You’re Not Alone: Reflecting on One Year of the PEARLS Program

In 2022, Centralina Area Agency on Aging (AAA) was awarded grant funding from the North Carolina Center for Health and Wellness to pilot the Program to Encourage Rewarding, Active Lives (PEARLS). This unique evidence-based program is implemented to combat depression and social isolation in older adults throughout North Carolina.  

Depression, also known and categorized as major depression, major depressive disorder or clinical depression, is a common, but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks and handles daily activities, such as sleeping, eating or working. Social isolation is defined as the lack of social connections and having few people to interact with regularly. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated. Although it’s hard to measure social isolation and loneliness precisely, strong evidence suggests that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that poor social relationships, (characterized by social isolation or loneliness) were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke. Depression or isolation symptoms may include: 

  • Persistent sad, anxious, or “empty” mood 
  • Irritability, restlessness or having trouble sitting still 
  • Moving or talking more slowly 
  • Difficulty concentrating, remembering or making decisions 
  • Difficulty sleeping, waking up too early in the morning or oversleeping 
  • Have limited social support   
  • Having a major loss or life change, such as the death of a spouse or partner or retirement   
  • Experiencing discrimination based on age, racial, ethnic, sexual orientation and/or gender identity  

The PEARLS program provides a solution that ensures aging adults receive proper treatment if they are experiencing depression or isolation symptoms. PEARLS offers eight sessions over a course of four to five months, which can take place in the client’s home, by phone, virtually or other community settings. Coaches assess each participants’ severity of depression and response to treatment by using the PHQ-9 (Patient Health Questionnaire) score during each session. Each session is client-driven through focused behavioral techniques to make sure participants feel seen, heard and comfortable. Decreasing PHQ-9 scores indicate that the intervention is working and participants are making progress. Moreover, PEARLS Coaches are able to journey with participants and witness growth in individual confidence levels.   

Centralina AAA staff began accepting participants in designated regional areas in December of 2022. Of those who have enrolled in PEARLS, three participants have completed the program in its entirety. Their success exceeded expectations and helped them become more confident in combatting problems using their own abilities. One participant stated, “This program put me in a positive place. I was no longer overwhelmed, I felt heard and not judged. I really enjoyed her company and most importantly, she gave me hope again.” Another participant relayed that “PEARLS is not as medical as other programs; it’s informal and fun to participate in.” 

The first graduate of the PEARLS program is a caregiver to her husband. She struggled with providing appropriate care for her husband, who is legally blind and experiences memory impairment, due to lack of financial support. The second graduate uses a wheelchair and is legally blind. She attended dialysis three times a week but experienced depressive symptoms, as many people outside of her support system were not sensitive to her needs. The most recent graduate just moved to Charlotte from Maryland. She felt very isolated living in a new city with just her son and his family as support. All three participants each learned individuated techniques on how to overcome their unique problems and challenges. Such techniques are outlined by program standards to specifically combat depression and social isolation symptoms. Centralina AAA hopes the continued progress of this program influences professionals, community leaders and other stakeholders to help proactively provide and expand the type of support PEARLS provides to more older adults throughout our region and beyond.  

PEARLS is currently open to receiving referrals across Centralina’s nine-county region. If you are interested in learning more about PEARLS or would like to refer someone who may benefit from participating in the program, reach out to Kamiya Williams at You can also learn more about the PEARLS program through this spotlight feature, aired on PBS North Carolina and produced as a part of ncIMPACT’s Town Hall series, specifically for an episode highlighting mental health in older adults.