Hamilton Seniors Isolation Impact Plan

Since May 2016, with support from the Government of Canada’s New Horizons for Seniors Program, the seven partners of the Hamilton Seniors Isolation Impact Plan (HSIIP) have collaborated to deliver innovative projects that address the issue of isolation.


  • Backbone Project: A Backbone staff coordinates meetings, guides planning and evaluation, shares information, promotes communication and outreaches with community.
  • CareDove Project: An online portal provides information about services available to seniors in Hamilton and enables organizations to exchange referrals (www.caredove.com/hamiltoncss).
  • Research Project: Researchers gain qualitative insights from seniors and service providers, and mobilize knowledge about isolation through delivery of training, reports and publications.
  • Community Connector Project: Staff work one on one with seniors throughout Greater Hamilton to anchor them into services and activities.
  • Hospital Connector Projects: Staff work one on one with seniors who are returning home from a hospital stay to anchor them into services and activities.
  • Peer Connector Project: Volunteers aged 55+ provide weekly friendly visits to seniors and can accompany them to activities in the community.

OUTCOMES (MAY 2016 – MARCH 2018)

Approximately 200 organizations, businesses and community groups engaged

  • Identifying isolated seniors required extensive community outreach to improve awareness and encourage referrals. In years one and two, the partners attended 75 events, delivered 104 presentations, distributed over 10,000 pamphlets and educational materials and generated 12,500 views to the HSIIP website (www.socialisolation.ca).

1671 seniors identified & contacted

  • In the first two fiscal years of the HSIIP, the partners were able to gain 1671 referrals for seniors identified to be at-risk of isolation. These seniors were contacted and provided with information, and 61% of them were admitted to receive one or more of the HSIIP Connector services.
  • Around 86% of referrals came from organizations, while 14% came from seniors, family members or acquaintances in the community.
  • An intake survey assessed risk factors and degrees of isolation; results demonstrated that 72% were either divorced, widowed or had never married, 66% lived alone, 82% had a chronic condition or disability, 44% had a vision or hearing impairment, and 57% lacked access to transportation.

1014 seniors provided with intensive one-on-one support to connect with community

  • In the same period, the HSIIP Connector services worked closely with 1014 seniors who were experiencing significant isolation. This is estimated to represent approximately 9% of the isolated senior population in the Greater Hamilton region. The number of seniors served per year increased from 302 in year one to 712 in year two.
  • Connectors met with seniors at home, where they assessed needs, discussed options and developed action plans together. Seniors then received encouragement and support to follow through on those plans for up to six months, getting anchored into services and activities that met their needs.
  • Types of programs that seniors were supported to access included adult day programs, friendly visiting, government services, grocery deliveries, health services, home care and maintenance, housing programs, meal programs, recreational activities, safety checks, and transportation services.

Exit surveys demonstrated meaningful impacts in the lives of seniors

  • An exit survey was conducted with a sample of about 30% of seniors served.
  • 90% of seniors served agreed they had more help and support, 87% agreed they were more connected to services and 65% agreed they were more connected to people.
  • On intake, 45% reported feeling isolated often or always, while upon exit this was reduced to 8%.
  • The proportion of seniors who reported participating in activities only a few times per year or less was reduced from 63% to 33%.
  • The proportion who felt they had plenty of help increased from 8% to 44%, while the proportion who felt they did not have enough help fell from 25% to 1%.

Valuable system level impacts are being achieved

  • Resulted in increased awareness and understanding of isolation. Key stakeholders are now in the habit of screening and referring seniors who are isolated.
  • Many services are overburdened, inflexible and fragmented – resulting in vulnerable seniors falling through the cracks of the existing system. Connector services addressed gaps by increasing collaboration among service providers, taking on clients/ tasks that others did not have capacity for.
  • The HSIIP partners helped to lead the development of a new Seniors At-Risk Community Collaborative, which is strengthening partnerships among a group of 40 plus partners serving vulnerable seniors in the Greater Hamilton region.
  • By increasing resiliency among seniors and improving the capacity of the community to address isolation, it is believed that the HSIIP will result in significant cost-savings in the longer term.

For More Information:

Visit: www.SocialIsolation.ca