Guest blog from Age UK’s Research Manager Vinal K Karania
“Loneliness is deeply personal – its causes, consequences and indeed its very existence are impossible to determine without reference to the individual and their own values, needs, wishes and feelings. As such, it is also a complex, and often time-consuming, issue to address. However it is an issue that must be addressed due to the far reaching and devastating impacts that it has on those who experience it on a daily basis.” (Promising Approaches to reducing loneliness and isolation in later life, p6)
Around 10% of people over 65 say that they are often lonely. Loneliness has been shown to be associated with a number of health issues, both physical and mental, that could potentially result in preventable costs to the health and social care service. It can also have a devastating impact on the quality of life of an older person.
It is accepted that many services offered to older people are likely to help prevent or reduce their feelings of loneliness. However, the level of evidence to measurably demonstrate these positive outcomes is relatively weak. One reason for this is the lack of services measuring loneliness using accepted measures. There are many validated measures of loneliness and the Campaign to End Loneliness in their report Measuring Your Impact on Loneliness In Later Life presents four such measures.
How can loneliness measures be used in practice? Over the last year Age UK’s Testing Promising Approaches to Reduce Loneliness programme has involved seven local Age UK Brand Partners all using the 3-item UCLA loneliness scale*. The use of the scale by the seven partners has provided learning on how the scale can most effectively be administered. The learning recommends that:
- the 3-item UCLA loneliness scale should be asked in the middle of a conversation;
- the 3-item UCLA loneliness scale should be asked as written (i.e. it should not be rephrased to suit the interpretation or preference of the person asking questions);
- the 3-item UCLA loneliness scale should be asked as part of the initial conversation, then again after a shorter internal (e.g. few weeks) and then again after a slightly longer interval (e.g. a few months), and where relevant at appropriate points beyond this.
The importance of asking the questions as written is that the questions have been designed and tested to capture aspects of loneliness and the use of different words may lead to measuring something different. Asking the questions as written also means different people asking the questions are eliciting the same information.
There is a tendency for those asking the questions to point out that the challenge is that some people have negative emotional reactions to being asked these questions. Although this may be the case, the issue is not asking the questions as written, but rather providing training to be comfortable asking these questions and knowing how to deal with emotional reactions, especially since many things could lead to an adverse emotional reaction.
So do not be afraid to ask older people about their feelings of loneliness – use validated questions as written and ensure those asking these questions have been trained to deal with difficult emotional reactions. The payoff will be being able to demonstrate the positive impact a service is having on a lonely person’s levels of loneliness.
*the 3-item UCLA loneliness scale consists of the following three questions: How often do you feel that you lack companionship? How often do you feel left out? and How often do you feel isolated from others? For each question there are the following three responses: Hardly ever, Some of the time and Often. Those answering “Hardly ever” are given a score of 1, those answering “Some of the time” are given a score of 2 and those answering “Often” are given a score of 3. The scale values therefore range from 3 (each question being responded with “Hardly ever”) to 9 (each question being responded with “often).
This blog was first published on the Age UK website