Closing the door on isolation

WORCESTER - Anna Daboul, 86, of Worcester, sat at a desk in the brightly decorated lobby of Beaumont Rehabilitation and Skilled Nursing Center on Plantation Street. Adorned with festive red antlers, she was selling raffle tickets for a basket of holiday gourmet treats, with proceeds going to support the residents' activities fund.

Make no mistake. This is largely a nursing home. But it appeared to be a far cry from the stereotypical institutions of yore where solitary residents waited out their sunset years.

The holiday season typically brings more visitors to seniors living in nursing homes and assisted living facilities. While it's a bright spot on the calendar, addressing loneliness and isolation year-round among residents has become a prominent focus in the senior care community.

"We have entertainment, we have bingo, things like that," Ms. Daboul said. "Lonely? No. We all get together."

Loneliness and social isolation have been associated with depression, deteriorating health, cognitive decline and higher mortality rates in older adults, several studies have found over the past few years.

"Loneliness is a terrible thing. And it's not just at the holidays," said Robert P. Dwyer, executive director of the Central Massachusetts Agency on Aging.

While many families and friends pay devoted attention to loved ones in nursing homes, he said, "there are families that simply dump their elders in the nursing home and never go see them."

It's a problem facing a growing portion of the population, as the baby-boomer bulge and longer life expectancies have pushed the number of Americans age 65 and older to 46.6 million, or 14.5 percent of the population in 2015, according to the U.S. Census Bureau.

Living arrangements have changed, too, leading to more isolation. According to a 2013 briefing paper for the Council on Contemporary Families, 100 years ago, 70 percent of widows and widowers moved in with their children. Today 38 percent do. A full third of older Americans live alone, rising to 40 percent for those 85 and older.

"In our typical medical model, we don't think of subjective feelings as affecting health," University of California at San Francisco researcher Carla Perissinotto said in a press release of a 2012 study on loneliness among the elderly, published in the Archives of Internal Medicine.

That approach is changing.

Edmund J. Taglieri Jr., executive director of the 164-bed Beaumont facility in Worcester, said, "We think of the nursing homes today as a home. We have four neighborhoods and it's just like they live at home."

Beaumont offers sub-acute care and a unit for residents with dementia as well as traditional nursing home care. It is part of family-owned Salmon Health and Retirement, which has five locations in Central Massachusetts and MetroWest.

The care plan, Mr. Taglieri said, is individualized for each resident. "It's not just medical; there's a psychosocial component."

Once a new resident gets comfortable, Recreation Director Christine Giguere explained, staff members introduce them one on one to other residents and help them find dining partners.

"After no time at all, they're part of the neighborhood," Ms. Giguere said.

Residents who spoke with a reporter talked about how they transitioned to their new home and what they do to maintain social connections.

Eighty-eight-year-old Rita Direda of Worcester has lived at Beaumont for a year and a half. She has nieces and a daughter-in-law who visit often, while her son lives in Hawaii and can come only once a year.

But she keeps active as a volunteer. She helps roll silverware and set up tables in the dining room. A former hairdresser, she helps in the salon with shampoos and taking out curlers. And one of her favorite activities was reading to the children in the on-site child care center, which closed in summer.

"I've lost a lot of my family," Mrs. Direda said. "I think that's why you have to spread yourself out and be friendly with lots of people."

She continued: "Some say, 'Nobody comes to see me.' I feel so bad. When I'm feeling down and I see someone feeling alone, I go over and talk to them. I remember how lucky I am."

Arlene Mastropieri, 79, who moved into Beaumont earlier this year after living in Worcester and Franklin, wasn't so happy at first about her family's placing her in a nursing home.

She said, though, "People here are so nice - the residents and the workers. It's not lonesome."

A big hit at Beaumont has been when Mrs. Mastropieri's son brings her two poodles to visit. The visits started when she was staying for a short time after a hospitalization several years ago. Even after Mrs. Mastropieri was discharged, her son kept bringing the dogs in to visit the other residents, which brightened everyone's day.

"Don't ever, ever hesitate to get a pet," Mrs. Mastropieri said.

At the Beaumont campus in Northbridge, Executive Director Michael Quirk said the integration in one site of the nursing home and rehabilitation facility with Whitney Place assisted living, an adult-day health center and a child care center contributes to the feeling of community.

"It's about facilitating a community of folks. So providing that platform is more important than anything else we do," Mr. Quirk said. "Engagement between staff and residents, residents and residents, and children and residents - it's seamless."

Claire Auffant, 92, of Northbridge, said, "I go every day out to activities."

Although she had originally planned to move into another Northbridge facility where she had stayed previously, which was full, she decided to stay at Beaumont even after a room opened at the other nursing home. "I had made friends here," she said.

"They're good to you. We go shopping at Walmart, we have parties. They keep us busy and happy," said another resident, Betty West, 90, of Northbridge.

To help residents stay connected with family members who can't visit in person, Beaumont has set up computers for email and the big-screen TVs are programmed to allow Skype videoconferencing.

"I used to Skype with Paul (her son)," Mrs. West said. "I'd say take me around your home (with the computer camera) so I can make sure it's clean."

Rudolf Swenson, 97, of Sutton, has care at home from his two sons but comes to the adult day program at Beaumont three times a week. "I can't really feel lonely during the day because we have such a wonderful staff," the retired Worcester firefighter said.

Patricia Bassette, 78, of Sutton came to live in Whitney Place assisted living with her friend who needed care. Her friend died three months ago, but Ms. Bassette chose to stay.

"The people are family," she said. "You can always see when somebody's lonely. I give them a hug."

Bette Lotterman, director of the Salmon Centers for Early Education child care center at Beaumont in Northbridge, said having the children visit with the older residents is part of the program. "It's great for the kids because it's more of a community for them, too," she said.

The avenues for interpersonal connections vary by long-term care facility, of course. And there are few, if any, formal local programs set up for "friendly visitors."

According to Martha Waldron, communications director for the Executive Office of Elder Affairs, volunteer long-term care ombudsmen visit with residents periodically all year and contribute to the state's assessment of facilities. She wrote in an email that they "do try and be sure to connect with those that have few visitors," although that's not their primary role.

The Senior Companion Program, one of two volunteer programs for seniors along with RSVP run by Family Services of Central Massachusetts in Worcester, recruits and trains volunteers 55 and older to visit frail, isolated elders in their homes each week. But because it's funded by a federal contract designed to keep people living independently, it doesn't include visiting nursing homes and assisted living facilities.

"I would believe there is a need," Family Services Executive Director Jim Regan said. "I'd like to see us build up to the point to do that with private resources, to prevent that loneliness and sense of abandonment."

Frances Morrier, of North Oxford, works with the Senior Companion Program and previously volunteered with the First Unitarian Church of Worcester to visit seniors in nursing homes.

"My sense was there was a good number of people who needed company," Ms. Morrier said. "Staff is sort of different from someone from the outside who comes in to spend time with me."

Contact Susan Spencer at susan.spencer@telegram.com. Visit her on Twitter @SusanSpencerTG.