Regular readers of this blog will be aware that addressing loneliness and social isolation among older people in our population has become something of a national priority in the United Kingdom. Secretaries of state and key ministers have made speeches about it, major national funders have set aside millions of pounds to address it and thousands of people across the UK have signed-up to the Campaign to get involved and do something in their own area.
Yet one of the challenges that councils, charities and even neighbourhoods continue to face is how to accurately identify and reach older people experiencing, or most at risk of, loneliness. In 2013, we consulted over 100 frontline service providers about what they needed to improve their support. Nearly half said they wanted a tool or information that could help them to identify people experiencing – or at risk of – loneliness.
To respond to this need, the Campaign and the University of Kent undertook a piece of research to learn more about identifying people experiencing loneliness. We explored current approaches to identifying loneliness and looked for insights into how services can improve their outreach and support.
Today we’re publishing a report explaining what we’ve found, and making a few recommendations for future research and practical work in this area. To download an executive summary of Hidden Citizens: How can we identify the most lonely adults? click here.
What things can lead to loneliness?
We found that loneliness can be triggered by a range of factors, which are both internal (intrinsic) and external (extrinsic). These can combine to make preventing or alleviating loneliness extremely complex. The more personal factors could include being part of a minority ethnic or social group, for example LGBT sexuality, or experiencing anxiety about social situations.
The external, ‘extrinsic’, factors included lack of affordable or accessible transport, living in an urban area with a high population turnover or not living near family. Life events, traumas and transitions were also regularly cited as leading to loneliness, particularly suffering a bereavement or becoming a carer.
Finally, being childless, living on a low income, experiencing poor health and poor mobility, and the loss of our sight and/or hearing can also increase our risk of loneliness.
What is already being done to identify loneliness in our communities?
Mass mail-outs, and advertising through local press and magazines, are a popular strategy for some services. Adverts in council-funded magazines and local radio programmes were seen as a particularly effective because of their older readership and listenership. Service providers used leaflets and posters in libraries, GP surgeries and supermarkets to promote their support.
Word of mouth and personal recommendations was also relied upon by many services. One benefit of this approach is that an invitation from a friend or acquaintance can overcome a lack of confidence. However, relying on word of mouth or self-referrals could exclude some of the most lonely or isolated older adults.
Finally, some of the most effective ways to identify people in need of support involved providers and commissioners developing partnerships across different sectors to improve referrals between different services. Partnerships varied by local areas, but could include health and care professionals, charity volunteers and high street facilities, including pubs and libraries.
Are loneliness maps the answer?
The report highlights that a number of councils are leading the way by identifying people experiencing loneliness, including Gloucestershire County Council, who have created a ‘map’ of factors that could cause it. The map highlights households with just one occupant, a head of household who is aged 65+, situated in a low income area, or do not own a car, amongst other indicators.
Neil Dixon, Joint Strategic Needs Analysis Manager at Gloucestershire County Council explained why their mapping exercise was important: “Targeting local people who need our help the most is a priority for us in Gloucestershire and we are always looking at new ways to reach them. The map we’ve adapted from a model by Essex County Council means that we can work out how many people could be lonely and where those people need us most.”
How can we challenge the stigma attached to loneliness?
Loneliness is a stigmatised experience, and this can make it difficult to identify people experiencing it. To avoid this, some services used strategies such as identifying ‘signals and signs’ in more open conversations. As one community development manager interviewed explained:
“Usually I don’t like to use the words “are you lonely?” because there is a stigma to it and people don’t like to admit to such a thing, but it comes out in conversation quite often. People ring up and say…“I don’t really see anyone and I’m really quite housebound and I am quite isolated.”…It’s like they’re skirting around the [issue]…They’re saying it in a different way”.
Services and commissioners have a choice to make about whether to mention the ‘L’ word. But either way, existing points of contact with older people could make time to have an open conversation, in a safe environment, about how someone is feeling – and what support they might like. This approach is recommended in the Campaign’s recent report with Age UK Promising Approaches to Tackling Loneliness and Isolation in Later Life, described in this document as a “guided conversation”.
To learn more…
A copy of the executive summary and full research report can be downloaded from our website here.