Kristi Kane is the Director of the Arrowhead Area Agency on Aging, a division of the Arrowhead Regional Development Commission. She spoke to United Way of 1000 Lakes about why keeping aging community members social matters for this installment of our ‘Ask the Expert‘ series.

Older Americans are one of the fastest-growing populations in the Itasca region. What are some of the challenges that this dramatic growth brings?

With transportation being one of the biggest gaps in our region and rural areas nationwide, just meeting older Americans’ basic needs is a challenge. We have many nonprofit programs and resources that are struggling to meet aging community members’ medical transportation needs—much less accommodate their social and work needs. This affects simple things, like chore services, as well. When we have to make really hard choices with our small funding amounts, kidney dialysis is going to trump yard trimming every time.

The Itasca region has been very proactive in planning for an aging community compared to other rural communities of like size nationwide, but there are still huge areas where we are not prepared. There are pockets of the region that I call “service deserts” because they don’t have access to home health services or other vital services due to distance and population workforce shortages. Workforce shortages can rarely be bridged in rural communities that are not equipped with adequate technology—such as broadband Internet. Our seven-county region is limited due to gaps in broadband. Things like virtual doctor’s appointments are possible in larger metropolitan areas but can’t happen here if people can’t dial in or if service is not reliable.

Finally, there will be continued housing needs. In mining communities like many of ours in the region, homes were built to be demolished and then rebuilt someplace else when the mining sites moved. We have a lot of tiny houses that have had multiple additions, and they’re just not meant for aging populations. The older buildings aren’t able to accommodate some of the adaptations that older people need in order to remain in the home for as long as possible. Things like wide hallways; main floor bedroom, bath, and laundry; attached garages; open spaces under cabinets to allow for wheelchairs were not kept in mind when most of the homes in our counties were built.

 

In Minnesota, more than 300,500 people over the age of 60 live alone. What are some of the risk factors that may influence, or exacerbate, social isolation for older Americans?

As we get older, our footprints tend to shrink. Everything from the size of our homes to the scope of our daily responsibilities gets smaller. Our social networks shrink due to friends and loved ones who pass or move away. As these changes take place we become at risk for loneliness and social isolation.

The signs of loneliness and social isolation can be easy to miss. This is partly because the people most at risk are not out at the forefront of the community, where they would be visible to the rest of us. We must depend on postal workers, Meals on Wheels and other volunteers, and doctors to identify the needs so that we can serve them.

Even those aging community members who do have frequent interaction with relatives and caregivers may be at risk if the depth and quality of the interactions is not sufficient Too often, programming for older people addresses the quantity of interactions, but not the quality.

 

What happens if we don’t continue to address the growing issue of aging Americans’ isolation?

Isolation carries numerous risks for adverse health outcomes. According to the World Health Organization, social isolation and exclusion are associated with an increased risk of premature death, lower general well-being, depression, and a higher rate of disability from chronic diseases. Most of the problems arise because people struggle to adjust to an unstructured daily routine.

For many people, old age is the first time since preschool when they haven’t had to be accountable to school or a job every day. Suddenly, they are spending two or three hours eating and getting dressed, and then the rest of the day is just idle time. As people look for ways to fill that time, you sometimes see them doing things they really shouldn’t be doing, like climbing up on a ladder to clean gutters, which is a fall risk. Idle time also leads to depression when people feel unneeded, or just sad that their friends have died. Ironically, depression causes undesirable behavior that can push family members away, leading to additional isolation. It’s a vicious cycle.

 

What are some of the best ways to address this important issue and what are the benefits?

The most comprehensive solutions will require cultural shifts—not just in our region, but as a nation. For example, we could change the way we structure jobs to allow more flexibility for older workers and people with caregiving responsibilities. We can also address loneliness by making jobs and informal social clubs available for older people so that they can continue to have the satisfaction of daily accountability in old age.

Cultural shifts occur slowly, but there are concrete steps we can take in our communities right away. One of the ways is to be alert to friends and neighbors who may need extra help with chores or transportation. This also means stepping up to report elder abuse, even when our family members are implicated. When we see mistreatment, we need to report it to the authorities so that our aging community members are safe.

As for programming, we can invest in re-engagement strategies for people who drop out of social activities because of injury or illness. Example: an older person has had to stop playing pickleball because they had a hip replacement – let’s find an alternative option that they can do to stay engaged instead of letting them become isolated. Building off the idea of health care navigators, we could develop new roles such as social isolation mentors and navigators. These people could assist in removing the barriers that lead to social isolation, perhaps by coming up with transportation plans, connecting people to a local faith community, or taking individuals on trial bus rides to help them get used to the routes.

 

Why is older people’s isolation an important social and health issue that affects everyone?

Social isolation increases the occurrence of chronic diseases, which creates a huge cost to our social support systems like health care and insurance. The community saves money when we invest in helping older Americans develop and maintain social networks. But beyond that, it’s an important thing to do because aging community members are valuable!

It benefits everybody from birth to death when we utilize our full potential as a community. Older people have polished skill sets and decades of experience. We want to keep them engaged so that we don’t lose their trove of knowledge and skills. For example, in community education there is a resurgence of young people interested in learning to can, and garden, meanwhile, there’s a whole generation of women where almost every single one of them knows how to do these activities. We can tap into their proficiencies as a community.

Finally, it’s important to care for older generations because they are our past and our future. If we think about the daily comforts we enjoy in our community, we can be sure that they were built by the people who went before us. Looking ahead to the future, each of us may one day be at risk of social isolation, and we can only hope that our communities will invite us to remain engaged. I always say that if we’re aging we are lucky, because it means we’re still here.

 

United Way supports programs and initiatives that meet the social, wellbeing, and independence needs of older adults through their Health Impact Pathway. To learn more about United Way’s impact goals, collaborations, and funded partners, visit uwlakes.org/our-work.