At midmorning, Lisa Carfagna, a marketing staffer for the 92nd Street Y in Manhattan, took a brief break from working at home on Long Island and called the Rubins on the Upper East Side.
They were doing fine, Seymour Rubin, 89, assured her over a speakerphone.
“We try to have a project every day,” said Shirley Rubin, 84. “Today, I’m making a beef stew for the first time in 40 years.”
“If I’m here tomorrow,” her husband put in, “you’ll know it was good.”
When the coronavirus outbreak forced the Y to shutter last month — leaving participants in its senior program bereft of their usual lectures, classes and exercise programs — about 70 staff members quickly volunteered to make weekly calls to all 650 of them. Ms. Carfagna regularly checks in with 25.
Like many cultural organizations, the Y has turned to digital technology — streamed concerts and lectures, classes on Zoom, discussion groups via conference call — to keep its older patrons engaged.
But computers and smartphones can feel daunting; about a third of Americans over 65 told Pew Research they weren’t confident about using digital technology. About half said they needed help in setting up new devices. Some seniors lack broadband connection.
Besides, “there’s something about that live, person-to-person connection,” said Julia Zeuner, who directs the senior program and mobilized the volunteers. “A friendly voice on the other end of the line.”
Social isolation and loneliness among older adults have become such a concern that two years ago, the National Academies of Sciences, Engineering and Medicine assembled an expert committee to analyze research findings and make recommendations.
Its report arrived in late February — as the coronavirus spread.
Now, older people have been sternly warned to adopt the very practices that, the committee found, can endanger their health. With senior centers, day programs, theaters, parks, gyms and restaurants closed and most in-person visiting prohibited, they are enduring a lengthening period of social separation. Nursing homes and assisted living facilities are barring family members.
“It’s a public health crisis that should be recognized,” said Colleen Galambos, a committee member and a gerontologist at the University of Wisconsin-Milwaukee. “People who normally wouldn’t be considered isolated or lonely are now experiencing it.”
These are not the same state, the National Academies report pointed out. Social isolation refers to an objective lack of social contact with others; loneliness, a subjective sense of being left out and ignored, can strike even when people are surrounded by others.
By itself, aging doesn’t create either problem. But it raises the risks. “Many older people, especially women over 75, are living by themselves because their spouses died,” said Dr. Dan Blazer, the committee chair and a psychiatrist at the Duke University School of Medicine.
Retirement, difficulty driving, hearing and vision loss, cognitive or physical problems that make getting out difficult — all contribute to a troubling tide of disconnection.
About a quarter of people over 65 living independently in their communities are considered socially isolated, and 43 percent of those over 60 report feeling lonely — and that was before public health officials instructed older people, and everyone else, to stay home.
“It’s not just touchy-feely stuff,” said Dr. Ken Covinsky, a geriatrician at the University of California, San Francisco, who has been a co-author on studies on loneliness. “Isolation is a real risk.”
In fact, it’s associated with significantly higher rates of heart disease and stroke and a 50 percent increased risk of dementia, the National Academies report pointed out. Isolated or lonely seniors report a greater incidence of depression and anxiety.
They suffer a mortality rate comparable to that linked to smoking, obesity, excessive alcohol consumption and physical inactivity.
When the committee looked for promising solutions, it found studies showing that attending exercise programs helped reduce isolation — not a useful approach at the moment. The evidence for much-heralded technological approaches, from robotic pets and Zoom to voice-activated assistants, remains thin thus far.
How, then, to help older people maintain their social connections when they’re supposed to be socially, or at least physically, distanced? Individuals and organizations around the country are proposing and trying a variety of tactics.
Dr. Covinsky, particularly concerned about restrictions on visitors to older people at home or in senior facilities, has suggested that as coronavirus testing becomes more broadly available, family members or friends who repeatedly test negative could become “designated visitors,” permitted to spend time with their quarantined loved ones.
“We have restricted something that’s pretty essential,” he said. “We need to move away from thinking of visitors to old people as optional.”
In Southern California, two PACE programs — federally funded efforts to provide full medical and social services for those aging in place — have leased tablets called GrandPads for their roughly 250 participants. Designed for those over 75, the devices allow seniors to call the PACE center, receive and reply to email, and receive video calls from PACE staff members (and play games).
At the Queens Public Library in New York, program assistants are calling about 50 homebound patrons each week to remind them of programs available by phone and to check on their well-being, said Madlyn Schneider, the older adult coordinator.
In Los Angeles, the Motion Picture and Television Fund has fielded a groundswell of new volunteers for its Daily Call Sheet program, which matches them with older people who share their entertainment industry backgrounds.
The volunteers, once vetted and trained, call once or twice a week. “It’s reminiscing and connecting and fundamental human conversation,” said Dr. Scott Kaiser, the geriatrician who established the program.
The Friendship Line in San Francisco similarly operates a “warmline,” though without the industry link. It has also seen a surge in users, and so many new volunteers that it has resorted to a waiting list.
Dr. Blazer reports that the drivers delivering Meals on Wheels to his 96-year-old mother-in-law in suburban Atlanta, instead of just dropping off food as usual, now tap on her door and chat from across the hallway of her independent living building. “They have a conversation from six feet away,” he said. “She says it makes a huge difference.”
However heartened by such efforts, Dr. Blazer cautioned that “social isolation isn’t going away.” He worries about what will happen when some degree of normalcy dawns — and millions of isolated or lonely elders recede from public attention.
“We’ll find ways to adapt to this, but my hope for older people is that we don’t forget them,” he said. “If this epidemic has taught us anything, it’s that we have to reach out.”
Individuals can do that, too. My friend Peg Rosen, a freelance writer in suburban New Jersey, has begun FaceTiming with her mother-in-law in Manhattan every morning.
They work the New York Times crossword puzzle together, just as they used to on Sundays in a city coffee shop, a pleasure now forbidden them. (To subvert generational stereotypes, it’s Ms. Rosen, 56, who prefers doing the puzzle on paper; the 87-year-old is using her tablet.)
