Mary Kay Bishop took up sewing in earnest after she left her job as a physician assistant. She delighted in the fabric, its many colors and textures, and in the work of bringing disparate pieces together.
But when the pandemic began, the social circles she’d formed around the pastime, like her weekly knitting group, became harder to maintain. “Sewing is an isolating activity,” Bishop, 63, said.
As a health provider, she knew how isolation could hurt someone’s health, but she didn’t see the symptoms in her own life until she received a call from Texas Health Resources in 2021. The community health worker on the other end asked if she’d like to join Reduce Social Isolation and Lift Outcomes for Seniors, or SILOS, a free program meant to decrease loneliness for older adults across Tarrant County.
The program serves as its own steady hand, threading together people and community and resources they might otherwise never know.
For Bishop and others, the method works. After the U.S. Surgeon General issued an advisory in early May about the “public health crisis of loneliness” in America, the program’s data show roughly three in four people who join report feeling less isolated and lonely than they did before.
Want to know more about Reduce SILOS?
What’s the program?
Reduce SILOS is a free program from Texas Health Resources meant to help low-income people 50 and older stay connected.
How does it work?
The program pairs a community health worker with a participant. The community health worker checks in regularly and shares custom lists of nearby events, activities and resources with the participant.
Who is eligible?
People who are 50 or older, eligible for both Medicare and Medicaid, and who live in one of 14 target zip codes around Tarrant County. For more information, or to check your own eligibility, email THRReduceSILOS@TexasHealth.org.
‘Your social calendar can impact your health’
As focus groups gathered throughout Tarrant County for Texas Health’s community health needs assessment in late 2018, Marsha Ingle and her colleagues in the hospital system heard a common theme: Some folks were stuck at home with nowhere to go.
“Of course, not many people used the term ‘social isolation,’” said Ingle, who serves as Texas Health’s senior director of community health improvement.
Instead, they mentioned troubles with money. Chronic disease that kept them indoors. No transportation to take them elsewhere. Each of these barriers damaged their ability to stay connected.
She’d heard from Texas Health physicians how isolation and loneliness affect the body: increasing a person’s risk for heart disease, depression, dementia and death. The connection stems, in part, from emotional pain, which like physical pain can inflame the body and erode the immune system over time.
“Your social calendar can impact your health,” Ingle said.
In 2019, during Texas Health’s next round of community impact grants, which fund projects related to themes from the community health needs assessment, Ingle’s team gave United Way of Tarrant County funds to screen for isolation and depression through a partnership with Meals on Wheels.
When the organization delivered a meal, a representative simultaneously checked for symptoms. As the work progressed through 2019, Ingle and her colleagues realized the need was far greater than they’d first imagined.
“We were focused on people that lived alone and couldn’t get out of the house,” she said. “But (social isolation) was much, much broader than that.”
To address the gravity of a problem they’d only just begun to grasp, the Texas Health team pursued their own funding from the AARP, formerly called the American Association of Retired Persons.
They piloted the Reduce SILOS program in January 2020 with an expanded target population: Low-income adults 50 and older who were socially isolated or lonely, regardless of the circumstances within their homes.
The program would, initially, identify people through hospitals and churches and connect them with events and other opportunities in their community. Community health workers would survey participants along the way using the Duke Social Support Index, a questionnaire that measures how connected someone feels.
Then, COVID-19. The timing felt apropos. “We were actually addressing social isolation during a time where everybody was forced to socially isolate,” Ingle said.
The pandemic required the program to move online and into people’s phones, including those of Bishop and an Arlington resident named Sharon George.
‘Almost everybody felt that pinch’
George, 60, had grown accustomed to isolation long before the world around her shut down.
A long time call-taker for the Fort Worth Police Department, she experienced a spate of bad health that led her to an early retirement: Diabetes, breast cancer and heart failure, chemotherapy, blood treatments and a pacemaker.
Moreover, she was highly sensitive to smells; a whiff of perfume could catalyze a punishing asthma attack. “People would come through with a heavy musk,” she said, “And I would run from the office with my inhaler.”
Still, her many friends and family, including a happy mess of great nieces and nephews who call her “Choo Choo,” surrounded her with affection.
But after the pandemic began, they dissipated out of necessity — many are essential workers, and George’s medical conditions made her a “bullseye” for COVID-19, she said. When a routine doctor’s appointment questionnaire asked if she was isolated or depressed, she answered yes to both.
“Almost everybody felt that pinch of depression,” she figured.
Afterward, she received a text from the same community health worker who reached out to Bishop. The exchange led to an interview about George’s needs and interests.
Since then, she’s received a gently used walker and regular lists of nearby and online events to attend.
What’s the difference between social isolation and loneliness?
What is social isolation?
- Spending most of your day alone
- Feeling separated or distant from friends or family
- It can happen when you live alone or with other people
- It is not the same as feeling lonely
What is loneliness?
- Feeling like you are not seen or heard
- Feeling alone when you are around other people
- Feeling no one really knows or understands you
- When you don’t feel useful to others
Definitions from Texas Health Resources
‘We walk away better people’
Lauren Latiolais, 33, first met George at the Mexican Inn Cafe on 8th Avenue in Fort Worth this past April.
The first-year graduate student, who’s studying social work at Texas Christian University, was immediately drawn to George, who uses phrases like “hot dog!” and calls her walker “The Rollinator.”
“We talked, god, I think we were there for two and a half hours,” Latiolais said. “I just couldn’t get enough of her.”
Earlier this year, Reduce SILOS partnered with TCU to pair students with participants. Latiolais, who plans to work with children of incarcerated parents, met with George for a class assignment. The meeting was symbiotic: Both walked away delighted and thankful.
For Latiolais especially, the encounter offered something she hadn’t known she needed — intergenerational friendship.
A nontraditional student, she joined the Air Force out of high school and moved around the country and world. Her travels didn’t afford her much time to get to know her grandparents, but they did allow her to see how other cultures revere and support their elders.
“We, as an individualistic society, forget our older population,” she said. “But sitting with Sharon, I was able to integrate those observations and, like, this missing piece of myself.”
Her most recent move, to Fort Worth, took place summer 2022, but she said the city didn’t feel like home until she met George.
Since their lunch, Latiolais and George have kept up by text. The former, who’s living in Germany this summer, said she’d be in touch when she returns. And, she’s pondering how intergenerational connectedness could help build resilience in her future clients.
“A lot of times, even as an adult, I think I know what I need to know,” she said. “And then you sit down and you speak with an elder, and it’s like, ‘Oh, man, there’s so much wisdom out there.’ And if we just sit and listen for a time, we walk away better people.”
‘It made me think about creative ways to get out there’
When Bishop, the physician assistant, first heard from Reduce SILOS, she told the community health worker that what would help her is to help someone else.
The community health worker took notes and hung up. Later, when she called again, she had an idea for Bishop: Had she heard of Faith Community Nursing, a Texas Health program that helps nurses tailor health-related resources for the churches they already attend?
Because of her background in medicine, Bishop could debut her own “health ministry” at her parish, St. Demetrios Greek Orthodox Church, to provide for the health needs of parishioners and neighbors.
The suggestion stuck. Bishop surveyed her congregation and began developing training around their medical needs and interests. Earlier this year, on Go Red Sunday, she gave a lesson on women and heart health. Right now, she’s putting together a presentation on adult health maintenance.
Bishop doesn’t usually attend the other events she hears about through Reduce SILOS, but like George, she also met with a TCU social work student through the program. Lately, the two have met up to quilt.
The program has served as a kind of preventive medicine, a “hand to hold” before she fell too deeply into isolation, Bishop said.
“I recognized that I needed to get myself out there more, and it made me think about creative ways to get out there,” she said.
Sometimes, that looks merely like taking a book to a coffee shop. She chats with the barista and others nearby. “Seeing people walking around, and just a ‘hi’ if they walk by — that kind of thing really was helpful,” she said.
As for George, she attends film screenings in a nearby park and connects often with the community health worker who initially contacted her. They’ve never met in person, George said, but their relationship is paramount.
“Just having her check in on me and make me feel like I mattered was huge,” she said.
She’s certain anyone, young or old, married or single, alone or in a crowd, could benefit from a program like Reduce SILOS.
“I’m a strong Christian woman,” she said. “I believe in prayer, and I have a huge network of people I can reach out to who may or may not have had any idea how dark the last, say, five years of my life have been. And SILOS helped me to get through a lot of that — without it being able to rob my joy.”
Alexis Allison is the health reporter at the Fort Worth Report. Contact her at alexis.allison@fortworthreport.org or via Twitter.
Her position is supported by a grant from Texas Health Resources. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.
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