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story.lead_photo.caption Wilma Darling explains her relationship with her friend Willie Mae Carter. The two met through the CareLink Senior Companion Program, which is designed to help homebound senior citizens combat loneliness. - Photo by John Sykes Jr.

Six years after her husband of 43 years died, Wilma Darling made a love connection over a game of dominoes.

She and her new beau got married in 1999, after getting reacquainted at the England senior center, when Darling was 72 years old.

The couple would take long drives together through the countryside; they drove slowly so they could take in the scenery. Darling's second husband, David Shelby, used to be a farmer and wanted to see how everyone's crops were doing. They drove from their home in England to Stuttgart, Carlisle, Hazen or Pine Bluff.

"Every afternoon around 2 o'clock, I would say where are we going today?" she said.

In 2014, 15 years after they were married, Shelby died, and Darling was left alone in their home. A photo of the two of them sits on the desk in her living room, next to a program from his funeral.

"You're never ready to give up a loved one," said Darling, now 91. "That's just when you have had good years. We had had 15 good years, and we did lots of things together."

About half of the senior citizens in the United States report feeling lonely or isolated, a problem that is exacerbated by the death of a family member or by living alone, according to a report from the American Association of Retired Persons' Connect2Affect. Connect2Affect is a push from the nonprofit to prevent loneliness in older Americans.


Isolation can be worse in states such as Arkansas where people who are homebound may not have access to transportation because they live far away from a city, said Debbie Brady, a social worker with the Donald W. Reynolds Institute on Aging, a part of the University of Arkansas for Medical Sciences.

In England, Darling relies on a caregiver to take her to the doctor or grocery store. She connected with her caregiver, Willie Mae Carter, through CareLink's Senior Companion Program. The program pairs a senior citizen with an adult who is at least 55 years old.

The goal is for the companion to check on and spend time with homebound senior citizens, said Michelle Gilbert, marketing and outreach manager for CareLink.

Because of budget constraints, it is one of CareLink's smaller programs. Last year, there was $166,000 allotted for the program, which offers training for caregivers and a stipend. Meals on Wheels is one of CareLink's largest outreach efforts, Gilbert said.

Carter, who has three children of her own and adopted two granddaughters, stops in to check on Darling at least once a day. She is a companion for six people, several of whom live in the same apartment complex.

"If she comes to see one, you bet she's going to pop in on all three," Darling said. "In other words, she's here every day almost."

Living alone is one of the top risk factors for loneliness, along with mobility impairment, sensory impairment and major life transitions, according to a report from the Administration on Aging.

Darling does not have any children and has never been a pet person. Her nieces and nephews live scattered around the country, she said.

About one-third of senior citizens live alone, according to another Institute on Aging, a California-based group that provides services and support for senior citizens.

Brady recommends that senior citizens learn to use social media as a means of connecting with family members who have moved away.

"To me personally, nothing is better than human contact but I think we have to be able to improvise," Brady said. "Some people are able to see their great-grandchild for the first time using FaceTime."

Brady also said senior citizens can use devices such as iPhone's Siri or Amazon's Alexa for companionship because it gives them the opportunity to talk to something that has a human-like response.

Darling has a computer in her house, but said she only uses it to play Solitaire during the day. She has one regular visitor other than Carter -- a man close to her age who visits occasionally.

"I have an old, old friend and a lot of people in town, if you hear his name, they automatically think of him being a boyfriend but he's not that," she said. "He may not come by for a month, but he drives an antique truck and you can hear it coming."

Darling's friend has hearing problems, which is another risk factor for loneliness, Gilbert said.

"I've seen this even with my own grandfather, to be in the same room with people, but not being able to converse with them," she said. "You don't get to be kind of a part of everything else."

Brady said she often sees cases of senior citizens who have hearing impairments, but lose the hearing aids their families buy for them. Once they've lost them, family members are unwilling or unable to buy new aids.

"People get irritated when they have to say 'What?' or that sort of thing," she said.

Darling and her visitor don't have problems with his hearing impairment, she said.

"He will be pecking on that door so I'll holler 'Come in,' and he's hard of hearing," she said. "But I've always been a loud mouth."


Loneliness is linked to depression in senior citizens, although it is nearly impossible to determine which comes first -- whether loneliness causes depression or whether people who are depressed behave in ways that push others away, Brady said.

"I think it's important to know that feelings of loneliness and depression can both sneak up on us," she said. "We think we're OK until all of a sudden we're not."

Brady, who used to work at Arkansas Children's Hospital, said end-of-life issues are more prevalent in treating geriatric mental health problems than they are with children, even children who are terminally ill.

"There was always more hope and trying to find some kind of cure or miracle, whereas with aging, I think the whole idea is that everybody wants to get old, nobody wants to be old," she said.

The Institute on Aging offers counseling. All patients who come into the Little Rock clinic are screened for depression; the triage nurse asks questions. If the patients' answers raise concern, they are given a longer test designed to determine whether they are clinically or situationally depressed, Brady said.

Clinical depression sometimes requires medication, and that is often difficult to prescribe in geriatrics because of other medicine they may be taking for other health problems. Because of lingering stigmas about mental health from years past, it can also be hard to get older people to go to counseling, Brady said.

"I think a lot of people that grew up a long time ago, you have the mentality that you should be able to handle this on their own and so they may be reluctant to admit that they have a problem," she said.

Gilbert said CareLink asks Meals on Wheels volunteers to report any concerns they have about a client's mental health to the program coordinator.

Warning signs of depression include changes in appetite, sleeping patterns, personal hygiene and withdrawing from social events such as church services or senior center activities.

Brady said older men are also at a high risk for suicide.

"They usually have a more specific plan, and they tend to follow through," she said.

Those who are at least 85 years old are at the second-highest risk. The first is adults between 45 and 54 years old, according to statistics from the American Foundation for Suicide Prevention.

Anyone experiencing a mental health crisis can call the National Suicide Prevention Hotline 24 hours a day at (800) 273-8255.


Loneliness and depression are linked to physical health problems. One study from the U.S. National Institute of Health linked depression to heart disease, diabetes, dementia, anxiety and insomnia.

"You're much more likely to end up in a nursing home or care facility than to be able to stay at home," Gilbert said of health problems related to depression.

UAMS students who take classes in geriatric care are taught to take a holistic approach to treatment, which includes mental as well as physical health, Brady said.

"They're very focused on the whole person and their environment," Brady said, adding that doctors may ask about a senior citizen's sleeping habits, hobbies and social life to determine risk levels for isolation.

Carter often takes Darling to her doctor's appointments. Once, on the way to a regular check-up, Darling had a stroke.

Darling said she is also prone to falling, and once fell and hit her ribs on the arm of a chair. She called 911, but had to wait longer than she expected for an ambulance.

"They were out there and the light was flashing, and I couldn't figure out why they hadn't been in yet," Darling said.

Carter was at Kroger when someone told her that an ambulance was headed out to Darling's apartment; she dropped everything and drove over to her friend's apartment.

She went outside to figure out what was taking so long and discovered that the responders had found another woman who lives alone outside on the sidewalk, and thought that she was the one who called them. Another ambulance came for Darling.

Brady said socialization is not the only way to combat feelings of isolation that can lead to health problems. Things such as exercise, practicing a religion and finding a hobby to fill time previously occupied by a job can also help.

Carter and Darling have a standing appointment every day to watch The Price Is Right, at 10 a.m. After that, Jeopardy is on, and Carter may step out to check on someone else, but she will usually come back, she said.

Carter spends all day checking on people; she is usually out from 9 a.m. to 5 p.m., and usually just goes home for dinner and a bath before bed, she said.

"I'm rolling every day, all day," she said; it was nearing 10 o'clock -- time for their show.

The two have grown close over the four years they have been together, something Gilbert said is a goal of the program, and one of the reasons she wants it to grow in coming years.

"I just love being with her," Carter said of Darling.

"Let's not get too much because I'm an emotional-type person, and it doesn't take much," Darling replied, tears forming in her eyes.

"She'll cry," Carter said. "She will. She'll cry in a minute. I say 'Don't do that.'"

Photo by John Sykes Jr.
Wilma Darling keeps a photo of herself and her husband, David Shelby, on her desk in her living room. Shelby died in 2014, after the two had been married for about 15 years.
Photo by John Sykes Jr.
Willie Mae Carter, 74, talks about her role as a caregiver to six homebound senior citizens in England. She visits Wilma Darling, 91, about once a day.

Style on 02/25/2018

Print Headline: Staying connected: Homebound retirees face risk of loneliness, isolation

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