Every day Dr. Kristin Stratton sees one or two elderly patients who say they are lonely.

“It’s a huge issue especially in Bend and Central Oregon,” the internist at Summit Medical Group Oregon-Bend Memorial Clinic said. “They either come here to be with their adult children or they come here to retire, and they end up being extremely lonely and having a hard time connecting to social activities here.”

Loneliness is much more than a social concern. It’s a health risk. Research shows that older people who feel lonely are at higher risk for a number of health problems, use more health care services and are more likely to die prematurely. With Central Oregon’s 65 and older population growing at twice the national rate, local aging experts fear there are too few resources to help isolated older adults.

To fill the gap, the Central Oregon Health Council has partnered with the San Francisco-based Institute of Aging to bring a friendship line to the region. Local seniors and adults with disabilities can call for free and speak to trained volunteers 24 hours a day, seven days a week.

The line was launched in 1973 by Patrick Arbore, director of the institute’s Center for Elderly Suicide Prevention, to serve seniors in the Bay Area. It now handles some 13,000 calls a month. The contract with the Central Oregon Health Council is the line’s first outside of California.

“It was really to try to introduce another way of engaging older people and younger disabled individuals,” Arbore said. “We’ve talked to thousands and thousands of people, many of whom are lonely, and that’s why they call us, because it’s safe for them.”

People can call the friendship line and have confidential discussions with trained volunteers.

The line is also an accredited suicide prevention hotline, and staff know how to handle those calls. But the vast majority of callers aren’t in crisis. They’re just lonely and have nowhere else to turn.

The line also has a call-out service, where doctors or other health professionals can, with the permission of their patients, have the volunteers call their patients. A friendship line client can receive up to seven calls per week.

Each call can last approximately 10 minutes.

“It’s very hard for older people to say, ‘I need you. I’m lonely,’” Arbore said. ‘Referring someone to the friendship line is a way that feels comfortable to them. What we’re doing is creating a conversation, not a confrontation.”

According to an AARP survey, 1 in 3 adults over the age of 45 say they are chronically lonely, and a 2009 study found that some 43 percent of older adults not in senior housing lived alone. Arbore cautions not to conflate the two. Some people live alone and do not feel lonely, while others could live with a spouse or close to family and friends, yet still feel profound loneliness.

“When you look nationally, older people often live within 5 or 10 miles of at least one family member,” Arbore said. “But what that statistic often doesn’t give you is the quality of that connection. Just because an older person has a family member nearby, that doesn’t mean they’re not lonely.”

When adult children move away, he said, they often continue to call from a sense of obligation. Oftentimes, those conversations focus on mundane topics like the weather. Children rarely ask the more pertinent questions: How are you handling dad’s death? Are you getting out of the house? Are you eating?

The older people get, the more their social circle tends to shrink. Friends and family die or move away. Reduced mobility and transportation issues prevent them visiting those who remain nearby, while vision and hearing problems can make socializing difficult. Many adults feel embarrassed about those limitations and even more ashamed to admit they’re feeling lonely.

“If we were all friends living in the same community, if you came to see me and I didn’t open the door or wouldn’t talk, you would do something,” Arbore said. “But when people slip into loneliness and social isolation, and no one cares, that’s a problem.”

And that can take a significant toll on their health. A University of California, San Francisco, study found that people over the age of 60 who reported feeling lonely had a 45 percent higher risk of early death.

In 2015, John Cacioppo, a psychologist at the University of Chicago, described how loneliness triggers a physiological reaction similar to the fight-or-flight response. That in turns tamps down the immune response and increases inflammation in the body. Loneliness has been linked to worse cardiovascular health, anxiety, depression and risk of suicide.

Cacioppo also found that loneliness can increase a person’s risk of premature death by 14 percent, or twice the impact of obesity. Researchers have calculated that the effect of loneliness on early death is the equivalent of smoking 15 cigarettes per day.

That has the potential to be a particularly troublesome and costly problem in communities such as Central Oregon that have become popular destinations for retirees. According to U.S. Census data, from 2010 to 2014, Oregon’s senior population grew 18 percent, outpacing the national average. Deschutes County had the biggest increase in the state over that time, increasing 31 percent.

The friendship line is being brought to Central Oregon with state funds under an older adult behavioral health initiative launched several years ago. That initiative placed two behavioral health specialists with the Central Oregon Health Council and charged them with investigating what services were missing for older adults.

They identified loneliness as a major issue in the region and committed to funding the first year of calls to the friendship line at $5,000 per month for the first 499 calls.

“We’re happy to get the ball rolling, and then we would hope that as the community sees the value, that more folks will come to the table and underwrite it,” said Angela Jensen, one of the two older adult behavioral health specialists at the council. “If we all do our little piece, we can altogether make this happen and it won’t be a burden on any one particularly agency or service.”

Jensen is distributing pamphlets and magnets with the friendship line number on it, and is trying to get the word out to health care providers who see older patients affected by loneliness.

“A doctor, dentist, really anybody, if you’re seeing an older adult, you’ve got something in your back pocket,” she said. “If they don’t know the phone number, give them the name: Friendship Line.”

Stratton said her clinic routinely screens patients for depression, and some of the questions asked reveal when a patient is lonely. She recommends people get more involved with their community or their church. Her clinic prints out schedules of activities at the Bend Senior Center and hands them out to patients.

“It’s just really important to be involved in something. It really doesn’t matter what,” Stratton said. “Get connected with your local community.”

— Reporter: 541-633-2162, mhawryluk@bendbulletin.com