Social Connections and Healthy Aging (The Senior Connection) (TSC)

• Suicidal Ideation [ Time Frame: Baseline, 3,6,12,18,24 months ] [ Designated as safety issue: No ]
  Severity of suicidal and death ideation assessed with the Geriatric Suicide Ideation Scale
  
  

• Social Connectedness [ Time Frame: Baseline, 3,6,12,18,24 months ] [ Designated as safety issue: No ]
  Thwarted belongingness and perceived burdensomeness assessed by the Interpersonal Needs Questionnaire.
  
  
• Connectedness [ Time Frame: Baseline, 3,6,12,18,24 months ] [ Designated as safety issue: No ]
  Social network size/density/quality assessed with the National Social Life, Health, and Aging Project Social Network Module.
  
  
• Depression [ Time Frame: Baseline, 3,6,12,18,24 months ] [ Designated as safety issue: No ]
  Assessed with the PHQ-9
  
  

There is a pressing need for interventions that reduce risk for suicide in later life. Older adults in the U.S. have the highest rate of suicide and are the fastest growing segment of the population. The investigators can anticipate a large rise in the number of older adults who die by suicide in coming decades. This application is in response to RFA-CE-10-006. Consistent with the CDC's key strategy of reducing suicide by promoting connectedness, our long-term goal is to reduce late life suicide-related morbidity and mortality by leveraging the resources and expertise of the aging services provider network (ASPN) to address unmet social needs of community-dwelling older adults. Our objectives with this proposal are (1) to examine whether linking socially disconnected seniors with peer supports through the Retired and Senior Volunteer Program (RSVP) is effective in reducing risk for suicide, and (2) to test an hypothesized mechanism for the association of social disconnectedness and suicidal ideation and behavior informed by the Interpersonal Theory of Suicide.

The investigators will recruit 400 primary care patients (200 men and 200 women) over age 60 years who endorse feeling lonely and/or as if they are a burden on others. They will be randomly assigned to either of two conditions. Those assigned to The Senior Connection (TSC) will either be paired with a peer companion or, if they prefer and are eligible, be trained and placed as a peer companion for others by RSVP. The comparison group will receive no further intervention ("care-as-usual" [CAU]). Subjects will be followed for up to 24 months with repeated in-home (baseline, 12, and 24 months) and telephone assessments (3, 6, and 18 months).