Robert Torres is the Pennsylvania Secretary of Aging. He recently spoke with Harry M. Baturin, an instructor at Georgetown University/Core Faculty Adjunct Member at Delaware Valley University, and NPO Trustee/Attorney at Baturin and Baturin, about both the social isolation faced by today’s seniors, exacerbated in recent months, and options and recommendations to reduce it.
This interview was conducted via email, and Secretary Torres’s responses are printed here verbatim.
Baturin: Good afternoon, Secretary Torres, thank you for joining me today!
Torres: Thank you for allowing me the opportunity to address this very important subject of social isolation among Pennsylvania’s older adults.
Baturin: Can you shed some light on the concern associated with the social isolation of Pennsylvania’s seniors prior to the onset of these unconventional times?
Torres: In Pennsylvania, there are over 3 million older adults 60 years old and over, making up nearly 24% of our total population. According to America’s Health Rankings 2020 analysis of U.S. Census Bureau, American Community Survey data, Pennsylvania ranked 37 out of 50 states when measuring risk level of social isolation for seniors. Therefore, we were in the bottom half of all states when evaluating risk factors used in this analysis. The factors used to conduct this analysis included whether they lived alone, whether they lived with a physical or mental impairment or whether their socioeconomic status was low.
Other factors that impact social isolation include race and ethnicity, immigration status, English proficiency, sexual orientation and gender identity, and meaningful social engagement with and support from family and the community. The risk of social isolation was an immediate concern for the Department of Aging and our network of Area Agencies on Aging and other partners and stakeholders because we had to order the closing of over 500 senior community centers and nearly 250 adult day centers. Social isolation was very concerning to us because of the resulting significant detrimental health outcomes in older adults compared to other adults, including the increased risk of premature death. Our data validated this concern showing that 7,416 older adults we serve have all 5 indicators of social isolation while 42,021 had four of the five risk factors. These risk indicators are marital status (single, divorced, widowed or never married are all indicators), disability status, lives alone, lives in poverty and number of activities of daily living needs.
Baturin: It follows then, in that these unconventional times have exacerbated the ills of social isolation for our seniors, (which were at critical stages prior thereto), concern may be, quite literally, nearing an all-time high? Is this a correct assessment?
Torres: While the impact of the COVID-19 pandemic on social isolation is difficult to quantify, it raised many concerns for the health and well-being of Pennsylvania seniors, including the increased risk of social isolation and its adverse impacts. This was especially true because of the serious health risks of the virus to older adults, closure of senior centers and adult day centers, social distancing requirements imposed to help mitigate the spread of the virus that essentially forced the isolation of older adults almost overnight and the resulting anxieties and fears that have developed in older adults.
The oldest older adults were of most concern to us as they were already most likely to be at risk due to social isolation prior to the introduction of COVID-19. These individuals are the most likely of any age group to attend senior centers regularly in order to stay connected to their communities. They are also most likely to be at higher risk of social isolation because they mostly reside in urban settings. The pandemic clearly helped to elevate this issue as an ongoing concern.
Baturin: In light of the need for all of us to reduce this social isolation, what steps have been taken by the Pennsylvania Department of Aging to combat it?
Torres: The Pennsylvania Department of Aging and its many partners have taken several steps to address social isolation during the COVID-19 pandemic. First and foremost, we worked with our Area Agencies on Aging and initiated periodic wellness checks on older adults who were now confined to their homes, especially if they were alone.
The Pennsylvania Council on Aging (PCoA), who had been researching and working on social isolation before the pandemic, undertook a survey of 3,700 older adults throughout the commonwealth to assess how older Pennsylvanians were managing during the pandemic and how services could be improved to better support them. Since then, the PCoA Social Isolation Task Force restructured pre-COVID-19 committees into three committees with the following focus:
- Risk Reduction – create a guide specifically for older adults to navigate “open” communities, while working within Pennsylvania Department of Health and CDC guidelines and being more responsive to specific needs of older adults, such as continued accommodations in retail environments.
- Socialization – gather resources, at the local level, and look at programming that can help combat and mitigate social isolation.
- Technology – work towards digital connectivity for older adults across the commonwealth, through legislation, programming and partnerships.
The Department recently prioritized identifying individuals at risk of social isolation, based on data gathered in our case management system. This was done to help us initiate and provide person-centered interventions to reduce social isolation. These interventions, that will be measured for effectiveness, include:
- Leveraging assistive technology, training and improved connectivity for older adults and individuals with disabilities
- Developing intergenerational service partnerships through engagement with various state university students and faculties from schools of social work, recreational therapy, public health and behavioral sciences
- Developing and supporting peer telephone programing
- Conducting Person-Centered Counseling
Baturin: Other recommendations include (1) Designated visitors conducting weekly scheduled visits; (2) Providing devices to seniors to foster interactive communication and games online; and (3) Specially designated shopping time frames, to reduce the fears of seniors who are reluctant to shop in person. Any thoughts on these recommendations and do you have any additional recommendations?
Torres: These recommendations are reasonable to protect both the older adults and staff who engage with them. They also align with some of the recommendations from the PCoA Report and other initiatives that the Department is supporting. The PCoA recommendations include:
- Social distancing and testing should be maintained as the most ideal mechanisms to help minimize risk and protect older adults.
- Stores should continue to offer senior-specific shopping hours, drive- through options, and pay-by-phone to mitigate exposure.
- Efforts to connect older adults to technology should be prioritized to help them stay socially connected and so they can benefit from online services like telehealth.
- Programming that addresses social isolation should be developed and made widely available.
We recently partnered with AARP on a pilot project to provide cell phones and tablets to long-term care facilities to help residents increase contact with their family and friends during this period of restrictions on visits.
We are also supporting a first of its kind initiative, organized by a public/private partnership, to engage seniors through eSports and virtual gaming. The Keystone Senior Games will be looking to incorporate virtual gaming as part of its annual Keystone Senior Games program in the near future.
Baturin: Lastly, many of the recommendations to help reduce the social isolation of our seniors involve basic tasks. Couple this with the fact that younger generations for the first time have been compelled to live with some form of social isolation, necessarily increasing their understanding and empathy.
As such, one can see a silver lining emerge from the ills of these unconventional times in that the general public may become more motivated to reduce the social isolation of our seniors. Do you anticipate a meaningful increase in the general public’s contribution to reduce the social isolation of our seniors (given the heightened awareness by the general population) or, are you concerned with the opposite, a lack of interest as things return to normalcy?
Torres: The overwhelming concern about social isolation of seniors during this pandemic emergency has raised the level of awareness of the problem and interest, from both the public and private sectors, in helping to address it. The challenges we face with social isolation existed before the pandemic, has been magnified during the pandemic and will exist after the pandemic is over. However, this experience has created opportunities to adapt and innovate how we deliver services to and support our seniors.
We are creating new partnerships and leveraging technology solutions that will empower older adults to connect and enrich their lives in ways they may not have imagined before this pandemic. It has been an incredibly challenging time for older adults and those who serve them. However, I believe our Department and aging network providers will emerge from this experience stronger than ever. Governor [of Pennsylvania Tom] Wolf has challenged all of us to take our lessons learned during this emergency and translate them into meaningful changes on how we deliver services. We are working toward that new future together with our many partners and interested stakeholders.
Harry M. Baturin, Esq. teaches at Georgetown University in their Summer and Special Programs. He is also an Adjunct at Delaware Valley College in their Graduate Policy Studies Program. He is a Managing Trustee of a Charitable Trust and has a background practicing in non-profit, estates and business and taxation law at Baturin and Baturin Law Offices, established in 1917. He was a Guest Instructor at the Penn State University Dickinson School of Law for the Elder Law Seminar with Professor Katherine C. Pearson, Esq., an Instructor at the Delaware County Community College, and clerked at the Philadelphia Law Department covering tax and real estate issues prior to practicing.
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