Addressing Social Isolation amongst Older People in Dorset Sharing the Experience…. Eleanor Jack Dr Ann Hemingway

1. Addressing Social Isolation amongst Older People in Dorset Sharing the Experience…. Eleanor Jack Dr Ann Hemingway

2. “The terms 'loneliness', 'social isolation' and 'living alone' are often used interchangeably, although they are three distinct (but linked) concepts.” Emotional isolation and social isolation are two distinct dimensions of loneliness in older people (Van-Baarsen, (2001). Bournemouth University and Brendoncare Friendship Clubs

3. Social Isolation in the Older Age Group Figures......... Bournemouth University and Brendoncare Friendship Clubs

4. Half a million people aged over 65 spent Christmas alone in 2009. According to Age Concern, more than one in 10 say they always or often feel lonely, and nearly half consider television their main form of company. More than a million people over 65 feel trapped in their own homes More than 180,000 people over 65 say they have gone for a whole week without speaking to friends, neighbours or family. Bournemouth University and Brendoncare Friendship Clubs

5. Locally….. More than 50% of those over 75yrs live on their own, and the Dorset region is likely to be more highly affected due to the larger proportion of elderly people choosing to retire by the coast. In Bournemouth, 22.4 % of people are of retirement age – 3.5% higher than the national average across England and Wales. Around 30 % of Poole’s residents are aged 60 and over, while in Christchurch, that figure is more than 36 %. As a whole, Dorset has the second highest proportion of elderly people of any county in Britain, second only to East Sussex, with 25.9 % of the population over 65. The closure of local services including shops, post offices and pubs have all helped to isolate people even further. Only 17 % of people over 65yrs use the internet, and only 50 % those over 50yrs have access to the web. Bournemouth University and Brendoncare Friendship Clubs

6. Why are the older age group more likely to become isolated? Bournemouth University and Brendoncare Friendship Clubs

7. Why are the older age group more likely to become isolated? Ageing often brings changes in social relationships as well as a need for (re) adjustment to changing life and personal circumstances as individuals retire, give up/modify activities….. losses may include bereavement, moving away, moving into new accommodation….. health losses may include cognition (dementia/ stroke), mobility…. (Hammill, 2009) These changes can lead to feelings of loneliness or isolation. March 2010 Bournemouth University and Brendoncare Friendship Clubs 7

8. What does it feel like to be socially isolated? Bournemouth University and Brendoncare Friendship Clubs

9. “I can go for a whole week and not speak to anyone at all in person… things are at their worst when you get poorly. You can’t look after yourself and you can’t even get up for a glass of water. No-one’s there and no-one cares if you’re ill.” This loneliness is a killer. It’s worse than the fear I had of being bombed in London during the war.” “The politicians are trying. They do their best but there are so many of us now. They haven’t much time for us. There are other things going on in the world that they have to look after. I am only a little blip.’” ‘Loneliness is like a cancer. It eats away at you until you feel destroyed and empty inside.’ Bournemouth University and Brendoncare Friendship Clubs

10. What does the research tell us.......? Why do we need to consider Social Isolation in the Older Age Group? Bournemouth University and Brendoncare Friendship Clubs

11. So how do researchers perceive “Social Isolation”? Two main forms of social isolation: • Objective isolation (i.e. physical separation from others) • Subjective isolation (i.e. feelings of loneliness, emotional distance, or lack of support from others). (Yorke and Waite, 2009) Bournemouth University and Brendoncare Friendship Clubs

12. However, others researchers crucially suggest that it is the level of perceived social isolation and sense of loneliness that matters...... (Hammill, 2009) Bournemouth University and Brendoncare Friendship Clubs

13. The NegativeHealth Impacts of Social Isolation Previous research indicates that social isolation negatively affects both physical and mental health, particularly among older adults (House 2001; House 2002; Tomaka, Thompson, and Palacios 2006). These negative health effects include all-cause mortality, morbidity, and cardiovascular disease (House 2001). The effects of social isolation have been compared in magnitude to the damaging health effects of smoking cigarettes and other major health risks(House 2001). Bournemouth University and Brendoncare Friendship Clubs

14. The Positive Health Impacts of Social Involvement The physiological effects of social involvement and the maintenance of social ties can increase immune function (Cohen et al. 1997; Pressman et al. 2005) and reduce cardiovascular and neuroendocrine damage related to exposure to stress (Seeman et al. 1994). Being embedded within a social network is thought to promote health-enhancing behaviors (Kinney et al. 2005) and to increase sense of control and self-esteem (Cornman et al. 2003). Social and productive activities are as effective as fitness activities in lowering the risk of death Enhanced social activities may help to increase the quality and length of life (BMJ Vol. 319 21 August 1999 P.482) Bournemouth University and Brendoncare Friendship Clubs

15. The Public Health Perspective Bournemouth University and Brendoncare Friendship Clubs

16. Promoting Health and Wellbeing Healthy active ageing should be encouraged Participation in leisure, social, cultural & spiritual activities, for example, in the community, helps older people maintain self esteem, maintain or create supportive and caring relationships by fostering social integration and is the key to staying informed (WHO, 2007). The South West Strategic Health Authority aims to keep older people healthy and shape services around their needs recognising the older age groups can be particularly vulnerable and are more likely to experience health inequalities. To maintain their health, older people need to be supported to take personal responsibility for maximising their potential to live a healthy, fulfilling and independent life (SWHA, 2008) Bournemouth University and Brendoncare Friendship Clubs

17. Social Relationships are Important to All Ages People who are embedded in a network of personal relationships experience a higher level of well-being than those who are socially isolated and they also tend to be healthier. Factors? • Identity and self respect: a personal network offers people a social identity • Social integration; personal involvement and a feeling of security • Social support: practical and emotional support, companionship -for the older age groups their personal and social functioning depends largely on the social support they can get. (Machielse, 2006) Bournemouth University and Brendoncare Friendship Clubs

18. Addressing Social Isolation In The Older Age Group The Bournemouth University and Brendoncare Research Project Bournemouth University and Brendoncare Friendship Clubs

19. Bournemouth University was commissioned by the Brendoncare Charity to undertake a 3yr, predominantly qualitative, research project focusing on the impact that Brendoncare Clubs may have on the experience of social isolation – an issue, not only well-documented in the literature, but also raised by club attendees themselves.  Project activity began at the end of 2008 in partnership with ten clubs based in Hampshire and Dorset. Bournemouth University and Brendoncare Friendship Clubs

20. Social Isolation and the Impact of FriendshipClubsMain Objectives 1. To explore and describe the reasons as to why attendees come to the clubs/volunteer, experience of barriers and expectations as well as the practical pathways involved. 2. Explore perceptions of the impact of attending Eg. impacts on well being/mental-physical health as described by those who take part in the study 3. Explore and describe the phenomenon of “social isolation” as experienced by those affected. 4.Identify measures that may help reduce the occurrence of social isolation from a older person’s perspective. 5. Develop a working partnership with external agencies ie. Brendoncare. 6. Meaningfully involve attendees, volunteers, and carers in the research study itself. Bournemouth University and Brendoncare Friendship Clubs

21. Research Project – Brief Overview The 10 Brendoncare Clubs from Dorset and Hampshire identified for inclusion in the study were selected through negotiation with the head of Brendoncare Clubs to ensure area spread and generalisability. The project is being carried out by a BU Researcher supervised by a BU Research Fellow. Bournemouth University and Brendoncare Friendship Clubs

22. Research Project – Progress The researcher has informally visited (and thoroughly enjoyed!) the Brendoncare Clubs to introduce herself and describe her role within the study, as well as providing a general overview of the study itself. These visits have also provided the opportunity to chat with members and staff about experiences of social isolation, and what impact the clubs may have on this, as well as what attendance at the clubs offers the members and volunteers generally. The researcher was also seeking club input in developing the Consent Forms and Participant Information Sheets to be used in the study. Numerical data from 13 Brendoncare clubs was also collected and analysed. Bournemouth University and Brendoncare Friendship Clubs

23. Brief Overview of Findings Thus Far.................... Bournemouth University and Brendoncare Friendship Clubs

24. The transport was needed, valued and appreciated by the club members. Many of whom could not otherwise attend the clubs. Bournemouth University and Brendoncare Friendship Clubs

25. Emerging Themes The members outlined the reasons as to why they may be at risk of becoming/being isolated – findings generally similar to the literature but also including: * Safety fears * Fear of falling and * General loss of confidence Feeling isolated……. • The members discussed social isolation within an objective and subjective framework – as described in the literature. • Attendance at the club provides the only contact with others for some members, indeed the weekly club is the only source of conversation in the entire week. Many members now live alone since the death of their partner. •    The social contact/conversation can begin with the transport driver who for some is also an important social contact. Bournemouth University and Brendoncare Friendship Clubs

26. (...confidant and community involvement Boldy, 2008) Emerging Themes A Key Theme was Friendship and the impact this had on the members In terms of social relationships, the members felt that they not only made new friends but enjoyed companionship and emotional support (empathy and the sharing of similar life experiences, good and bad) “Who is that old person in the mirror?!” There were benefits to be had from the practical information and guidance from these relationships, and for some a reaffirming of their social identity. “We have a laugh about our aches and pains....” Bournemouth University and Brendoncare Friendship Clubs

27. .......Vincenzi and Grabosky (1987) describe emotional isolation as a deficiency in intimacy and attachments Emerging Themes A Key Theme was Friendship and the impact this had on the members Emotional/romantic relationships are established and conducted, in part, at the clubs. For the bereaved, the new friendships were key as often they had subsequently moved away from established networks and friends to be nearer family.........the clubs also provide a valuable support through the grief process..... Bournemouth University and Brendoncare Friendship Clubs

28. Emerging Themes A Key Theme was Friendship and the impact this had on the members Some members, albeit not living alone, and/or having frequent contact with their family still described feeling lonely as they did not feel they were truly engaged with their family at a level they enjoyed. They viewed attendance at the club as a welcome relief! “I just like to get away from them!” Bournemouth University and Brendoncare Friendship Clubs

29. Emerging Themes A Key Theme was Friendship and the impact this had on the members Members described suddenly losing roles and responsibilities eg. by having to move home/location or as grandchildren grow up. “I had nothing to get up for.” The members described feeling valued by friends and everyone at the club. “No-one else has time for our age group” “We just don’t feel listened to.” The members feel that the clubs acknowledge members as valuable members of society with a wealth of life experience to share and draw upon, often within the clubs themselves. Bournemouth University and Brendoncare Friendship Clubs

30. Many members described having been isolated due to their limited income, however, the clubs’ low cost of attendance meant that an active social life was now possible! Emerging Themes A Key Theme was Friendship and the impact this had on the members The members appreciated the flexibility in attending the clubs. Just like within friendships, there is no pressure eg. no pressure to attend if members do not feel well either mentally or physically, or they simply “don’t feel up to it”. There is also no pressure to take part in any of the activities or days out either, where cost may also be an influencing factor. Bournemouth University and Brendoncare Friendship Clubs

31. Have older people discovered a solution for combating social isolation themselves? Literally….THEMSELVES? Is “facilitation” and “enabling” the key to the success of the Friendship Clubs? Is it about bringing people together to support each other and providing a mechanism for this to happen? Reflections…….. March 2010 Bournemouth University and Brendoncare Friendship Clubs 31

32. Health and Wellbeing of the Older Adult The Value of Social Involvement in Friendship Clubs Findings from This Study WELLBEING Improved self-esteem. Improved quality of life. Improved fitness through club activities. Established or enhanced social ties. Sense of empowerment and control. Social Relationships Enhanced social and personal identity. Role development. Sense of personal and community involvement. Practical and emotional support. Companionship. Inclusivity. HEALTH Positive health impacts. Reduction in negative impacts. Bournemouth University and Brendoncare Friendship Clubs

33. To summarise...... This study so far succinctly highlights that Friendship Clubs can be seen to help tackle the challenge and subsequent effects of social isolation for the older age group. The next stage of the study is to undertake focus groups across ten clubs to further establish and develop the thematic research findings. Bournemouth University and Brendoncare Friendship Clubs

34. Final Thoughts “No man is an island.. “ (J Donne) Meditation XVII, 1624: • Human beings do not thrive when isolated from others- social creatures in general • Developmental Psychology: emphasizes the social formation of the mind and the role of the other in development throughout life (Leiman, 2002). • We define ourselves and find our voices through the response of another and vice versa. Bournemouth University and Brendoncare Friendship Clubs

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