PART I. SOCIAL ISOLATION AND BEHAVIORAL HEALTH NEEDS
Drawing upon nearly a decade of telehealth program experiences primarily serving older adult residents of affordable housing communities, and a successful 2016 pilot study that has today expanded to multiple locations, the Front Porch Center for Innovation and Wellbeing has designed a guide to a set of best practices for other providers to establish technology-based behavioral health programs in their own communities.
The impact of social isolation and loneliness among older adults cannot be understated. A 2012 University of California, San Francisco study found not only that 43 percent of surveyed older adults felt lonely, but that only 18 percent lived alone. Similarly, IBM’s 2017 call-to-action research which cited Front Porch among its expert sources, “Loneliness and the Aging Population: How Businesses and Governments Can Address a Looming Crisis,” outlines some alarming statistics on older adults experiencing social isolation and loneliness: 29% increased risk of cardiovascular disease, 64% increased risk of dementia, and 26% increased risk of death. The consequences of loneliness and social isolation extend beyond the individual to negatively affect caregivers, the healthcare system, and the general economy.
While physical disabilities and social isolation among older adults can separately produce enormous personal, social and economic consequences, these issues are not mutually exclusive. A quarter of individuals between the ages of 65 and 74 experiencing a disability live alone, and the proportion increases to more than a third of adults 85 and older living alone and with at least one disability. With an average age of 85 among residents at Front Porch communities, the likelihood of individuals living with a disability or experiencing loneliness is high. Our affordable housing survey similarly found that 32% to 37% of residents lived with hearing loss, vision loss, mobility challenges, or low cognition; 37% lived with 2 or more of these disabilities.
LeadingAge conducted a national survey of its affordable housing members in late 2021 to assess challenges in addressing the needs of its residents throughout the COVID crisis. Their reported noted that “Resident mental health issues came ahead of every other available response, including staffing, funding, inspections, compliance, staffing, vaccine mandates, vacancy issues, fair housing issues, and disaster preparedness,” at 54.7%.
FPCIW conducted its own resident survey across two affordable housing communities during the COVID- 19 pandemic. The mental and behavioral health conditions impacting the older adult residents of these communities include depression, drug/alcohol abuse, distress/anxiety, and loneliness. Our data collected from over 350 residents representing 7 languages pointed to some grim realities exacerbated by the COVID-19 crisis: 48% of residents rated their emotional health as “fair” or “poor”. The study further showed that 43% self-reported feeling lonely “sometimes” or “often”; the Lubben social index tool further revealed, however, that over half (51%) of our residents were at “at risk” for social isolation.
This Playbook is designed to help affordable housing providers to connect with locally available, community-based resources to build sustainable mental and behavioral health programs to identify and meet the needs of residents living with depression, anxiety, and loneliness.