Lisa Marsh Ryerson is president of AARP Foundation, the charitable affiliate of AARP. A bold, disciplined and collaborative leader, she sets the Foundation’s strategic direction and steers its efforts to realize an audacious vision: a country free of poverty, where no older person feels vulnerable. Since she took the helm, AARP Foundation has developed pioneering initiatives, explored new avenues for collaboration, and secured unprecedented funding to support programs that truly change lives.
Frank: Well welcome to the Aging Boomers. I'm your host, Frank Sampson. Of course, on our show we discuss so many of the issues facing boomers and their parents. I want to just thank everybody for tuning in, your support is greatly appreciated. Our listeners are growing each and every day. As I mentioned, we have a great guest today. We have with us Lisa Marsh Ryerson, who's president of AARP Foundation. The charitable affiliate of AARP, a bold, disciplined and collaborative leader. She sets the foundations strategic direction and steers its efforts to realize an audacious vision. A country free of poverty, where no older person feels vulnerable.
Frank: Since she took the helm, AARP Foundation has developed pioneering initiatives, explored new avenues for collaboration, and secured unprecedented funding to support programs that truly change lives. Lisa, it's an honor to have you on our show. Thanks for joining us.
Lisa: Thank you Frank and let me tell you, the honor is mine. It's a real treat to be on the Aging Boomers podcast with you.
Frank: Well great. We're thrilled to have you and I know we're going to talk quite a bit about a survey that you recently conducted that we want to share with our listeners but maybe first you could tell us a little bit more about AARP?
Lisa: Yeah, happy to, Frank. That's such a great place to start and of course I'm pleased that so many of the listeners and people know about AARP and the good work of the AARP. As you said earlier, we're the charitable affiliate of AARP and our mission is to work to end senior poverty and Frank, as you and I will be discussing, this is part of growing issue. We focus on increasing economic opportunity and social connection for low income older adults to be sure that they can secure the essentials in their lives.
Frank: That's fantastic. It's a wonderful organization.
Lisa: Helping low income and vulnerable older adults certainly has been part of AARP's mission from the very beginning and we're delighted to have that mission focused here also at AARP Foundation.
Frank: Yeah, so I know you conducted a study back in 2010 that focused on loneliness and social connections amongst adults age 45 and over. You then conducted a similar study very recently. Can you tell us about what you found?
Lisa: Yes. We fielded the first study at AARP Foundation in 2010 and then wanted to do this eight years afterwards to look at several issues. One reason is that there's a growing body of education and information now, as you and I know, about this very important topic of loneliness and social isolation. We also wanted to think about some changes in the environment. The increased use of social media, for example, and what we would see and of course, we also know that I'm a boomer as well and we know that we have an aging population with more aging older adults. What we found is really interesting. The percentage of older adults who tell us they're lonely is just over a third.
But then again, there will be more older adults who are lonely just based on the total number of individuals who are 50 and older in society. We found some interesting subsets of data within the survey, Frank, that I'm delighted to dig into a bit with you as we go forward. For example, the intersection of low income or living in poverty or moderate income and how much that can increase your risk for social isolation.
Frank: There's a lot of information and you know, as you know, I'm in this industry and we're working with many of those people who are lonely, trying to get them assistance and as you mentioned, low income individuals. It's also mentioned in the study about unpaid caregivers which, you know, that's who we deal with usually on our podcast. I’d like to go ahead and ask you while I have the chance, why do you think these unpaid caregivers are also feeling isolated and lonely?
Lisa: Well, just given your vast background and expertise I want to learn from you on this topic, as well. But I think you and I know and probably listeners, as well, that the caregiving journey can be very, very isolating. You've often taken on your unpaid caregiving role as just one additional role in lives that can be full and very busy already. When you're caught up in the task or journey of caregiving, as gratifying as it is to help those whom we love, you lose connection with your social network. You don't have time to connect to other family members or friends or activities in your community that were important to you. Isolation has many, many factors but is really predominately about the size of your social network and the frequency and quality of contact with it. Think about all the caregivers that you and I have talked with and in particular, with whom you've worked. It’s easy to lose touch with your social network when you're caregiving.
Frank: Yeah and you know, especially those that are caregiving with somebody with cognitive issues. Quite a bit more challenging and I'm not sure if the study got into that or if or when they talked about the unpaid caregivers. Did they talk about people who had family members with dementia or Parkinson or did it get into that level of detail at all?
Lisa: Not that specific but certainly it looked at the whole category of unpaid caregiving. What you and I know is when you're providing care for an older adult in your life, across their lifespan or aging journey, the likelihood now that you will be addressing issues of dementia and other chronic diseases is high.
Frank: Yeah, absolutely. You know, I just recently interviewed someone who has an organization to help educate caregivers on working with the LGBTQ community. It was kind of ironic that I just did that interview recently but that's a category of increase risk for chronic loneliness. Can you maybe expound upon that a little bit as well?
Lisa: Yes, Frank, let's spend some time on this because it certainly is. The study found clearly that in older adults who identify as LGBTQ, there is a 14 percentage point increase in loneliness for that population, which we think of as very significant. It’s important for us to know this as we think about outreach. Just as your previous guest was talking about, planning interventions that truly meet the needs of an individual who identifies as LGBTQ is really important and when I think about it, it also relates to just societal issues and accessing communities to health care, to resources, to activities. Without that access, which can be the case for some LGBTQ individuals over time, they increasingly become isolated. I also know that searching for housing for long-term care has become an issue. There certainly is some dialogue about how difficult it can be for an LGBTQ elder when they look for senior housing and how some might feel that they cannot be themselves.
Frank: Right. Yeah, it's a challenge. I have to say, I haven't seen it as much with caregivers as I see with the other residents, but if they suffer from dementia, it’s possible they could regress slightly in terms of their beliefs and biases. Maybe they changed over time but they're actually going back in time, you know?
Frank: That bias comes back. It's kinda crazy.
Lisa: Yes, you know, that's an interesting way of putting it, Frank, and having loved and lost my parents and having dementia and my caregiving journey, I know what you're talking about when you talk about going into the long term memories. So certainly, just as you described, it’s possible for biases from a long time ago to re-emerge.
Really what you and I are talking about is how not all of the systems or communities have caught up to the beliefs of present day, and there still is some structural or systemic discrimination for LGBTQ older adults. What’s even more important that we're aware of increased risk for loneliness and isolation in that group, and that as we're building models of care, we're building them as inclusively as possible.
Frank: Well and I like to think of the future, and I have to make a prediction and say that when you conduct this survey again in the future, the issue is going to be worse. Because I think more and more people are choosing not to have children, alright? And I think as they age, alright, without children and then they, you know, lose a partner or a spouse or whatever and many are choosing not to get remarried. That's what the statistics show.
Lisa: That's right.
Frank: So I have to ask, did you study show that individuals without a spouse or children were more likely to suffer from higher rates of loneliness, or something similar to that?
Lisa: You know, Frank, you've hit on something. You're right about your predictions in terms of, I would say, the growing number of older adults who will be on their own for a variety of reasons. So yes, it increases, and in doing so it also increases the need for caregivers, right?
Lisa: And in many cases these will have to be non-family member caregivers going forward. Living alone or the death or loss of a partner or someone you're close to in your social network is a key trigger for social isolation. So you're absolutely right that we might see the numbers of those who are suffering from isolation increase, which makes it even more urgent that we pay attention to this survey and to this national and growing dialogue around the issue of loneliness and isolation. I always say we need to grow awareness and educate but then we also want to make sure we're connecting people, right? How many times do we have big dialogues and we don't get to the execution plan?
Frank: Right, and if I may just give my two cents, I’m sure that if you send out another survey like the one you just conducted and ask, "Where do you want to spend the rest of your life?" You know? Well everybody says, you know, why they pay money for a survey, everybody's going to say, "I want to be home."
Lisa: You're right to the tune of 90%+ who want to age in place.
Frank: I'm surprised it's not 100%, you know? But being home alone, especially if you're going to need care, you know, is one of the reasons that, you know, the study's showing what it's showing – an in increase in loneliness. I think we have to do a better job of educating everybody that while being at home is a wonderful thing, it may not be in your best interest physically, cognitively, everything. That doesn’t mean that you’ll be going to a nursing home; there are communities that still offer a lot of independence if that’s something you’re looking for. I was wondering if I could get your thoughts on that?
Lisa: Well, Frank, I think you've really hit on it. Yes the survey data shows clearly that the vast majority of us always say we want to remain at home and be as independent as we can be. But it is true when you think about sometimes the home itself, I think what I hear you saying, and I would agree, can become the cause of increased loneliness and isolation because there you are in a situation where you're unable to reach out to a social network. So imagine if you're remaining in a home where you don't have access to affordable, accessible transportation where you are distant from family members or where you lose friends and loved ones because of death and are unable to rebuild your social network.
Lisa: What's critically important is the ability to maintain a social network over time. People we can count on and who listen to us, who care for us, and that we're able to have frequent contact with that network. Then additionally, it's critical that we have the ability to access what you and I would call the social support, which is everything from access to your community center or your exercise class to quality health care to your grocery store. All of those supports are important.
Lisa: We don't want isolation. I'm agreeing with you. We want to be very careful and thoughtful. And it may be, you know, I know for example with my parents while they were still alive, the first step was to not stay in their home which wouldn't meet their aging needs but to stay within their community where they could still attend the events that were important to them. Still, Frank, as you're saying, they didn't want to leave their house, but it was most important to remain in community.
Frank: Absolutely. I don't know if it was in your survey or I read this in another one, but it had to do with social isolation showing that it's been found that social isolation is more of a health risk than obesity. And the health risk of prolonged isolation are equivalent to smoking 15 cigarettes a day.
Lisa: That's right and it was in the study. It's been in many studies. The 15 cigarettes a day was a separate study but one that I quote frequently and know Doctor Julian Holt-Lundstat, the researcher on that study. But it draws this very fine point on an issue that is this growing public health concern so think about it. If the negative health outcomes are the equivalent, worse than obesity, bad for cardiovascular health, sustained loneliness has a very high percentage rate of early death. Smoking 15 cigarettes a day, we all know that benefits of finding sustainable solutions will be incredible, not just for the individual but also for communities.
Frank, I also want to share with you, not sure if you've had a chance to access it yet, but there was a very important study that was published by AARP's policy institute earlier this year and it was looking at medicare spending and of the about four million medicare participants who are found to be socially isolated, the annual increase in medicare spending is 6.7 billion dollars a year. And on an individual level it's 134 more dollars per month on the individual so I think we need to solve this because it's the right thing to do because the health impact is so negative for individuals and because if individuals are isolated, we lose their contribution in our communities. But also, the health care costs and those consequences are significant, as well.
Frank: Right so I know we won’t be able to solve this problem here and now, but we can certainly talk about some solutions to it. You know, getting to know ones neighbors certainly can help reduce loneliness and it shows that in your study, right? Talk to us about AARP's Foundation and some of the tools that you have to help with this challenging issue.
Lisa: Thanks for allowing me that opportunity, Frank. I want to start with being a good neighbor, which is so important and pretty easy if each of us in our communities nationwide decided that we would be more mindful neighbors and be on the lookout for older adults who could be lonely or isolated or in need. It would go a long way toward solving this problem. The study showed that for older adults who do not know their neighbors, 64% of them are lonely compared to only 25% who know their neighbors. So knowing that with our survey, the foundation participated earlier in September, on September 28th, what is National Good Neighbor day as a way to educate all of us across the nation to look out for our neighbors, to knock on our neighbors door, ask people how they're doing, have a cup of coffee, take someone to run their errands, for example.
We have proof that being a good neighbor and having good neighbors is important for health outcomes. So that's one area where we are kind of condensing that into a platform. I would want listeners, if they're able, to go check out connecttoaffect.org, which is a platform that demonstrates AARP Foundations long term commitment to addressing this growing issue of social isolation and on it, listeners will find articles, research, also an assessment tool. Very easy to take if you want to know what your risk factors are or what your level of potential isolation is. Or you could take it for a loved one if you're a caregiver or concerned about someone. Then, Frank, you can put in your zip code and be connected with resources in your community, direct resources. So I think that's a good option.
You've heard it absolutely accurately and we're really seeing this platform as a collaborative initiative. We worked in collaboration with some organizations, with the Gerontological Society of America, with N4A, with Given Hour and with United Health Group and many, many other organizations who are providing their expertise, research and just practical solutions or evidence based solutions that are working in communities. For example, listeners will find videos that sort of growing movement of community choirs, where older adults are finding that if they take that first step and reach out and continue with a hobby or a passion, they can address the isolation or loneliness that's existing in their lives.
But we're also innovating, Frank. I'm curious to know, given your vast background, what you're seeing in senior housing in particular or with individuals you're working with. So for example, in the area of technology the study confirms, I think, what we all intuitively know, which is that technology is very important to facilitate connection. So learning to use Facebook or FaceTime, being able to remain connected to resources through the internet really helpful for isolated older adults but it's no substitute for one on one or human connection, which we need in order to thrive. We're looking at technologies such as voice activated technologies and in particular, have a pilot project going where a voice activated tool are installed in low income or senior housing and both activities directors and residents are trained on the use and then the voice activated technology. I call it a leapfrogging technology because you just have to have your voice to use the technology, can cue residents about activities that are taking place or meetings that are happening or residents can stay in touch with music that they love and invite their friends in. So that's an example of something interesting.
Frank: I'm seeing more and more assisted living communities, even smaller residential care homes around the country, you know, making sure that they have caregivers that are trained to work with the residents so that they can use FaceTime or something like that to connect with grandchildren, or other relatives, and it makes a huge difference. These are mainly privately owned organizations and their business is going to grow by doing that, so I think what you're saying is absolutely correct. I mean, it just needs to be done. It needs to be done.
Lisa: It really does. We have also been studying how the lack of access to reliable, affordable transportation is a real problem for people. As you age, if you have issues with mobility or you're not driving any longer and are cut off from these services, it can really take a toll on your social life and who you get to see and interact with. So we've been running a research project with USC and Lyft and United Healthcare to provide for a period of months unlimited rides using ride hailing apps. By training older adults who are isolated to use the application or they can call in and do it not through the app but by phone. Older adults are using this to get to their doctors appointments and to do other important things in their lives, but also just to go out to lunch or meet a friend for coffee, which as we just discussed is also very important. The findings are showing an increase in connection for the older adults who are isolated and have access to transportation. So long way of saying it is, it’s true we need to work on transportation and that we need to be sure that individuals can make their own choices, you know? As we age we want to tap into our own agency to continue to enjoy what we love.
Frank: Yeah and I'm seeing more small companies starting up to fulfill that type of need in communities. So I know you said you're working with Lyft, I've heard of Uber doing some things to try to also, you know, hit the senior community and help them as well. So you know, us boomers, we're pretty demanding and I think that people are becoming more and more innovative. Now before we end I do have one thing that I'd like you just to share with our listeners and that's how can people get involved with your organization whether it be just their own time to help, maybe they want to help financially. Share how people can do that.
Lisa: Yeah, many, many ways. One is we want to tap into people's good ideas because we do believe that co-creation and innovation is a way forward so know that we're easy to find at AARPFoundation.org and communicate with us. Information about organizations that are doing great work, ideas that people have. As you said, and I appreciate it, Frank, we're a public charity and we fuel our work based on donations. So for those who are as passionate as we are about ending senior poverty and ending loneliness and isolation among older adults we appreciate your financial support, as well. We also need volunteers always at the foundation. Volunteering itself is a way for us as individuals to remain healthy and connected. So plenty of volunteer activities, whether it's tutoring school children in an underserved school where we run a program called AARP Foundation Experience Core, serving as an AARP Foundation tax aide volunteer or many other ways. Then for the listeners who are clinicians or involved in the many roles that make up health care across this nation, know that we have on our mind a desire to grow education on this topic and to think about possible screening, you know?
What the survey showed is that very few individuals are ever talking about whether or not they're lonely or isolated with their physicians or clinicians, and so we're very much interested in growing the dialogue about what would be effective screening tools as importantly, we all know we can't screen if we don't intervene.
Frank: Great. Lisa Marsh-Ryerson, from the AARP Foundation. Lisa, thank you so much for joining us. Wealth of information and I want to just thank everybody out there for joining us, as well, on the Aging Boomers. Just be safe out there and talk to you all soon.