News Details

25 June

Tackling loneliness and social isolation: the role of commissioners

In September 2017, SCIE and Renaisi organised a seminar with commissioners, local authorities and third sector representatives to explore the opportunities and barriers faced by commissioners seeking to address social isolation in older people. This was part of a three-year evaluation that SCIE and Renaisi are undertaking of a new national programme to help address isolation in older people through reading-based interventions.

The impact of loneliness and social isolation

Loneliness can affect people at any age, but the focus of this report is on older people. There are many ways to define, and differentiate between, loneliness and social isolation. Loneliness is the ‘subjective, unpleasant and distressing phenomenon stemming from a discrepancy between individuals’ desired and achieved levels of social relations’. (2) Social isolation is ‘an imposed isolation from normal social networks caused by loss of mobility or deteriorating health’. (3) A way of clarifying the difference is to say that ‘a person can be lonely in a crowded room’ but they are not socially isolated.The impact that loneliness and social isolation can have on the physical, mental and social health of isolated older people is well documented. The Campaign to End Loneliness points to research which shows that lacking social connections is as damaging to health as smoking 15 cigarettes a day. (4) Lonely individuals are more likely to visit their GP, use more medication and have a higher incidence of falls. (5) They are also more likely to enter early into residential or nursing care. (6)

What works to help address loneliness and social isolation?

The landscape of interventions is diverse including direct one-to-one or group-based support and signposting to other services. The emphasis is often on creating opportunities to bring people together, maintaining and creating networks and friendships, and promoting activities that help to overcome the risks faced by and poor health outcomes of many individuals who are lonely and socially isolated.At the seminar, health and social care consultant Dr Karen Windle suggested that while there is more evidence about the impact of interventions than there was six years ago, quality remains an issue. (†) Sample sizes are small and few studies offer a counter factual assessment; in many cases, due to the small-scale nature of interventions, this might not even be feasible. In addition, few studies have explored the impact of maintaining interventions over longer periods and the changes that might then arise for beneficiaries.

Reference

Davidson, S. and Rossall, P. (2014) Evidence Review: Loneliness in Later Life. Loneliness Evidence Review, Age UK.

  1. Perlman, D. and Peplau, L. A. (1981) ‘Toward a Social Psychology of Loneliness’. In R. Gilmour & S. Duck (Eds.), Personal Relationships: 3.
  2. Relationships in Disorder, pp 31–56. London: Academic Press.
  3. Windle, K. et al. (2011) Preventing loneliness and social isolation: interventions and outcomes. London: SCIE.
  4. Holt-Lunstad, J. et al. (2015) ‘Loneliness and social isolation as risk factors for mortality: a meta-analytic review’. Perspectives on Psychological Science, vol 10, no 2.
  5. Cohen, G.D. et al. (2006) ‘The impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults’ The Gerontologist, vol 46, no 6.
  6. Russell, D.W., Cutrona, C.E., de la Mora, A. and Wallace, R.B. (1997) ‘Loneliness and nursing home admission among rural older adults’. Psychology and Aging, vol 12, no 4, pp 574–89.
     

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