LeadingAge Magazine · January/February 2016 • Volume 06 • Number 01

Technology Reduces Social Isolation in Senior Housing

January 17, 2016 | by David Tobenkin

Tools to build community and connect independent living residents are becoming increasingly easy to use and powerful.

For Esther Giddens, an 81-year-old resident of Montbello Manor in Denver, CO, who endures severe pain in both knees and related problems in her back, a high point most days comes 10:00-10:30 a.m., when she and another resident sit in front of a television in a commons area and Giddens turns on the television, uses a mouse to navigate through a display of different programming options, and selects “Sit and Be Fit.”

Six months ago, before she began regularly watching the program, in which an RN leads viewers through a variety of exercises they can perform while seated, she needed help getting into cars because she couldn’t lift her right leg. Now Giddens says she can do it by herself.

“Sit and Be Fit has been very important for me because it makes me feel good to do something for myself and it has helped me tremendously by strengthening my muscles,” Giddens says.

Giddens is taking advantage of a system provided by It’s Never 2 Late (iN2L) that has been installed in 17 affordable senior housing communities by Alexandria, VA-based Volunteers of America (VOA). The system, which allows users to touch a screen to find content, also facilitates the use of e-mail and Web cams, and physical and mental rehabilitation programs.

While relatively common in assisted living and nursing communities, such technologies designed to reduce isolation and facilitate group activities are also now being installed in senior housing communities, in many cases functioning as communications hubs and activity centers for residents.

“We had used iN2L in assisted living and skilled nursing, but not in housing,” notes Shirley Maisel, director, housing and healthcare services integration at VOA. “Typically, senior housing communities don’t have activities staff, and not a lot of general staff time to lead residents in adopting these technologies. But residents have championed it, and we have had success with volunteers who are computer-savvy and have stepped up.”

“We’ve incorporated the equipment into almost everything we are doing now,” says Pauline Melvin, service coordinator at Oak Park Plaza in Baton Rouge, LA, a 100-unit VOA community for low-income residents. The 60-inch screen with the service was installed in July 2015 and is operated and overseen by her, with direct use by residents as well. “Before we received the equipment, we provided all our services to residents using volunteers to show them how to exercise, eat right—which made it just a lecture. Now, with the equipment, they can learn visually,” Melvin says.

VOA uses the system to provide a wide variety of programs. For example, it streams and records for future on-demand use a video of a non-denominational Sunday worship service led by a VOA Gulf Coast Village spiritual leader, Rev. Tom Hafer, which Maisel says can be a valuable addition for those not able to attend actual services. Other popular uses include general access to the Internet, games, a jukebox, general health applications and communication through programs such as Skype.

Maisel says monthly usage reports allow her to track which services are and are not popular on an aggregated basis, to respect privacy concerns of residents. She says popularity of the services can vary widely by community, with recreational games representing top uses in some while spiritual services lead in others. She says that VOA will begin examining usage and desired applications with iN2L and its sites in 2016.

The systems are located in community areas and use a computer and video screen on a mobile stand so that it can be relocated. When in operation, the video screen presents large icons for video content and popular websites. It is a safe way to use the Internet and does not save downloads so viruses are not an issue, says Maisel. In addition there are staff tools that allow VOA staff to upload internal information.

The keys for good technology for senior housing communities are that the systems have good content, good technical support and be easy to use, Maisel says.

“Having a centralized system was better for us, because Internet connectivity in some properties can be problematic at times. In the future, we probably will move to more Web-based applications that residents can access from various devices.”

Episcopal Senior Communities, Walnut Creek, CA, implemented its own technological solution to senior isolation more than a decade ago with its “Senior Center Without Walls” program. The “old technology” it relies on—the telephone—isn’t quite as sexy as the shiny 21st century gadgetry we like to learn about, but it has been very effective.

“In the beginning it was geared to what we’d call a home-bound person,” says Tracy Powell, Episcopal Senior Communities’ vice president, home & community based services.

Users can dial in to: participate in classes; learn about practical subjects like Medicare Part D; participate in a daily gratitude class (probably the most popular offering) that is also just starting to be offered in Spanish; enjoy Pet Tales, Open Mic or Boggle; join support groups for low vision or a discussion group for the blind; hear special presentations on fall prevention, food safety, and much more. Powell says almost 70 classes are offered each year at no cost, mostly facilitated by volunteers. Episcopal Senior Communities hopes to use a new provider that would allow recorded video presentations to be accessed 24 hours a day to make it more convenient for seniors.

“People form friendships over the phone, even though the vast majority have never met each other,” says Powell. “But they feel connected and trade numbers to interact offline. A lot of these people were very involved at different times in their lives, but when you can’t get out you can’t volunteer, so a lot of the programs are facilitated by the seniors themselves.”

Episcopal Senior Communities has just announced that the Senior Center Without Walls will now be available to users across the country. Click here for details. See this Contra Costa Times article for a positive review of the program.

For all the benefits the Senior Center Without Walls has generated in 10 years, it’s clear that more sophisticated technology can boost its benefits.

That’s where Caremerge, a cloud-based suite of applications, comes into the picture. One module, Caremerge Social, is a social engagement platform that Episcopal Senior Communities is installing in three of its life plan communities (a.k.a., CCRCs) in the Bay Area. The organization has branded this module as “Senior Resources Explorer.”

Click here to see the “lobby view” of the tool at the St. Paul’s Towers site. Registered resident users gain access to many more features.

The tool can be used on multiple devices including smartphones, and touch-screen kiosks are also being installed in the 3 initial sites.

“We see it eventually being the single pane of glass for all of our resident-facing technologies,” says Chris Dana, vice president of information technology. “If they want to book a dinner reservation at a community, or get a ride to an event or put in a work order for a light bulb that’s out, we see Caremerge as being that interface they can do it through. We have vibrant resident-led committees, so Caremerge is going to be the central platform for sharing documents, sharing meeting minutes, booking rooms and coordinating all those committee efforts.”

Dana says Caremerge has a “dimensions of wellness” feature that may help the organization learn more about trends in residents’ well-being.

“We’re excited about Caremerge,” says Powell, “and one way we’re hoping to bridge it is to target our existing participants in the Senior Center Without Walls. We also have a friendly-visitor program geared to socially isolated seniors. What if we could take some volunteers already visiting people, and [add] some new volunteers, to go to our clients in the phone program, and if they have aptitude, hook them up to the technology piece? It could double as another way to visit someone, but help facilitate getting them online.”

Caremerge has some features that Powell describes as “Facebook-like,” that allow users to post comments and photos, have conversations and build communities of interest.

“We know that building of communities can also extend beyond those walls, and Caremerge is working more to engage seniors where they live and help them become part of a community,” says Powell. “We also know we can [use it to] disseminate all kinds of information to help people stay healthy and well. You’re still at home, you haven’t paid an entry fee or come to our community, but you can still get a lot of information about senior services.”

“We think there is a small segment of residents who are into technology and embrace it, and a small segment that wants nothing to do with it, and then there’s a large swath of residents in-between, who could use some additional support to get over technology barriers and make this successful,” says Dana. “We’ve looked at some outside organizations to come in and provide direct support to residents but we are more likely going to hire our own staff member who can rove and provide in-room resident device support and training.”

“We are excited that the Caremerge technology will help us reach more seniors and engage them in community,” says Powell. “But whether on the phone or online, we welcome participants and volunteers from anywhere in the country.”

- Gene Mitchell

Another recently introduced senior connectivity service is the Virtual Senior Center (VSC), launched in 2010 by Selfhelp Community Services in New York City. The VSC, a mechanism to connect with and engage socially isolated, vulnerable, homebound elderly, is offered by Selfhelp to about 250 individuals participating across the country, mostly in New York City but including about 75 individuals in Chicago, Baltimore and San Diego, says David Dring, executive director of Selfhelp Innovations.

Participants in the project receive an all-in-one touchscreen computer with Selfhelp’s senior-friendly interface, together with Internet connectivity. The VSC interface enables older people at home to see and hear the other people in classes offered through the system and to actively participate in two-way discussions and activities.

Many of the interactive classes are facilitated by volunteers from community-based organizations; cultural organizations, such as the Guggenheim Museum, MOMA and Lyric Opera in Chicago; and the rest by individuals who run the classes from their homes and offices. The classes enable participants to take part in activities such as armchair yoga, painting classes, current events discussions, well-being sessions with geriatricians, museum tours, holiday events, music programming, sing-alongs and Tai Chi, Dring says.

A 2015 evaluation of the Virtual Senior Center Program in Chicago, New York City and San Diego found improvements in users’ social connectivity, health status and computer literacy.

“The results of the evaluation confirm our observations that the VSC is an important tool to reduce social isolation (reduced feelings of isolation by 85%), makes a positive impact on perceived health status, improves computer literacy, and 97% reported the VSC improved their quality of life,” says the evaluation.

Another senior care provider offering VSC to its residents is Chicago-based CJE SeniorLife, which implemented the program in 2013. CJE’s involvement started when it became involved in the research study, says Gerri Fiterman Persin, manager of the Center for Healthy Living at CJE SeniorLife.

The decision to retain the system after the study reflected the benefits it provided, Fiterman Persin says. “We have seen older adults who do not have much experience with computers accept and use technology on a daily basis,” Fiterman Persin says. “This has made a tremendous impact on the quality of their daily lives. They are connected to friends and family through the VSC in addition to staying engaged and meeting new people through the interactive classes.”

“It’s been an enormous improvement over my past life, as it keeps me in touch with my body, and in touch with the community of people we interact with through the system,” says Janice Baker-Offutt, 63, of Evanston, IL, who has limited mobility due to multiple sclerosis. “I feel less isolated. I use the system for exercises, classes like Tai Chi, memoir writing, and marine biology, and to stay in touch with friends I have met through the program. For example, I couldn’t go to my 45th year college reunion but I was able to participate via Skype through the VSC.”

Not all users are a good fit for the system, says Fiterman Persin: “In our experience, providers serving those with a high level of impairment are not a good fit. Although very easy to use, the technology is too confusing and frustrating to navigate for those with memory issues and who may not easily recall how to use the computer in front of them. During our initial pilot, a cohort with memory loss found the platform increasingly frustrating as their memory deteriorated. In contrast, home care, residential [communities], and geriatric care managers are ‘good fit’ organizations. It can be a wonderful benefit not only to the clients they serve, but also to their communities’ managers, as it provides opportunities for virtual visits, check-ins and reminders.”

Another caveat with such systems is that some residents prefer dealing with live human instructors and presenters. Giddens, for example, says that there were 10 residents of her community that attended a daily Sit and Be Fit-like class led by a live instructor over a 7-week period. That was then replaced with the Sit and Be Fit video recording on iN2L and attendance dropped to 2 regular and 3 occasional attendees because many individuals preferred a live instructor, Giddens says.