Community Connection: How Adult Foster Care Prevents Isolation in Home-Based Care

Home-based care is a critical intervention for preventing social isolation. By moving beyond strictly medical tasks, home care providers address the “epidemic of loneliness” through companionship, technology training, and community reintegration. “Loneliness and social isolation affect more than 1 in 4 community-dwelling older adults in the United States, who may also require long-term care support,” explains a study from Frontiers in Public Health. Home-based care can help. “Most older adults prefer to age in place rather than using skilled nursing facilities.” On the other hand, the study continues, “in-home care is unsustainable due to a shortage of direct care workers and may exacerbate social isolation by confining older adults to their homes.”

In Massachusetts, Adult Foster Care — home-based care where a friend or loved one provides round-the-clock in-home care with support from MassHealth — provides a solution for the loneliness epidemic by offering in-home care at lower cost and without relying on a shrinking supply of in-home health aids. What can caregivers do to help prevent loneliness and isolation in those they care for?

In this article we explore:

The epidemic of loneliness among the elderly in America
Some devastating effects of loneliness and isolation
The role Adult Foster Care can play in reversing these outcomes
Key strategies Adult Foster Care providers can use to prevent the risk of isolation
Ways to create lasting community connections

The Epidemic of Loneliness

Social isolation and loneliness are not exactly the same. While social isolation means you have infrequent social contact with other people, loneliness describes the feeling caused by isolation. It’s this feeling that is dangerous. Older adults are at uniquely high risk of social isolation due to several factors due to their limited ability to leave their homes and connect with others. “People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility, and lack of transportation are at particular risk,” notes the National Institute on Aging.

Other risk factors include:

living alone
having small social networks
lacking reliable transportation
mobility or sensory impairments.

As a result, “In the United States, 24% of adults over 60 experience social isolation, and 43% report feeling lonely,” reports Frontiers in Public Health.

While home-based care may seem to offer a solution to these risk factors, and “the policy landscape increasingly supports home and community-based services,” it turns out that a lot depends on the type of home-based care. When the elderly person is visited by a home-health aid just a few hours a week, it “may exacerbate social isolation and loneliness.” Studies show that this type of home-care, with only intermittent interaction with a care-provider, “confines older adults to their homes with limited opportunities for social interaction,” notes Frontiers in Public Health.

The cause of this is two-fold. First, home health nurses are unable to dedicate resources to combating loneliness because the care providers don’t see this as an accepted need for nursing care. And secondly, even if they could provide companionship as a billable service, “the direct care workforce shortage has made it increasingly difficult for families to access reliable and affordable in-home care services,” explains Frontiers in Public Health. This lack of access to social interaction has direct, and devastating consequences on physical health.

“A fertilizer for other diseases”

According to the National Institute on Aging, “Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.”

To put it into perspective, Frontiers in Public Health describes the “impacts of loneliness and social isolation on health” as “worse than smoking cigarettes.” Besides increasing the risk of premature death by 26 percent, loneliness has also been found to increase “cognitive decline, dementia, depression, and cardiovascular disease.”

How is this possible? “‘Loneliness acts as a fertilizer for other diseases,’” explains Steve Cole, Ph.D., director of the Social Genomics Core Laboratory at the University of California, Los Angeles “The biology of loneliness can accelerate the buildup of plaque in arteries, help cancer cells grow and spread, and promote inflammation in the brain leading to Alzheimer’s disease,” continues Dr. Cole. ‘“Loneliness promotes several different types of wear and tear on the body.’”

And the risks aren’t just related to physical health. “Social isolation and loneliness may also be bad for brain health,” explains the National Institute on Aging. “These have been linked to poorer cognitive function and higher risk for dementia, including Alzheimer’s disease. Also, too little social activity and being alone often may make it more difficult to perform everyday tasks such as driving, paying bills, taking medicine, and cooking.”

Filling the Gap with Adult Foster Care

Connecting with community can combat loneliness. According to the NIA, “people who engage in meaningful, productive activities with others tend to live longer, boost their mood, and have a sense of purpose. These activities seem to help maintain their well-being and may improve their cognitive function.”

Adult Foster Care (AFC) provides a powerful solution by fostering connections, building relationships and creating a supportive home environment. At Mass Care Link, we prioritize not only physical care but also the emotional well-being of our members, helping them stay engaged and connected. Adult Foster Care can help reduce loneliness in elderly people who struggle to live alone by:

Reducing Depression:
Regular companionship helps alleviate symptoms of depression.
Increasing Safety and Independence:
Allowing seniors to remain in their homes, which are familiar environments, often creates a more socially connected experience than isolation in a hospital bed.
Providing Personalized Care:
Services are tailored to individual needs to ensure social and emotional, not just physical, requirements are met.

Tips for Preventing Isolation

Caregivers in the Adult Foster Care program can use several layered approaches to keep homebound individuals connected:

Companion Care & Social Interaction:

Beyond medical aid, caregivers provide essential emotional support through meaningful conversation, shared meals, and hobbies like puzzles or gardening. Regular schedules provide a consistent social routine for the senior to look forward to. This companionship with your friend or loved one is their first line of defense against loneliness and isolation.

Technology Enablement:

Caregivers often provide training on digital tools — such as Zoom, FaceTime, or social media — to help seniors maintain existing relationships with distant family. A 2022 study found that “Technology interventions can improve social connectedness in older adults,” especially “ ICT [information & communications technology] and videoconferencing.” Interactive technology can also provide entertainment and cognitive stimulation. Always be vigilant against scams and teach the elderly person in your care how to protect themselves online.

Personalized Care Plans:

A cornerstone of Mass Care Link’s care strategy, these individualized plans provide “a tailored roadmap that addresses each member’s unique needs and preferences.” Effective plans are tailored to individual interests (e.g., music, art, or animal therapy) to foster a sense of purpose and belonging. By incorporating meaningful activities and opportunities for socialization into these plans, caregivers can help reduce the risk of loneliness and isolation. In their Tips for Staying Connected, the National Institute on aging recommends the following examples of suggested activities:

Schedule time each day to contact family, friends, and neighbors in person, by phone, email, video chat, or social media.
Restart an old hobby.
Take a class to learn something new.
Sign up for an online or in-person class at your local public library or community center. Volunteer to help others in your community.
Adopt a pet if you are able to care for them.

Community Reconnection:

Caregivers can also facilitate “social prescriptions” by providing transportation and accompaniment to local events, faith-based organizations, or senior centers. This participation lowers the anxiety and physical barriers associated with leaving the home.

Benefits of Community Integration

Reduced Social Isolation: Active engagement combats loneliness and boosts self-esteem.
Enhanced Mental & Physical Health: Social interaction provides mental stimulation and encourages physical activity.
Improved Support Systems: Building a “local tribe” creates a network for sharing resources and advice.

Strategies for Community Connections

Building community connections in home-based care involves fostering social interaction through local events, caregiver support groups, and leveraging technology to reduce isolation. Key strategies include engaging in neighborhood activities, utilizing transportation assistance for outings, and partnering with local organizations for resources. These connections enhance mental health, promote independence, and create a supportive environment for both care recipients and caregivers.

Leverage Local Resources & Events: Encourage participation in community fairs, festivals, and gatherings to build relationships.
Join Caregiver Support Networks: Connect with local or online groups to share experiences and find emotional comfort, such as The Arc Rhode Island’s “Circles of Connection” for caregivers.
Utilize Technology: Use video calls and social media to maintain connections with friends and family, especially for those with limited mobility.
Incorporate Social Activity in Care Plans: Designate time for community outings, hobbies, and group activities to foster a sense of belonging.
Engage with Neighborhood Services: Utilize community centers, libraries, and local cafes for social interaction.
Build Intergenerational Connections: Participate in programs that bring different age groups together, fostering community integration.
Strengthen Local Partnerships: Home care agencies can collaborate with community organizations, forming advisory groups and organizing town hall meetings to tailor services.

Leverage the resources at Mass Care Link:

Our ability to connect caregivers and care recipients to local resources is right in our name. We are the “link” between individuals and communities. Are you taking care of a friend or loved one at home and need help connecting to community resources or receiving monthly payments from MassHealth? Contact Mass Care Link today so we can start connecting you to the resources you need most.