I'll quickly go over some of the risk factors that we have from our own research at NICE. We looked at social isolation within the context of age-friendly communities. That is one of my overall suggestions, that we look at how to empower communities to support older adults who stay in their homes. We know that older adults want to age in place; we've heard this a lot. We know that older adults want to not go to long-term care if they can stay within their communities and stay in their own homes and remain engaged.
We know from the literature that an individual who is over 80 years old, who is living alone, who has a compromised health status, who doesn't have a child or a contact with family, who lacks access to transportation, and who has low income or is disabled will be at risk for being socially isolated.
One of the problems that we encountered in the research studies we conducted through NICE on age-friendly communities, and we've heard this from other witnesses as well, is the fact that individuals who are socially isolated are very difficult to identify. They're isolated; therefore, we can't reach them. Often the problem is that when we do reach socially isolated individuals, it's in a state of crisis, so you'll find them in the emergency department. The next problem is that you've identified someone who is socially isolated, you've assessed them for the risk factors and they're at risk of being isolated, so now where do you refer them within the community? What services do you provide to those individuals? Where can you send them?
Within the larger context of social isolation, one of the risk factors we've also uncovered as a result of our work is that little opportunity for engagement within the community is a big problem, but the larger problem that participants from our study also suggested was that it's not mutually rewarding. The programming and the community initiatives have to be mutually rewarding. The older adult has to feel that they're contributing something to the programming and to the community, that the programming is not just for them but that they're able to contribute something back. That's the way we should approach programming.