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Health, Well-Being, and/or Social Connections in a Remote Environment

As of August 31, 2020

As we get older, sometimes we lose interaction with others. During a pandemic like COVID-19 where 

social distancing was encouraged to limit the spread of the virus, social interactions became even more 

difficult. Yet, social interactions are important for one’s health and well-being. Research has shown 

many health benefits to socialization to include:

• Increased appetite

• Delayed memory loss

• Improved self-esteem

• Intellectual engagement and stimulation

• Reduced risk of depression and anxiety

• Improved immune system and cardiovascular health.

Prior to the COVID-19 pandemic, social isolation was already affecting older adults at a rate higher than 

other populations. Twenty-five percent of community-dwelling Americans age 65 years and older are 

considered socially isolated, and a significant number of adults in the United States report feeling lonely.

In fact, more than 40% of seniors regularly experience loneliness, according to a University of California, 

San Francisco (UCSF) study (Holt-Lunstad et al., 2015). This age group struggles with loneliness, isolation,

and lack of regular companionship. Life changes such as disability, retirement, hearing loss, living alone, 

loss of a spouse or significant other, chronic illness and loss of a driver’s license are all factors that can 

contribute to loneliness. Socially isolated individuals have higher rates of infection, diabetes, 

hypertension, cardiovascular disease, and premature cognitive decline. Social isolation has been found 

to be as bad for one’s health as smoking 15 cigarettes a day (Holt-Lunstad et al., 2015.) In addition, 

isolation increases Medicare costs by $6.7 billion per year (Flowers, 2017).

One purpose of the Older Americans Nutrition Program is to promote socialization of older adults. The 

program strives to reduce hunger, food insecurity and malnutrition as well as promote health and wellbeing. Aging experts knew the value of socialization many years ago when they included it as one of the 

primary purposes of Older Americans Act. 

COVID-19 has exacerbated social isolation with the restricted access and closing of senior centers and 

nutrition sites. Social connectivity has nearly ceased with family and friends practicing social distancing 

from their loved ones. In addition, we know based on data from our Nutrition evaluation that 60% of 

congregate participants live alone. The closure of these sites and other distancing measures will likely 

have harmful effects on the health and well-being of older Americans today and in the future. 

Providing social connectivity to now homebound older Americans has become a challenge during the 

COVID-19 public health emergency. With fewer volunteers and a greater number of homebound 

individuals, the pandemic has increased the need for a formalized social connection program. 
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Listed below are different levels of social engagement that can be used to check on older adults or to 

provide a social connection. Each level provides increased engagement with program participants. 

• Telephone Checks

• Automated Telephone Calls

• Wellness Calls

• Comfort Calls

• Virtual Programs

Many excellent programs exist, and this tip sheet only highlights a few. The National Resource Center 

for Nutrition and Aging is an excellent resource for additional programs demonstrating best practices in 

the area of socialization and well checks. 

Automated Telephone Calls 

Overview Participants receive an automated phone call once a day, in an hour they 

pre-schedule. If the person does not pick up the phone after three 

attempts, the service notifies a relative, friend or neighbor to check on 

them. If no one on the notification list answers the phone, the service 

alerts the local police or the sheriff’s office to check on the program 

participant. 

Pros • Does not require staff or volunteer support.

• The only technology required is a telephone.

• Program participant has a daily check-in.

Cons • No “person to person” contact which allows the caller to ask 

questions and no feedback on the health and well-being of the 

participant.

• If the automated calling system fails, a participant could “slip 

through the cracks” since there is no human touch point.

Learn More • Maryland Senior Call Check Program

Best Practice • Senior Call Check Program, Maryland Department of Aging, 

Baltimore, MD
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Wellness Calls

Overview Wellness calls are a volunteer-based effort that connects isolated older 

adults to friendly volunteers via the telephone. Callers contact program 

participants one to two times per week and they ask questions around their 

health and well-being. Talking points are focused on how the person is 

doing physically and emotionally vs. a conversation. The intent of these 

calls is to provide a touch-base and to connect them to services or 

programs. Examples of questions include how are you doing today, do you 

have concerns around your personal safety, do you have food in your 

house, and/or are you taking your medications.

Pros • Volunteers have been vetted (background checks) by the program.

• Easy and safe access to clients via telephone.

• Volunteers/staff check in with program recipients based on how 

they are getting along.

• Volunteers may provide connections to resources the community 

has to offer.

Cons • No “face to face” contact for visual confirmations around physical 

health, general well-being, home surroundings and mental state.

• Training and retention of qualified volunteers.

• Closed questions do not usually generate conversation (especially 

those who may be more guarded), which can often lead to more 

detail around how the person is really doing.

Learn More • Wisconsin Home Delivered Meals Well Check Talking Points

Best Practice • Telephone Reassurance Program, MAC Inc., Salisbury, MD

• Telephone Reassurance Partnership, Aging and Long Term Care of 

Eastern Washington, Spokane, WA
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Comfort Calls 

Overview Telephone comfort calls are an effective, high-touch, low-cost intervention

to combat social isolation and loneliness. Conversations are “open-ended” 

and more about friends connecting around mutual interests vs. a random 

volunteer calling and asking “closed” questions. Callers contact program 

participants one to two times per week and talk about whatever they 

choose. Matching of volunteer and program participant is based on 

interests but not required.

Pros • Volunteers and case managers have established relationships with 

clients, and many are like family.

• Volunteers have been vetted (background checks) by the program.

• Easy and safe access to clients via telephone.

• High touch, low cost conversations between “friends”.

• “Open-ended” questions deliver true insight into the wellbeing of 

clients.

Cons • Volunteers and case managers must be careful to not ask “closed 

questions” which reveal few details of the client’s wellbeing.

• Pairing of people can be time-consuming.

• Training volunteers to engage in conversation and be good active 

listeners.

• Volunteer recruitment and retention may be difficult.

Learn More • Caring for Wellbeing of Older Adults During COVID-19

• Enhancing Socialization Through Making Meaningful Volunteer 

Connections During COVID-19

Best Practice • The Daily Call Sheet, Maureen Feldman, Director, Social Isolation 

Impact Project (818-876-1190) maureen.feldman@mptf.com

• Project Hello (Helping Elders Limit Loneliness Outreach), Elise 

Swearingen, Community Engagement Director 

elise.swearingen@oha.ri.gov. 
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Virtual Program

Overview Virtual programs provide an opportunity for isolated older adults to stay in 

touch with friends, loved ones, and/or their local aging network through 

video platforms like Skype, FaceTime, and Google Hangouts. Provides an 

opportunity for participants to engage in their specific location and with 

activities like chair yoga, group word search, bingo and/or support groups.

Pros • Many software tools are free or low cost.

• May allow providers to expand from telephone “well” or “comfort” 

checks to creative and fun activities like crafts, games, and exercise.

• Volunteers have been vetted (background checks) by the program.

• Easy and safe access to clients via the internet.

• Provides a venue for “face to face” contact and increases the social 

connection between the two parties.

• Can expand to a group and include other clients.

Cons • Requires internet connection, which may be difficult in rural areas. 

Software tools and hardware are also required.

• Security can be a concern depending on the type of video platform 

utilized.

• Clients (or other persons in the home) must be knowledgeable with 

the platforms and able to sign the client into the program.

• Staff must provide support to clients who are unfamiliar with virtual 

platforms. 

• Multiple platforms may need to be offered based on the client’s 

familiarity with the programs.

Learn More • Tools for Reaching a Remote Audience

Best Practice • Social Distancing Support Group/Staying Safe, Sane and 

Supported,

JFCS Check-Ins; Jewish Family and Children's Service of Greater 

Philadelphia, Carly Bruski, Assistant Director, 267.858.7510 

cbruski@jfcsphilly.org

• Project Vital: Virtual Inclusion Technology for All, Florida 

Department of Elder Affairs, Tallahassee, FL

• Village Connector Experience, Juanita C. Grant Foundation, Capital 

Heights, MD