Isolation is Big Health Risk for Seniors. But There's Community Online

Originally published June 26, 2017

Orazgul Tachmuradova, age 71, emigrated to the United States alone, about a decade ago. Learning to get around San Francisco wasn't easy.

“My eyes are not good, my hearing’s not good, my English is not good,” is how she puts it. Having grown up in a rural area, surrounded by family,  she was “slowly dying of disconnection.” 

“This world does not belong to me; I do not belong to this world,” she recalls feeling.

But recently, things have been looking up, thanks to a new high-tech relationship.

“The iPad is like a genie,” she says. She mimes pressing a button: “Hello, Siri? Tell me this one!”

Tachmuradova and Siri started conversing during a year-long pilot project, now coming to an end, at San Francisco’s Curry Senior Center. Seventeen seniors were given iPads, FitBits and digital scales to monitor their health, and to reduce isolation by teaching them how to socialize, learn and enjoy themselves online.

“When I started this program, I was reborn,” says Tachmuradova. “I am becoming alive! More and more now, we are busy. I don’t feel I am alone. I live alone without being alone.”

All of the program’s seniors live alone, and most are very low-income.

“Some people felt isolated, technologically-wise, because they didn't know what other people were doing on the internet,” says Angela Di Martino, who teaches the weekly class on how to use the devices. “Now I think they feel a lot more comfortable because they have that knowledge.”

Di Martino devoted early lessons to finding trustworthy medical information on the web, emailing your doctor and checking lab results online. Her students have also been introduced to an array of social tech tools; some of the group’s favorite are FaceTime and Skype for video chatting and Messenger for sharing photos. Many in the group use their iPads to tune in the radio or podcasts, and one has her own YouTube channel.

The last few classes have been devoted to iPad photography, so today everyone is editing their best shots. In one corner, Marilyn Chan and Shirley Smith keep leaning over to see what’s happening on each other’s screens. Chan is polishing up a selfie of the two of them making the most of Ben & Jerry’s Free Cone Day. Across the room, Linda Rospendowski, 68, is contemplating a photo of herself in a hot pink dress. But she has a problem: The photographer has chopped off the top of her head, and she's wondering if you can digitally repair hair. 

“The bouffant—it has to be there,” she says.

America: Getting Old

As baby boomers head into their 60s and 70s, advocacy groups are now exploring the benefits of this kind of tech education for seniors. Prime candidates are elderly people who live in rural areas, are estranged or live far from family, or have health or mobility problems that make it difficult to get around.

Lisa Marsh Ryerson, president of the AARP Foundation, a charitable affiliate of the advocacy group for seniors, points out that 10,000 Americans turn 65 every day. But despite their numbers, baby boomers don’t always feel like they’re aging together.

“As many as 40 percent of adults who are 65 or older say that they experience significant loneliness,” says Ryerson.

Loneliness isn’t quite the same thing as being alone, but both can influence health. “Loneliness is something that is subjective. It’s our own perception of our experiences,” says Ryerson. It is also one measure of distress. Isolation, on the other hand, is an objective metric, “based on the size of someone’s social network, the frequency of contact with their social network and their access to services.”

Isolation can cause health problems even for a person who feels perfectly satisfied with a small or distant network. (Imagine not knowing anyone nearby who can check on you when you’re ill.) Ryerson says isolation is often triggered by loss of hearing or mobility, a move to a new community or a partner’s death, and it’s especially common among those who are low-income or identify as a member of a marginalized group.

To address the problem, the AARP Foundation recently launched Connect2Affect,  a resource portal for older adults and caregivers that encourages online engagement, and includes a study of social connectedness among people over age 62. The AARP Academy also offers free online tutorials for using smartphones, tablets or social media, and for conducting job searches on the internet.

Meanwhile, the National Council on Aging completed its own two-year tablet program, similar to Curry’s. The result? “The more time [participants] were spending on the tablets, the stronger their social interactions, their emotional support, self-esteem,” says Susan Stiles, senior director of product development and strategy for the group.

Getting Seniors Connected

Yet enticing people online isn’t always easy. According to a study released in May by the Pew Research Center, while mobile device use is climbing among seniors, still only about a third own a tablet, 42 percent own smartphones, and just over half have broadband at home. Only about a third use social media.

“There were some fears going into the project,” says Stiles of the NCOA program. “People did not necessarily think that a tablet computer had any relevancy for their lives. They had privacy concerns and were afraid of potentially being exposed to scams.” (Ditto the Curry class, where people asked pointed questions about putting credit card information on their iPad and worried about being unfairly charged when ordering photo prints online.)

For the NCOA program, the trick was helping users find their personal killer app. For a former taxi driver now in his 90s, it was Google Maps. Stiles recalls a colleague asking the man to name some streets on his old route.

“She zoomed in on these streets and his eyes just lit up, " Stiles says. "And then he wanted to go everywhere in New York City.”

For a former B-movie actress, the most alluring app was YouTube, where she found her old film clips.

Tablets seem to be a nice middle ground for those who are skeptical of full-sized computers. You can use voice commands instead of struggling with a mouse or keyboard; they fit neatly into a small living space like a senior apartment; and you can use them while sitting in your favorite comfy chair. “It doesn't feel like this weighty technology object,” says Stiles. “It really feels like a book.”

Designing for Seniors

Pittsburgh-based Breezie, which sells tech solutions for seniors and partnered with the NCOA on its program, is trying to make Android-based devices even easier for new users by offering a service that simplifies a tablet’s interface.

“If you went right now to a Best Buy and if you bought a tablet to give to a senior, there are 43 different settings you would want to change before you make it senior-friendly,” says CEO and founder Jeh Kazimi. He means things that Breezie can pre-adjust, like brightness and volume, consolidating logins, and making the screen more forgiving if you accidentally put your thumb on it. The company is also trying to develop a way to cancel out hand tremor for people with Parkinson's disease, because uneven pressure can make the tablet think a user is swiping when they mean to click.

Caregivers or Breezie staff can also curate each person’s desktop, like providing ready-made YouTube playlists for fans of jazz music or Muhammad Ali’s boxing matches. For an avid gardener, Kazimi says, they might install a few outdoorsy apps “that don’t show you ads every two minutes or ask you to upgrade every three minutes.”

But tablets aren’t a foolproof platform. Kazimi has seen seniors who need stickers to label the camera, volume and charging socket, because the devices can suddenly flip screen orientation, leaving confused people holding them upside down and wondering where the buttons are. Di Martino encountered some unexpected hurdles, too, “like a couple of the men in the class didn't know how to type.” She helped get people comfortable with the touchscreen by offering styluses, which are more accurate pointing tools than fingers. And she encouraged her students to feel OK about making mistakes. “Sometimes I tell them, ‘I don’t know what that button does. Let’s hit it,’” she says.

Dip in Loneliness

The seniors in the Curry program report different feelings about living alone—for example, Kaycee Springer enjoys it and is content using video chat to keep in touch with her daughters long-distance. But she does feel a bit socially crimped in the Tenderloin, where it doesn't always seem safe to walk around, especially at night. And she knows some of her elderly neighbors are extremely withdrawn. “There are people in my building, they just lay around and do absolutely nothing,” she says.

Di Martino has put together some preliminary stats from surveying participants at the program’s 6-month point. Almost all of the seniors said they used their iPad daily. As with the NCOA program, she noted a slight dip in reported loneliness. But the leaders of both projects say it’s hard to know if that stems from people making friends in class or becoming more social online. The AARP’s Ryerson says you might as well encourage both, so that technological and real-world connections reinforce each other. For example, she says, “FitBits are about taking steps. So let’s walk together.”

At the Curry Center, one other result is very clear: Now that the class is ending, nobody wants to give up their iPads. "We just started!” exclaims Tachmuradova.

Springer still finds her tablet hard to put down: “I will put it on my bed—and then I will go, ‘It’s calling me.’”

Di Martino says not to worry—they’re looking into a second phase that will allow everyone to keep their tablets, perhaps in exchange for peer mentoring the next round of students. Now that she’s taught them every iPad trick she knows, their new challenge will be teaching each other.