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The impact of social isolation and loneliness on older people
I've been exploring the research on this topic this week. In the current state of social care, only the most dependent people are being supported and this has led many older people who live alone to become socially isolated. They are the folk who need minimal help to maintain a good quality of life but unless they have family and friends to give them the support or confidence to get out they easily become trapped in their own homes.
The Social Care Institute for Excellence (SCIE) says "social isolation and loneliness have a detrimental effect on health and well-being". What is even more concerning is the government funded research carried out by the Residents & Relatives Association that identified 8 % of care home residents with no kith or kin and at high risk of being socially isolated. Large scale studies by University College London reported in the Nursing Times conclude that "efforts to reduce social isolation of older people are likely to have positive outcomes for well-being and this research suggests that they could also reduce mortality".
Socially isolated people can quickly become withdrawn and even clinically depressed. There seems to be a general assumption that living in a care home means you have constant company. But having people around you is no guarantee that you won't feel lonely or socially isolated. I have seen many people move into care homes who are in poor health, have lived alone for many years, suddenly lost everything precious to them and then found themselves living amongst strangers. It is no surprise then that they retreat into their own room which becomes their safe space. It takes time for them to build relationships and trust those around them.
A skilled activity provider will know how to start to build a rapport with short but frequent room visits. Gently building a picture of that person’s past life and what holds meaning for them. It might be that they are missing a favourite TV or radio programme or even a magazine that they used to have delivered. Providing these things will be the first step on the road to integrating with others and feeling safe within the care home.
Many years ago I worked with a lady with chronic hearing loss who was too embarrassed to leave her room. She feared that others would think she was rude if she ignored them. She was becoming more and more isolated and her mood was routinely low and withdrawn. I devised a programme that included inviting her to sort through old magazines for me looking for pictures of dogs which I knew she loved. I needed them to build a collage board for another gentleman's bedroom. Initially, she did this in her room and later was prepared to join me in the nearby small quiet sitting room. After a few weeks of doing these sessions twice a week, I invited another hand picked resident to join us. Over time I could leave them chatting while I did other things. The two ladies became firm friends and would visit each other's rooms. Neither of them would go to the busy dining room or the TV lounge because they didn't like to be amongst other people but they didn't need too as they had each other. They had formed a relationship of trust and friendship and neither was lonely or isolated.
Of course when one lady passed away the other was very upset. Comments were made at the time that it was unfair to allow them to be so dependent on each other and they should have been made to mix with others. My response was that their friendship had mirrored that of people living in the community. They had enjoyed 3 years of each other's company and if they had not had each other they might have died sooner as a result of their loneliness and isolation. It is reassuring, all these years later, to see that research reflects the views I held at that time.
I would like to see more attention paid to the impact of social isolation both in care homes and older people living alone. NAPA is currently looking for grant funds to help us develop more training courses for care teams and activity providers that help staff to recognise and deal with these issues.
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