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Combating social isolation among Iowa's elderly

As the concern for the mental health of older Iowans grows, statewide agencies aim to fill the gaps

Jun 20, 2018 at 10:45 am
    DJ Spilker (left) and Jeri Thomas clean up after clearing leaves from Jeri's garden in Marion on Friday, May 18, 2018. The two have known each other since 1962, when DJ began baby-sitting for Jeri's children, and have remained friends. (Liz Martin/The Gazette)

    D.J. Spilker and Jeri Thomas couldn’t be more different.

    Sixty-nine-year-old Spilker is a type A personality, an active person who is not one to let tasks sit uncompleted.

    Thomas, on the other hand, is very much type B. The 80-year-old is content to spend her mornings in her “nest,” a pool of blankets on her lap while she reads the newspaper.

    But together, the dynamic works for them. They’ve been friends since 1962, more than 55 years, and have found their personalities can complement the best in each other.

    Both Thomas and Spilker live alone in their respective Marion homes, and they check in on each other every day. They often visit one another, as they just enjoy the company.

    One sunny day this past May was no exception. Spilker, who has an itch to landscape but, with no yard of her own, planned to dig up rock along a small retaining wall on Thomas’s back property line and replace it with mulch.


    Thomas planned to clean up an old car in the front driveway to get ready to sell it.

    About 5 miles away in Cedar Rapids, Michael Kelly Sr. converses with people half a world away. With a few clicks on the keyboard, the 76-year-old responds to comments on a post he made on the Facebook page of the Irish Post, a London-based newspaper.

    The computer in his living room has become his lifeline to the outside world. Kelly suffers from diabetes, a disease that has kept him homebound in his apartment for the past five years or so. He only counts a handful of trips outside, all to the doctor’s office, in the past year.

    It’s a situation, however, that doesn’t bother Kelly.

    “I find ways of offsetting the darkness,” he said, referring to occasional feelings of sadness or loneliness. “I don’t feel I have a problem myself. I don’t think ‘poor me’ — if I did that, I wouldn’t be here.”

    Kelly has a very different mind-set than Spilker and Thomas when it comes to their lifestyle after retirement. But they all have something in common — they are using their own means of combating a state of isolation that has become more prevalent among Iowans aged 65 and older, some experts say. This has raised concerns not just on the physical well-being of these older adults, but particularly their mental health.

    “Isolation, to me, would equal depression,” Spilker said. “I know I wouldn’t handle it well.”

    In 2015, Iowans aged 65 and up accounted for about 16 percent of the state’s total population of 3.12 million — for a total of 491,349 — according to the State Data Center of Iowa.

    Of those older Iowans, 45 percent lived alone, according to the state data center.

    Living alone, or spending the majority of their time alone, is not an issue most of the time, said Mercedes Bern-Klug, director of the University of Iowa’s Aging Studies Program.

    But when it’s forced isolation, due to a change in lifestyle or other unforeseen circumstances, that’s when individual health concerns can rise, Bern-Klug said.

    Social isolation is defined as the complete, or nearly complete, lack of contact between an individual and society. Older adults — especially those who experience mobility issues or have transportation barriers — are most at risk for this condition, which can have significant effects on an individual’s health.

    Studies, such as a 2011 article published on the U.S. National Library of Medicine website, have found that “social isolation was as strong a risk factor for morbidity and mortality as smoking, obesity, sedentary lifestyle and high blood pressure.”

    In addition, the impact on one’s mental well-being can be severe.

    Nationwide, according to the Centers for Disease Control and Prevention, it’s estimated that about 20 percent of Americans aged 55 and older experience some type of mental health concern.

    " a heartbeat, I can see where you might become depressed.”

    - Jeri Thomas

    80-year-old Marion resident


    Although the rate of older adults with depressive symptoms tends to increase with age, “depression is not a normal part of growing older,” the CDC states. Eighty percent of cases are treatable, but “depressive disorders are a widely underrecognized condition and often are untreated or undertreated among older adults.”

    “Depression can be tied back to how isolated people are and the connections they have with others,” said Donell Doering, director of operations for the Elderbridge Agency on Aging in Mason City. “Connections are so important. If you lose social connections or network of friends or families or whoever, that can lead to depression.”

    Those who deal with elder populations within Iowa, including Doering, said it’s “clearly an issue” here.

    These experts could speak only anecdotally on the effect of social isolation on mental health, as there is no hard data to measure isolation.

    But what impact is seen has been enough for organizations and agencies across the state to create programs and initiatives — tailored to the needs of the region and the senior population living there — aimed at minimizing isolation.

    However, challenges remain. Services are more readily accessible to residents in urban areas, leaving their rural counterparts more at risk, Bern-Klug said.

    “Depending on the type of community the person lives in, the experience of older adulthood will be different,” she said.


    Elderbridge is one of six Area Agencies on Aging in Iowa, each meant to provide information, programs and services to older adults that help maintain their health and independence.

    Elderbridge is the largest geographically, covering a 29-county mostly rural region in northwest and northern Iowa that stretches from Lyons to Mitchell counties, from the Iowa-Minnesota border southward to Guthrie County.

    The majority of the Elderbridge clients live in small towns or in solitary farmhouses, and almost all want to stay where they are, Doering said.

    But for those who experience mobility issues, declining vision or financial constraints that have left them without the means to drive a vehicle, these seniors find themselves “trapped at home,” Doering said.

    Programs — such as LIFTS, a transportation service for elderly and disabled residents in the Cedar Rapids metro area — have been created in the past several years to address some of the needs for transportation.

    But federally or state-funded programs don’t always address the entire need, and it’s costly for local agencies to take on that task, said Hollie Kane, director of Central City Senior Dining. If someone does call a LIFTS bus for a ride, she said, that individual could be left at the doctor’s office for three hours, waiting for a ride home.

    “I’m always getting calls from people at home (asking) if I know somebody because they don’t have a ride,” Kane said.

    Thomas, the 80-year-old Marion resident, was a school bus driver for the Linn-Mar Community School District for decades. Even after retirement, she finds comfort in aimlessly driving and exploring places she hasn’t seen.

    “When they take the keys from me, that’s when it’ll go downhill (for me),” Thomas said.

    Thomas’ fear is one Linda Madison knows about. The 67-year-old recently gave up her car and moved to an apartment in an independent senior housing facility in Spencer in northwest Iowa.

    Madison’s daughter, who lives about 11 miles away, was driving her to the grocery store. Eventually, Madison’s daughter burned out, said Nancy Ketcham, elder rights specialist at Elderbridge.

    Elderbridge was able to help. About a year ago, it began piloting a program called Errand Buddy, offered through its not-for-profit Elderbridge Alliance.

    Every other week, Ketcham, as an Errand Buddy volunteer, picks up Madison at her apartment and takes her grocery shopping. Sometimes they go to the drugstore or do some clothes shopping.

    Ketcham and other volunteers offer other personal assistant-type help to seniors who face barriers performing these tasks for themselves.

    It’s made a world of difference for Madison.

    It’s a relief, she said, to have transportation duties taken away from her daughter, so the two of them can spend time together that isn’t focused on caring for Madison.

    “My daughter gets to be a daughter,” Madison said.



    Mealtime provides another chance to address social isolation.

    The well-known Meals on Wheels program provides home-delivered and congregate meals in Cedar Rapids, and Linn County offers a congregate meal site in Central City, which also delivers meals.

    The home-delivered meals offer nutritious food and a daily check on seniors whose mobility is limited, said Jill Sindt, interim co-director of the Heritage Area Agency on Aging in Cedar Rapids.

    Central City serves around 200 congregate meals per month, five days a week for anyone 60 and older. Because of misconceptions about the meals — such as they’re meant only for the poor — the program has added a salad bar as well as activities after the meal, to emphasize the social aspects of sharing meals.

    Linn County, through the Heritage Area Agency on Aging, recently received a two-year federal innovation grant to “spruce up the senior dining site” in Central City.

    The grant — from the Administration for Community Living, part of the U.S. Department of Health and Human Services — provides $168,000 over two fiscal years.

    The grant — in addition to revamping the Central City site — aims to increase attendance at congregate meals, which has declined in recent years, said Kane, of Central City Senior Dining.

    Toward that goal, Heritage, after studying the demographics, decided to open two new congregate meal sites — one at Lowe Park in Marion and the other at the Marion Public Library. The new sites are called Encore Cafes.

    The May 11 opening of the Encore Cafe at the public library almost felt like a restaurant’s grand opening. There was much applause, and much anticipation for the delicious-smelling food. Marion Mayor Nick AbouAssaly offered brief remarks and cut the ribbon with a giant pair of scissors.

    “The library noticed that they were seeing a group of older adults congregate there, and Lowe Park had a group of older adults that were congregating there to play cards and bingo,” Sindt said. “So,” she added, “we’re going where the people are.”

    D.J. Spilker and Jeri Thomas were among those at the Encore Cafe opening in Lowe Park. They hope to go back.

    They do think about the possibility of becoming homebound and isolated, should they lose their mobility.

    “The isolation can happen so easily,” Spilker said.

    “And in a heartbeat,” Thomas added. “I can see where you might become depressed.”

    But for now, they are doing what they can to keep that possibility at bay.

    Spilker has just signed up for pickleball classes and plans to take Thomas out to a Marion court for a few games this summer.

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    This story appears in the June 24, 2018 edition of the Iowa Ideas magazine. Find it in The Gazette, or single copies and subscriptions are available for purchase at

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