Senior Peers Provide Companionship to Homebound: New York City Program Addresses Social Isolation in Older Adults

Individuals of any age group benefit from being socially connected: having friends, outside activities and people to talk to. Older adults, especially those with a mental illness, potentially have more difficulty remaining connected because it is easier for them to gradually lose their social relationships as a result of their illness or as they retire from their jobs and physically challenging social activities. Many studies, old and new, have found that older adults who adjust to later life transitions by remaining socially active are happier and healthier than those who don’t engage in social activities (Cavan et al. 1949; Lemon, Bengtson, and Peterson 1972). While it is not easy for many seniors, especially those who are home bound to remain socially active, there are very few programs that address social isolation. This article highlights an exciting program in New York City that tries to address loneliness among homebound seniors.

Despite how aware we are about the importance of being socially connected, the truth is that most older adults eventually lose many of their relationships due to retirement, relocation, or a death of a loved one. Mullins and Dugan (1990) say that individuals who are 65 and over are at higher risk of becoming socially isolated with advancing age than younger adults. Compared to several decades ago, changing family structures and cultural shifts have compelled many seniors to live alone. A study on seniors living below the poverty line (Klinenberg. Pg. 32) concluded that of all seniors living alone, one out of three do not see friends or neighbors for as long as two weeks at a time, and one out of five have no phone conservations with friends. The Baby Boomer generation, which will be the largest cohort of seniors ever, is expected to be at even more risk for social isolation than their parents.

Sadly, even in a place like New York City that has over eight million people (almost a million of whom are seniors age 65 and above), as many as thirty five percent of them live alone (United Neighborhood Houses, 2005). And even in densely populated areas like upper Manhattan, the South Bronx, central Brooklyn, and portions of lower Manhattan, many seniors live in isolation.

As mentioned earlier, older adults who suffer from a physical or mental disability are usually even further isolated from the rest of the community. Many are unable to travel, or the nature of their illness prevents them from initiating and maintaining social relationships. Reports estimate that roughly forty six percent of New York City’s seniors live with a physical or mental disability. The New York City Community Health Survey (2009) showed that thirteen percent of the City’s adults 65 and older reported a history of diagnosed depression. Many more seniors remain undiagnosed because they are reluctant to seek help or because they don’t have access to screening and treatment.

To address the mental health needs of older adults, New York City currently has about 120 publicly funded mental health programs throughout its five boroughs. More than half of the programs provide treatment for mental illness and the rest provide a range of services from outreach and advocacy to case management and rehabilitation. A few of the latter group of programs try to address social isolation by providing outreach and recreational opportunities for their senior members. Among these few programs is a unique Peer Volunteer program called the Baruch Elders Services Team (BEST) run by Grand Street Settlement. Located in a primarily Hispanic, Asian and Jewish neighborhood in New York City’s Lower East Side, Grand Street Settlement offers a continuum of innovative programs from early childhood and youth development to community support for adults and seniors. Established in 2003, BEST is one of the several recreational and socialization programs for seniors offered by the agency. It is located in the Bernard Baruch Houses’ NORC (Naturally-Occurring Retirement Community) environment, the largest public housing complex in Manhattan, and has senior Peer Volunteers serving home bound senior clients.

BEST, designed after the evidence-based Peer Support model, has an active 18-member Peer Volunteer Corps that live in the Bernard Baruch Houses. They serve around thirty homebound, frail, and socially isolated seniors, 95% of whom are Hispanic. The majority of Peer Volunteers themselves are of Hispanic origin and all are fluent in Spanish. The average age of a Peer Volunteer is 70-72 years and many are women. About half have a history of depression and most suffer from physical ailments like arthritis and diabetes. The Peers receive extensive training on mental health and other related issues when they are first hired and continue to receive refresher trainings throughout the year. They do home visits, go to medical appointments, run small errands and make frequent phone calls to their clients who are in their 80s and 90s. The majority of the senior clients also have a history of depression and suffer from various physical ailments. In exchange for their small stipend of $50 a month, the Peer Volunteers are expected to work only about 12 hours a month. Nevertheless, almost all of them voluntarily put in many more hours without any additional compensation. Case Managers and Clinicians at Grand Street Settlement refer clients to the BEST program and Lead Service Volunteers coordinate Peer activities. Peers have supervision with program staff twice a month and staff is also available to assist them with any challenges encountered during their meetings with clients.

Many of the Peer Volunteers have worked with the program for several years and say that their work is very rewarding. They tend to visit their clients in the evenings and nights when the seniors are less likely to have home attendants or other companionship. They also visit seniors while they are hospitalized. Most Peer Volunteers as well as the seniors they serve shared with us that they have few family members or friends in the city and feel somewhat isolated. Many are widowed. Peers and their clients have lived in the same community for several years and know each other so they find this companionship mutually rewarding. One senior said that her Peer Volunteer is her best friend. Another said that she prefers spending time with her Peer Volunteer more than with her own children because she has more patience and understands how she feels. When asked why they chose to become Peer Volunteers, many replied, “this work helps me overcome my own loneliness” and “it is very rewarding to be able to help someone else.”

  1. Yoshita Pinnaduwa, MA, MPA, is a Policy Analyst in the Office of the Assistant Commissioner, and Pilar Pardon, MSW is a Program Specialist, in the Office of Treatment Programs at the Bureau of Mental Health, New York City Department of Health and Mental Hygiene (DOHMH).

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