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Transforming Loneliness into Connection [Home Care and Adult Day Services]

Loneliness and Isolation have been clinically proven to have hugely negative health outcomes. Just because there's a caregiver in the home or the person participates in a day services program doesn't mean that they aren't lonely and feeling isolated.  I lost my Aunt Myrna a few years back and she had in home care for the last years of her life, but while they were there to provide for her needs they weren't having conversations with her.  By contrast, my mom who is 86 and has Alzheimer's disease participates in a day program, but since she has poor hearing her engagement is low.

Today's guest Deb Skovron, created a program called Circle Talk (see CircleTalk.org) which is used in home care and various day programs including PACE programs. She has witnessed many instances where a weekly program that encourages people to form relationships has dramatically improved participants' quality of life.


I'd highly encourage you to learn more about Deb and the  CircleTalk program itself, but we always make sure that when you listen to Home Care Heroes and Day Service Stars, that you will come away from the episode with actions that you can put into place right away.  We're going to share this podcast episode via an email suggesting 10 great conversation starters that your caregivers can use to drive meaningful connections with clients.

You can learn more about Deb and CircleTalk by visiting CircleTalk.org.

Home Care Heroes and Day Service Stars is produced and sponsored by Ankota - If you provide services that enable older or disabled people to continue living at home , Ankota can provide you the software to successfully run your agency.. Visit us at https://www.ankota.com. 



Loneliness and isolation have serious consequences for the people that we take care of. Just having a caregiver or being in a day program doesn't take care of it, but today's expert on the podcast knows exactly how to get the problem fixed. Enjoy. Welcome to the Home Care Heroes and Day Service Stars podcast. If you provide services to keep older or disabled people living at home, then this podcast is for you. Now, here's your host, Ken Acardi.


Hi everybody, welcome to the next installment of Home Care Heroes and Day Service Start. We have a fantastic guest today. Her name is Deb Scobron and her company is called Circle Talk, which is now part of a bigger company, which is called TeleGen. But we're gonna focus on Circle Talk today because it's an amazing system that really helps a lot of folks in a lot of settings to combat a huge issue, which is isolation and loneliness. And with that,


Let me introduce our special guest Deb. Welcome to Home Care Heroes and Day Service Stars. Thank you, Ken. I'm so glad to be here. Well, we're very glad to have you. Okay, so why don't we just dig right into it. As I mentioned, I mean, loneliness and isolation are huge issues. Since this is your area of expertise, could you kind of tell us what that issue is and how big of a epidemic of an issue it is and some of the impacts that it has on people's lives?


Yes, I will. I first of all want to say social isolation and loneliness are of course two different things. If we think about it. Loneliness is a feeling of not having enough not having enough in terms of networks and not having enough people in your life and it's


it's actually very subjective. You can you and I could wake up on any given day and feel lonely. It's almost like a free floating, almost like anxiety that can come and go. And social isolation is a little bit different because it's measurable. You can measure the number of calls a person has with their family in a given week.


or how often they get out into public spaces or interact with others. So social isolation is something that actually is quite objective. And the links that we're finding out, and they're very interrelated, of course. And so the links that are being discovered are pretty remarkable in terms of the serious pub


public health risks that are being identified. And in particular in older adults, we know that more than one third of adults aged 45 and older feel lonely. Just wrap your head around that. It only gets worse as people get older. And then according to current statistics, people over 65 nearly...


50% of people, and these are identified people, feel a sense of isolation and loneliness in their life. And, you know, they're living alone, they have lost significant others, families are no longer surrounding us, they have moved away.


chronic illness sets in hearing loss, all kinds of risk factors that really amp up this issue. And what we're finding is that social isolation is now associated with a 50% increase in the risk of dementia. I mean, it is, I mean, it is pretty stunning when you think about it.


that there's a 29% increased risk of heart disease and 32% increased risk of stroke. So these are all measurable health impacts of just this condition of being kind of removed, feeling a sense of being removed from the mainstream, not seen by other people.


and not seeing other people. So there's a ton of other statistics, but that I hope just, you know, starts to give you a sense of the enormity of this particular issue. And of course the associated risks are depression, higher rates of suicide, which we're seeing.


in younger people and in older adults. So the veil has been lifted. Right. So yeah, a lot of the things you just said resonated. So I do mention my mom a lot on this podcast. So my mom is 86. She has pretty severe Alzheimer's dementia. And she, you know, one thing that really struck a chord is that my mom's had hearing loss, like,


for a pretty long time. So she's 86 now, but her hearing has been more of an issue since, yeah, I'd say like in her 60s is when she started wearing hearing aids and she's never been that great at keeping the hearing aids in and that sort of thing. So it does sound like, looking generationally, I mean, this next generation of folks could be like more focused on dealing with issues, even like hearing loss.


and how that can help them to understand as an early form of isolation that this could have serious health risks. So it sounds like you're onto something really, really, really, really important. And I deliberately asked you for statistics because of course, when people start listening to something where they wanna learn, we wanna make sure that we have some data behind that. So you provided some.


incredible statistics about how this impacts public health and how it also leads to diseases and that's been measurable and that it's interesting to think about how social isolation is measurable and that we could get those results. So thank you for doing that. But tell me like a story or two that like how does this become more of a personal situation? Can you walk us through


Yeah, I can. You know, I would use my mother as a story who passed away last year at 92. But she's not a good example, because she's always been a very social person and loved living alone. But she...


was a part of this great experiment that we'll talk about of Circle Talk because she never seemed to get enough social stimulation. My mom would stay up as late as everybody else in the house so she could just talk and engage with people. And I involved her in this program and she was on fire more than I've ever seen. She


could not believe, and this was during COVID, she could not believe that she could make new friends over Zoom, first of all. But if I back up to when we started back in 2011, I met a woman who had, and this is kind of a common scenario with our generation and our parents.


Her daughter, I'm in Boulder, Colorado, and her daughter who is in Boulder moved her mom from Boulder, from California to Boulder so she could support her as she aged. She moved. Her name is Doris she moved Doris into an independent living community. And Doris had been her husband had died a few years ago she was very connected to everyone on our street.


that she knew the mailman, she was in a bridge club and played golf. And as she got older, those things started to fall away because she couldn't drive anymore. So Doris moves out to Boulder, Colorado, and her daughter's thinking, great, my mom's going to have me around and her grandkids around. And she'll meet other people in this community. And Doris got to this community of 300 people and proceeded to


pretty much barricade herself into her apartment because she was so overwhelmed by the change and she didn't want to admit it, but she was developing some cognitive and processing issues and she couldn't physically navigate around that setting and she didn't want to tell anyone. So her daughter contacted


us at Circle Talk and said, can you bring your bring my mom into this social engagement program. And it took us about a month to get her to come out of her apartment. And then we hooked her up with a buddy that would get her to the program. And within, I would say two weeks of one hour meetings.


We saw a metamorphosis occur that we invited her daughter to actually attend a Circle Talk meeting and her daughter just she said it's my mother again that all she needed was a setting where this sole purpose was high social engagement.


and she was able to gain her confidence again in being around people and feeling known. So, you know, Doris is just a perfect example of where people can go if they don't feel engaged and don't feel like they're in a valued social setting in the soup of social engagement and how


the and what the actual impact is and how people can pull themselves out of that spiral of loneliness and isolation. Yeah, that's fantastic. Yeah, yeah, I'm sorry, Circle Talk has, you know, really a profound impact from this story. I guess, taking a step back, I'd love to hear, I mean, how did you get into this and get this idea? And what was your inspiration?


and we'll talk much more about how the program works down the road, but I'd like to hear a little bit more about your personal story. Well, my personal story is I, for many years, was a process leader, a facilitator, and understood the power of creating a container for people to really be able to speak their lives.


And I did this in a variety of settings for, you know, small nonprofits and management teams, and then was approached by a friend of mine who created a K through 12 program and curriculum for kids to have positive peer relationships in school settings. In particular, she started in middle school, so we all know what that's like. Middle school kids.


really need some help engaging in a positive way with each other. She asked if I could, because I had a group process background, translate her program into a setting where older people, for older adults. And so I was all in immediately because I had seen and heard so many of my friends


told me that their parents were becoming so isolated and depressed as they got older. And you know that there didn't seem to be any solution.


any solution to really put them back in contact in a meaningful way with other people. And so we piloted this K through 12 program, which is all about engagement. We modified some of the activities and kind of created the themes that would that really spoke to the concerns and interests of older adults.


as discussion prompts. And it was what was supposed to be a 10 week pilot project turned into a 35 week pilot project because it was so successful. And from there, I was just just bodied on it was in back in 2012, not that many people were talking about this. And I said, this is important that this


really is a path forward to normalize aging and humanize the aging process. Oh, that's, and it really inspired you and you've made this work. And I kind of remember you telling me that there was actually a full year of sessions. So I think you said you started in, you know, for a number of weeks in the program, but now you have like a full year of these, of these sessions for engagement. Let's talk about Circle Talk specifically. So,


How does it work? What is it and how does it work?


It's, it's actually so simple. It's almost embarrassing to try to, to break it down. When you pull people together, we, we create small circles, say eight to 10 people. And when you face people in circles, everyone sees each other, everyone hears each other. And when you have a leader,


that has a very robust one hour program every week, that's kind of non repeating thematically. You give people an opportunity in a structured way to share about themselves. So a circle would look like this, the first five minutes we ask people to arrive and the leader


leads everyone in a what we call settling, it calms the nervous system down. So it's a guided meditation. So that people really we call it changing the air. They've gone from the outside world to a different space with a smaller group of people. And we really mark that moment by doing a short let's all just relax and leave everything at the door.


And then we do a warm up question, which is usually very easy to access. A good warm up question is, if you could spend your birthday any way you want it, what would that be? And everyone can talk about that for a minute or two. Um, very kind of fun whimsical question. And then we introduce the main theme. And the main theme is designed to.


Allow each person to tell a story that relates to that theme. An example of a main theme in just one of our very early circles in the group would be joy. And we read a short poem on joy. We talk about the concept of joy. And then the leader goes around the circle and asks people.


to tell us a short story about what brings joy into their life. And I wanna say one thing about, it sounds so simple, doesn't it Ken? I mean, it's just sounds so incredibly basic and simple. But when's the last time you've been asked that? That's a great question. Yeah, I don't think I've been asked a lot, what brings joy in my life and what a wonderful uplifting question.


and things like that. No, fantastic. Keep going. So when you have a conversation that can go, you know, that's deep, actually, it's, it's deep question. And you have someone to guide that conversation so that everyone in your group feels heard. And everyone learns a little bit more about each other all of a sudden.


You've created a rich fabric. You've created a group because people are sharing and people are feeling heard. And all of a sudden, if you and I are in the same group and I see you outside of that group, I have something else to connect with you about. Like, Kev, I love that story that you told about, you know, your childhood and joy. And when you think back to that,


I know more about you now. So that's our goal. It's purely social, and it's purely for people to feel known to other people. And we're lucky that, you know, there's amazing material out there to really evoke these stories. So we've created a year's worth of one hour programs.


And each one starts with either a poem, a short story that the group talks about. It's very accessible. It's accessible to people with some cognitive and processing issues. We train our leaders how to, you know, if a person is experiencing some depression or dementia, how to work with that.


We never ask anything that isn't here and now as a story or 30 years ago because of memory, because memories are really most poignant for us when they're grounded in emotion. And a lot of times that happens when we're younger. So if you think about the things as a kid that you really, really remember well.


it's because it's grounded typically in a positive emotion, but not always. So that's kind of like, those are some of the principles of the program that it's built on. Right, no, and I can see just with your explanation, I mean, how it could work, because if everybody's encouraged to tell their story and it's something everybody has a story, taking the example you gave about, what brings joy in their life,


And I'm sure that there's wonderful techniques for somebody who's a little shy and breaking into the group for the first time and these types of things. But yeah, if somebody does share that story, and maybe they've just been a isolated and quiet person sitting off in the corner, even in the adult aid services center, because they're a little bit shy, and then other people hear a story that they've told, and they'll go and engage with them. And I could see the power of that. Let me shift gears on us a little bit. So yeah, this podcast.


Home Care Heroes Day Service stars. So we actually met you and I face to face at a adult day, the National Adult Day Program in Chicago. And I know that we have Circle Talk running in PACE programs, which is an adult day service kind of a program and other adult day service centers. The example that you gave earlier was about somebody who was isolated and then.


they asked if they could come join a group. So it sounds like there's maybe independently facilitating groups and things like that. But I mean, clearly this isn't a program that we just wanna have in Boulder, Colorado alone and that kind of thing. So how does this program get out to the world?


Oh, such a good question. Well, in, I don't know, probably 19 or 2017 or 2018, we were at some national conferences similar to the one that you and I met at. And we had, you know, people from Seattle and from New York and from Australia, saying


you know, how do we get trained in this? Because we only did it face to face. So we train people to lead the program and really utilize the curriculum to its maximum. And so we went, we developed a virtual training program and launched it in January of 2020, if you can believe that, just before COVID was at our doorstep.


And so now the way we bring this out, bring Circle Talk out there is we train people all across the country. And I think there's 10 or 15 leaders in Australia up and down the Gold Coast, they're conducting Circle Talk and in Canada and South Africa so far. So we've gotten out there through our virtual training program.


And we're just really, really feel fortunate that we launched it when we did. Okay. No, very, very good. Yeah. Who would have anticipated a pandemic and all that kind of thing as well. And you mentioned also that it's worked well on zoom and that people were making friends on zoom and that kind of thing, which brings me to kind of the second part of the question, which was going to be with respect to home care, where it's generally one.


care provider going into a home, dealing with one person. And I know you mentioned in an earlier conversation we had that there's a lot of focus around the tasks. What should I make you for your lunch? When should I bring you this? How should I do the bath? It's very, very task oriented and it's not as social. So I guess a few questions since we are, we have a predominantly home care audience here. What have you seen in home care and how can we make Circle Talk work in a home care setting?


So this is where I have direct experience with my mom when we hired home health aides to come into her home. She was quite, she was a very social person and she was fairly offended that they would come in and they would help her with some of her adult daily living tasks, but she said then they would sit and kind of sit on the couch and watch her.


and not engage with her. And so we brought this to a couple of home healthcare companies here in Colorado, and they trained their people to really engage in a very natural way using our curriculum about that person's life and what makes them tick. And that's exactly what our curriculum is based on. It's a tell me about a time when.


story. Tell me about a time when you made a really big life decision that's affected you the rest of your life. Tell me about a time when you had a friend that you had a falling out with and then repaired it. Tell me about a cherished moment when you were 10 years old. So there's all different ways


in natural ways to kind of really amp up that level of interaction when a person is in supporting another person in their home and making it an experience where people feel like they're actually interacting on a very meaningful level rather than just the chores to get through the day.


So that's been our experience in Home Health. Yeah, it's even in Encode, I mean, we're a software company, very different thing, but we're all distributed in different places. So we have a meeting on Fridays where we always get together and talk about, we call it customer success. We're always talking about, you know, what have we done to help our customers be more successful? But we always have a, with the question of the week in this session. And,


And sometimes we've had really profound questions of the week on the lines of, you know, how did your parents give you the name that you have and things like that, and that just evokes really huge conversations. And then other weeks we have a question like, all right, well, do you think your Christmas tree should go up before Thanksgiving or after Thanksgiving? And then people are like, I think after, you know, I think before. But I do think that the prompts and the questions and the quality of the questions is really, really relevant in that case. Let me ask you a question, you know,


Of course, every time we do a podcast with an expert such as yourself, we'd love for the folks to engage in your program specifically, because you have such a great program. But having said that, a lot of folks are going to be listening to this in their car. They're going to be, you know, they've already made some of their takeaways for today. But if you were just going to say, hey, even without doing Circle Talk, you know, here's here's one or two or three things that you should do in your either day services program or your home care agency to improve.


immediately on isolation and loneliness. What would be one or two or three suggestions you'd make just so that people could just start doing tomorrow?


What a great question. I would say, look at your spaces, just on a physical level, and see if you have the spaces set up for just small, intimate connection. Like, is there like a private spot with two or three chairs that looks kind of warm and cozy, that people could sit and face each other?


and really engage outside of the fray. Because when we talk about adult day centers, they're the congregate. It's a congregate setting. People eat in the congregate. People go from place to place and pass each other in groups. But where are you physically setting up opportunities for people to have small?


intimate, more intimate small group conversation. So that's just a kind of a little conversation space. Do you have one that draws people in? Another thing that I would suggest is for staff to, you know, ask the who, what, where, when, and how questions.


of other people rather than just the what to get the full story. What town do you come from? How long have you lived there? Do you have other children in the area? Really try to just in a systematic way get people's stories and be interested in them rather than just get the


what I call, get into light, trite and polite conversations, which is our tendency, I think, in our society to not, to have more boundaries that we self-impose when we meet a new person. People want to be asked. People want to be known. Yeah, that's fantastic. So I think what I'm going


on you and me for after this. So one of the other ways we get things out there is we do blog articles and things like that. I'd love to write a blog article with your help along the lines of 10 great conversation starters for your care staff to ask their clients. And if we can come up with just a list and maybe we'll come out with a new one in six months or that kind of thing, but if we could think of some great questions that are, as you said,


much more into building relationships and less about making sure they eat their lunch and things like that. I think that that might go a long way and I'd love to write that article with you. Okay. So with that, I think that we've gotten a great deal out of this and time flies when we're having fun always. So let's start in the wind down phase. So first of all, if folks want to learn more about...


CircleCare specifically or get in touch with you, how can that happen? It's very easy. CircleTalk.org. Oh, I'm still at.org, right. Okay, CircleTalk.org is our website. And that will kind of lay in the background for you and give you our training schedule if you're interested in getting trained and getting a hold of our materials.


Right. And I actually found it on circle talk.com as well. Nope, I didn't. It was circle talk.org. You are absolutely correct. I Google circle talk. All right. Got it. All right. So that answers that question. And, and perfect. And if people do want to get in touch with you to engage, would you just say they should go to the circle talk.org site and maybe fill out like a contact us forum or what would be best for you?


Uh, we always answer, contact us. We will get right back to you and I can give you my TeleGen address if you wanted. It's pretty simple. Sure. Let's go for it. Uh, D S K O V R O N at telligen.com T E L L I G E N telligen.com D Skovron.


Right, well that is perfect. All right, well I think with that we're gonna wrap up today's episode. So thank you so, so much to Deb Scobron for being here today and really giving us some great tips on how we could start tomorrow, improving loneliness and isolation. And I certainly learned a lot about what's objective and what's subjective and how to measure it and looking at all these results. And I think that there's definitely some takeaways that even outside of


home care itself, there's some things that I could do in my in my own life to, uh, to better engage folks and things like that. For example, I teach a college class and I'm like, okay, now maybe I know some better ways to engage some of those more quiet students and things like that. So it's been a fantastic, um, addition to the home care heroes and day service stars podcast. And with that, let me thank you and, and say goodbye for today. Thank you so much.


Thanks for joining us today on the Home Care Heroes and Days Service Stars podcast, produced by Ankota. You can listen to back episodes by visiting 4HomeCareHeroes.com. That's the number four, then the words HomeCareHeroes.com.

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