This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

The COVID-19 crisis has exacerbated the high levels of isolation older adults experience in today’s society and the serious health impacts that can result. But many providers are working to ease that loneliness by providing “friendly reassurance” phone calls to check in on Michigan’s elders.

The Tri-Country Office on Aging (TCOA) was in the midst of developing a friendly reassurance program when COVID-19 arrived in Michigan. Realizing that the pandemic would further isolate the elders that the agency serves in Eaton, Ingham, and Clinton counties, the program launched earlier than expected. Volunteers from TCOA’s Retired Senior Volunteer Program (RSVP) make the calls, following a script that allows conversations to evolve about any number of topics.

Tri-County Office on Aging volunteer LaVendee Fulton makes a friendly reassurance call from her home.

“They ask ‘How are you doing? Is there anything you need?’ As they go along, they may talk about a variety of things,” says Marian Owen, executive director of TCOA. “The conversations are about family, books, the weather, their pets, and reminiscing. That’s something that’s very important to people and it’s also fun to listen to their stories.”

In addition to the volunteers, case managers on TCOA’s staff are checking in with elders who live alone or have special needs. Owen reports that the calls are reaching about 3,000 elders.

“The calls make the difference between [people having] feelings of loneliness and total isolation to a feeling of connectedness with the outside world and knowing that they are cared about,” she says. “It is probably one big way to ease the fears and anxiety that these people are experiencing right now. It has also been a way to reach new people with ongoing needs that we can help in the long run.”

40 years of friendly reassurance

In southern and western Wayne County, The Senior Alliance, Area Agency on Aging 1-C, has had its friendly reassurance program in place since the ‘80s.

“We have a participant whose mother was in the program. When her mother passed, she joined. She is now in her 90s,” says Lori Zimmerman, The Senior Alliance’s information and assistance manager. “Since COVID-19, we have gained new participants every day.”

When Tamera Kiger started working as CEO for The Senior Alliance, the friendly reassurance callers sat right outside her door. She couldn’t help but overhear the conversations. She recalls hearing the question, “What are you going to eat today?” The staff person soon realized that the elder on the phone had no food in the house and had not eaten for three days. The Senior Alliance was able to connect her to food resources.

“Those connections are so important,” Kiger says. “The friendly reassurance callers get very invested in the people they call. They truly care about these people and get to know them. They know when something’s just not right and will alert us if they think there is a need to follow up.”

Many new participants are finding their way to the program through the Michigan Department of Health and Human Services’ Aging and Adult Services Agency website.

“That’s made a positive impact in getting the word out about Area Agencies on Aging in Michigan, that we’re here for you and will help in any way that we can. Because of COVID-19, a lot of seniors are looking for resources everywhere. Families that live far away have also gotten several people connected via that state website,” Kiger says. “Though seemingly small, a phone call is really a big deal. When we can’t reach someone and they are in jeopardy, our staff can intervene.”

Teresa Coleman is a friendly reassurance caller for The Senior Alliance.

Some participants only want a check-in call to assure their safety and basic needs are met. Others stay engaged in conversations for 30 or 40 minutes. The phone calls also serve as a bridge, connecting elders to other Senior Alliance services and community resources.

“We know isolation is detrimental to folks’ health. … It’s equivalent to smoking two packs of cigarettes a day,” Kiger says. “Friendly reassurance calls really make a positive impact. Just by knowing that someone out there cares and is going to call and check in on them can improve overall wellbeing and health.”

During Michigan’s stay-home order, concerns about rent, utilities, and food have come to the forefront. If callers cannot reach their elderly phone friend, they reach out to the elder’s emergency contact or call the police to request a safety check.

“It doesn’t seem like that big a deal to make a call, but in many cases we have intervened to help someone in a life-and-death situation,” Kiger says.

Shifting adult day care to phone care

When COVID-19 closed the Catholic Charities of Southeast Michigan Adult Day Programs in Auburn Hills and St. Clair Shores, staff members joined volunteers from the facilities’ Senior Companions program to make friendly reassurance calls. From the safety of their own homes, they made 1,300 calls to program participants and their caregivers during the first three weeks of the stay-home order.

“As soon as we realized how serious the virus was, we had to shut down. These people are way too vulnerable a population,” says Nikki Harvey, program manager for the St. Claire Shores Adult Day Program. “We started right away exploring options. Our staff, who would otherwise be unemployed, are making these phone calls weekly or on a daily basis in some cases. They’ve worked with these clients and families every single day. Remaining connected with our families is important.”

The Day Programs provided opportunities for adults experiencing dementia or other cognitive difficulties to socialize with their peers while giving their caregivers a much-needed break. Some came one day a week, others five. Harvey notes that even under normal circumstances, family and spouses providing care to their loved ones experience a great deal of stress. COVID-19’s rampage through Wayne, Oakland, and Macomb counties has increased that stress exponentially. So the friendly reassurance calls include both clients and their caregivers.

“Some just want a ‘Good morning. Have you taken your meds?’ Others have kept our volunteers on the phone for an hour and a half,” Harvey says. “On top of dealing with what everyone is dealing with, [caregivers] have the added burden of having to do everything for their loved ones. These people had already reached out for help because they needed a break. Now they just don’t have that. We have connected some with home services, but many can’t afford it.”

A Catholic Charities of Southeast Michigan staffer makes a friendly reassurance call from her home.

Volunteers also discovered that many program participants needed food. This inspired program staff to deliver groceries to 200 elders in Wayne, Macomb, and Oakland counties, as well as hot meals to 200 residents of a Mt. Clemens low-income housing facility where some residents had tested positive for COVID-19.

While elders are at high risk for dying from COVID-19, social isolation is increasing their health risks in general. Friendly reassurance telephone calls are one way Michigan’s Area Agencies on Aging are responding. However, those serving our elderly residents agree they deserve even more consideration.

“Ageism is alive and well. When we look at where our priorities [in COVID-19 response] were, look at how long it took to respond to nursing homes. Prisons were brought up before nursing homes,” Harvey says. “It has really been difficult, really sad, that in a country as large, vast, and rich as ours, we have not had enough [personal protective equipment] to go around. That includes nursing homes, adult foster care facilities, and assisted living facilities.”

Kiger agrees. She says COVID-19 has exposed the need for Michigan agencies to communicate better with elders and each other about best practices for serving them.

“There are a lot of us doing a lot of things,” she says. “How can we not step on each other and work more collectively to meet these needs in the community? We can do better, and I think we will — all of us working together.”

Special thanks to all the friendly reassurance callers who provided photos of themselves for this story.

A freelance writer and editor, Estelle Slootmaker is happiest writing about social justice, wellness, and the arts. She is development news editor for Rapid Growth Media, communications manager for Our Kitchen Table, and chairs The Tree Amigos, City of Wyoming Tree Commission. Her finest accomplishment is her five amazing adult children. You can contact Estelle at Estelle.Slootmaker@gmail.com or www.constellations.biz.