Phone call outreach fights off social isolation of the elderly

Nieves Fernandez is a participant in the Senior Center Without Walls program. NAM/Jeffrey Cheung

LOS ANGELES–Falling stars are the stuff of Hollywood legend. Early film industry folklore had it that the Pacific Coast was littered with the bodies of actors who failed to make the transition from silent movies to sound – victims of suicidal depression.

While myth, the story nevertheless suggests that the fine line between success and failure in the City of Angels has always been dangerously thin.

Insecurity in the entertainment industry — for actors, technicians and executives alike — has sparked a new telephone outreach program targeting social isolation in the Los Angeles area. Launched this month by the Motion Picture and Television Fund, it targets former members of the film and television industries – and their parents.

“Loneliness is this really impactful risk factor,” says geriatrician Scott Kaiser, MD, who spearheads the program as the Fund’s director of innovation. “And we’re not screening for it.”

Debilitating health effects

His own research on social isolation found links to various debilitating health effects including hypertension, insomnia, depression, anxiety, and lowered immune function. One study even compared it to smoking 15 cigarettes a day.

In some areas, loneliness and social isolation are being successfully countered in person: arts programs by Stagebridge; social outings like San Jose’s Senior Safari; and health groups at the Hotel Oakland Village.

In Silicon Valley, physicians at the Palo Alto Medical Foundation actually “prescribe” the social connectivity program linkAges to isolated patients.

Yet the Fund is targeting hard-to-find Angelenos — those living in the shadows.

“There are all sorts of programs,” says Kaiser, “But we’re not reaching the people who are most in need.”

Hollywood help since 1921

Established in 1921 as the nonprofit Motion Picture Relief Fund — with Hollywood star Mary Pickford as vice president — the Fund’s website codifies its mission: “As the entertainment industry evolves, there is one thing that remains certain: Many workers in our business don’t always know where their next paycheck will come from.”

The Fund operates a progressive retirement community on tony Mulholland Drive in Woodland Hills, where its well-tended residents are the 18-month pilot program’s backbone, acting as volunteer callers.

Largely social check-ins, the calls can span more perilous territory. Volunteers are trained on other critical issues: food insecurity; transportation woes; behavioral health options; and elder or financial abuse.

Could this be an answer to the country’s dwindling number of geriatricians and overwhelmed social services?

“Given what we all know about the significant geriatric workforce shortage issue,” says Kaiser, “there are major gaps where the professional workforce is not able to cover the extensive need.”

AARP priority

The AARP Foundation has made this arena a priority, and last year launched its Connect2Affect.org program to combat social isolation. Its website includes articles and a comprehensive list of essential resources.

“Social connections that are not technological or virtual are on the decline,” laments Lisa Marsh Ryerson, AARP Foundation president,” and we know that many older adults are paying a price.”

One inspiration across the pond is the Silver Line in the United Kingdom, which has received over one million calls since its launch in 2013. The free helpline provides companionship — including group friendship calls — along with advice and guidance to social services.

Kaiser says the ultimate Los Angeles goal is to scale the program for other needy retirees in a metropolitan area of over 18 million people – teachers, faith communities, civic organizations, even retired football players.

“There are hundreds of thousands of people who need this service.”

Phone intervention

While the phone often remains the most direct, low-cost intervention for isolated seniors, it’s also a tightrope act between passive and active engagement.

Headquartered in San Francisco, the Senior Center Without Walls hosts 75 educational telephone classes weekly for its over 700 students. Besides engaging topics spanning travel to exercise and trivia, each day features two “gratitude” classes in English, with one a week in Spanish and Russian.

Many isolated seniors consider the classes a lifeline to the outside world; some claim the camaraderie has even saved them from suicide.

Yet the center has admittedly struggled to expand its student base.

“People love the idea, but they have trouble connecting with it,” says Amber Carroll, the center’s director.

From Bay Area to New York

Last January, it expanded nationally, offering classes outside California for the first time. It immediately cross-marketed with the University Without Walls at Dorot University in New York City— a long-time ally and the inspiration for the Bay Area site. Of Dorot’s 500 students, about 30 now take the west coast classes and comprise about five percent of the center’s students.

Still, Carroll says she’s reached out to several other potential partners–with mixed results. Many conversations wound up as dead ends despite her pleas “Don’t reinvent the wheel — we’re already doing this.”

An Arizona group accepted her outreach offer then warned she’d be inundated with new students. She wasn’t. While she has received a handful of referrals from the state’s Area Agencies on Aging and the American Foundation for the Blind, the only other steady partner is a small “without walls” program in Kenosha, Wisconsin.

Why can it be such a challenge to engage older adults by phone?

Generally hooked

“Once people take a class they’re generally hooked and they tend to take a fair number of classes,” says Catherine Li, Dorot’s director of educational services. “But, I think perhaps the issue is that there are lots of different services… and they’re often dealing with a lot of other problems.”

Both Dorot and the Senior Center Without Walls are part of the Without Walls Network that meets quarterly and includes the Kenosha site and three programs in Canada.

Stanford aging expert Laura Carstensen says the key to engagement is knowing that you matter to others.

“Offer people roles where they are valued and contribute,” says Carstensen, who heads the Stanford Center on Longevity. [https://longevity3.stanford.edu/] “When you wake up in the morning, someone needs you.”

Kaiser says the L.A. effort provides this value — for everyone.

“It’s about purpose, for both the caller and the call recipient. There’s really an opportunity to have an enhanced sense of meaning.”

Matt Perry wrote this article for the California Health Report’s new Aging With Dignity blog with the support of a journalism fellowship from New America Media, the Gerontological Society of America and the Silver Century Foundation.