The Center for Disease Control and the Philadelphia Mayor’s Council on Aging report that one fourth of adults aged 65 and older living in Philadelphia are considered to be socially isolated.The risks associated with social isolation and loneliness are well documented and significant:
- Premature death from all causes, a risk that rivals those of smoking, obesity, and physical inactivity.
- A 50% increased risk of dementia.
- A 29% increased risk of heart disease and a 32% increased risk of stroke.
- Higher rates of depression, anxiety, and suicide.
- Among heart patients, a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.
Tackling the issue of social isolation among the elderly is a focus of The Sarah Ralston Foundation, a non-profit which funds organizations that serve the aging population in Philadelphia County. Lynette Killen, the Executive Director of the Sarah Ralston Foundation, believes that technology can be a critical component of the solution.
“Data collection can help identify the isolated,” said Killen. “This is a problem which is at once large in scope and difficult to uncover. And while human contact is essential, there simply will not be enough professional or non-professional caregivers to meet the needs of an aging population.”
Laptops, smartphones, and iPads cannot be overestimated as a viable and effective means of contact with the outside world. Use of these devices increased greatly during the first years of the COVID pandemic. Killen pointed out, “With minimal instruction, many elders were able to connect with their family and friends via ZOOM. I saw elders joining fitness classes to maintain or improve their health. Some even met new friends and joined educational groups, such as art classes, lectures on health, and virtual museum tours.”
Many older Philadelphians already use technology to interact with home health agencies and healthcare providers. Remote monitoring of weight, pulse, oxygen, blood sugar level, and blood pressure are just a few examples. “My 98 year- old mother lives with me. Although she always enjoys a personal visit from her nurse, she finds comfort in knowing that her vitals are being constantly monitored,” Killen said. Technology that alerts authorities after a fall or an accident is another frequently deployed option. “If an elderly individual is consistent about wearing the device – armband or necklace – in their home, it provides a valuable safety net and response system for the elder, their family and/or caregiver,” Killen said.
Dr. George Demiris, a professor at the University of Pennsylvania’s School of Nursing, is currently researching how smart home technology can be used to effectively monitor and assess social isolation in older adults. He and his team have placed non-intrusive sensors throughout homes in a test sample to collect valuable information about time spent inside versus outside and amount of daily movement. Demiris notes, “It’s a user-friendly way to capture data automatically, with nothing to learn and no burden on the test subjects to enter information.”
Demiris uses the data to develop algorithms that identify patterns of isolation or loneliness. The data can detect if someone is becoming increasingly isolated in their life, spending more time at home with few or no visitors, changes in their quality of sleep, and any increases in sedentary behavior. ”The data enables us to predict how isolation unfolds.”
Simply uncovering patterns and sharing the data with participants has also made an impact, by making elders more mindful of their day. Demiris adds, “When people get to see their own data it’s always a surprise to see how sedentary they are. ‘I can’t believe I sat on the couch for six hours!’ People tend to overestimate their level of activity. They also overestimate how often they leave the home. The data forces them to think more about their activities of daily living.”
Phase One of Demiris’s research concentrates on how the technology can be utilized for personalized interventions during an at-home visit within a retirement community. Phase Two will focus on how to best structure the actual interventions, based on the available data. The individualized data will be culled and used to find solutions and recommendations, based on the participant’s particular set of challenges. Demiris cites examples of this: “Knowing what we know from the data, we can determine what interventions would be appropriate. For example, we may want to link them up with other peers or volunteers for more social engagement.”
Social isolation among the elderly is garnering more attention these days and there is plenty of early stage research but there is still a long way to go. “There are so many ethical and clinical issues that have not been addressed,” Demiris says. “We don’t yet know how the technologies can be used. Tech may inadvertently lead to even more isolation. If we use technology to link with each other via, say, Zoom or on social media, it might lead to increased connections for people who might not otherwise have them, and provide a way for people to be checked on. But the other side of the issue is, as we rely more on technological solutions, we may be reducing personal interactions. People ask, ‘Does this mean I might see my nurse or family less often?’ It can connect, but it can also exacerbate the problem if we rely too heavily on the technology,”
Lynette Killen of the Sarah Ralston Foundation sums it up: “The challenge is to find ways to use technology as a supplemental tool, rather than as a substitute for human interaction.”
For more information about the Sarah Ralston Foundation, visit www.sarahralstonfoundation.org.