials with a group of three people each, one with family members (children and father; aged 55, 56, and 82 years old) and the other with a group of friends (aged 72, 72, and 74 years old), over two weeks. In each trial, data were collected in three interviews (pre-, mid-, and posttrial) and via system logging. RESULTS Collected data indicate positive social effects for deepening and developing relationships. The parcel metaphor was easily understood and the computational system was readily adopted. Preferences with regard to media production or consumption varied among participants. In the family group, children preferred receiving media parcels (because of their sentimental value) to producing them, whereas the father enjoyed both. In the friendship group, preferences varied: one friend enjoyed both producing and receiving, while the other two preferred one over the other. In general, participants reported a preference for the production of items of a certain type depending on the associated content. Apart from having a strong engagement with the system, participants reported feeling closer to each other than usual. CONCLUSIONS For both groups, <italic>Media Parcels</italic> was effective in promoting media sharing and social connections, resulting in the deepening of existing relationships. Its design informs researchers who are attempting to promote social connection in older adults.

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Demographic and Psychographic Factors of Social Isolation During the COVID-19 Pandemic: The Importance of Technology Confidence

Frontiers in Public Health ◽

10.3389/fpubh.2021.749515 ◽

2021 ◽

Vol 9 ◽

Author(s):

Becky R. Horst ◽

Andrew Sixsmith ◽

Dorina Simeonov ◽

Alex Mihailidis

Keyword(s):

Older Adults ◽

Social Isolation ◽

Technology Use ◽

Demographic Factors ◽

Risk Groups ◽

Technology Proficiency ◽

Viral Spread ◽

Digital World ◽

Modifiable Factor ◽

Demographic Background

The COVID-19 pandemic presents an unprecedented situation in which physical distancing and “stay at home” orders have increased the pressures for social isolation. Critically, certain demographic factors have been linked to increased feelings of isolation and loneliness. These at-risk groups for social isolation may be disproportionately affected by the changes and restrictions that have been implemented to prevent viral spread. In our analysis, we sought to evaluate if perceived feelings of social isolation, during the COVID-19 pandemic, was related to demographic and technology-related psychographic characteristics. Older adults across Canada were surveyed about their demographic background, their feelings concerning confidence and proficiency in technology use, and how frequently they have felt isolated during the pandemic. In total 927 responses from Canadians over 65 years old, of varying demographic characteristics were collected. Our data shows that many older adults are feeling isolated “Often” or “Some of the time” in 2020, regardless of most demographic factors that have been previously associated with increased isolation risk. However, feelings of proficiency in using technology was an important factor affecting feelings of isolation. Given that technology proficiency is a modifiable factor, and remained significant after adjustment for demographic factors, future efforts to reduce social isolation should consider training programs for older adults to improve technology confidence, especially in an increasingly digital world.

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