![[ Visit Client Website ]](images/banner.gif)
Social isolation increases the risk of disability and early death (Wesołowska et al., 2017). Individuals who lack social connections or report frequent feelings of loneliness tend to suffer higher rates of serious health problems such as heart disease, cancer, and stroke, which disproportionately affect rural residents compared with their urban counterparts (Brummett et al., 2001; Holt-Lunstad et al., 2015; Kulshreshtha et. al., 2014; Seeman, 2000; Stahl et al., 2017; Wildman et al., 2019). The rural elderly population of Pennsylvania is at an added disadvantage of being unable to routinely socialize because of the geographical distances between communities and neighbors, complicated by limited transportation services. The purpose of this study was to identify the factors that contribute to older adults’ social isolation.
Methods
This study used focus groups to collect qualitative data. Seven focus groups with a total of 35 participants were conducted between July 2021 and November 2021. The final sample included a broad range of frontline case managers from AAA protective services, housing supports, shared housing, OPTIONS assessment, base service unit mental health case workers, and supervisors from AAA and MH/A/DP from 14 counties. The average years of experience among the study sample is 8.85 years with a range of one to 25 years of experience. Focus groups were conducted online using Zoom teleconferencing technology, and each focus group lasted approximately 90 minutes. The focus group narratives were captured by Zoom, cleaned by the research team, and uploaded to Nvivo 12 for data analysis. Repetitive themes emerged during the focus groups, suggesting data saturation.
Results
Six themes emerged that case managers believe contribute to social isolation among adults 65 years and older in rural Pennsylvania: (a) the role of family, (b) transportation, (c) the effects of COVID-19, (d) knowledge of community programs, (e) problems using technology, and (f) access to services.
In the results, case managers discuss and describe the intersectionality of multiple challenges, including health and mental health, the effect of stigma, the challenge for work-displaced families, the difficulty accessing and using technology, problems accessing transportation, staffing problems at partnering agencies limiting the ability to refer people to services, isolating and limiting the effect of COVID on rural elderly by limiting space in senior centers, home care services that address health care and socialization needs of the rural elderly, and difficulty getting information to older adults about programs and how to access them. These problems increase the risk of social isolation for older rural adults.
Conclusions and Implications
Our results show that lack of family support and transportation, limited accessibility of social services and community programs, impacts of health conditions and COVID, and problems using technology all contribute to older adults’ social isolation. We suggest that the government address the transportation barriers by offering free transit or shared-ride programs, expanding and funding the telehealth and case management services, and partnering with the local aging and mental health services to provide more social connection activities to reduce social isolation among Pennsylvania older adults.