Jennifer Francis, Research Analyst at the Social Care Institute for Excellence (SCIE), discusses evidence from research and practice, which shows that services to support friendships are successful in reducing loneliness and improving health and quality of life.
A recent study carried out by DEMOS for WRVS found that UK older people are the loneliest among other European countries. The research was a comparative study involving analysis of an ‘Ageing Matrix’, which describes and compares the experiences of older people in Germany, the United Kingdom, the Netherlands and Sweden.
The report suggests one reason for the UK’s poor performance on the loneliness indicator is that local authorities have failed to invest in services which are likely to reduce social isolation among older people. This seems like a huge missed opportunity since we have evidence that certain services do reduce loneliness and services such as befriending schemes save more money than they cost to provide.
The savings that these types of services deliver owe in large part to the fact that loneliness and isolation are associated with high blood pressure, depression, decreased life expectancy and earlier admittance to long term residential care. Therefore in tackling the problem we can expect health and wellbeing improvements and an impact on health and social care service use, limiting dependence on more costly, intensive services.
When SCIE reviewed the research evidence in this area we classified the wide variety of interventions aimed at reducing isolation and loneliness as one to one interventions, group services and wider community engagement. We also focused on how well those services addressed three important outcomes; a reduction in loneliness, improvements in health and wellbeing and health service use.
We found good evidence that befriending schemes and Community Navigators successfully reduce loneliness; that befriending schemes reduce depression, social group activities can improve self reported health, wellbeing and mortality and that health service use had decreased among people in a group based intervention.
In our subsequent ‘at a glance briefing’ on social isolation, co-produced with Contact the Elderly, we’ve summarized the research evidence and also provided case study examples of two services in the UK designed to help mitigate loneliness and social isolation.
Contact the Elderly itself has a good example of a social group scheme. The charity organises free monthly Sunday afternoon tea parties for small groups of older people, aged 75 and above – who live alone without nearby family and friends. As Contact the Elderly’s director, Keith Arscott says
“…The benefits extend beyond the one-Sunday-a-month gathering…. Real friendships are formed and volunteers often help older guests with their weekly shopping and transporting them to and from hospital appointments.”
Our briefing features Maud, who was left lonely and depressed following the death of her lifelong friend with whom she lived for many years. When Maud spotted an advert for Contact the Elderly she decided to become a guest. Maud commented “It’s changed my life. I feel like I have a whole new set of friends to talk to. It’s wonderful.”
The other case study featured in our briefing is the Oxfordshire Befriending at End of Life (OxBEL) service run by Age UK Oxfordshire with funding from the Department of Health and the local primary care trust. Volunteers provide one-to-one befriending to adults of all ages, with either life-threatening conditions or who are at end-of-life. Befriending can last for a matter of weeks, months to many years.
One person who benefitted is Joyce. Joyce, who was divorced and estranged from her daughter, was in the late stages of untreatable cancer. New to the local area, having moved shortly before becoming ill, she was lonely and very frightened. Her befriender, May, provided Joyce with companionship, support at medical appointments, and a listening ear. She facilitated an emotional reconciliation between Joyce and her daughter. May continued to visit Joyce when she went into a hospice, and supported Joyce and her daughter during Joyce’s last hours before she died.
Stories like these vividly illustrate the crucial impact such services have on people’s lives. Although testimonies are useful we also need a reliable research evidence base to help make the case for investment in and development of interventions that reduce loneliness – especially since we know its adverse effects.
Research evidence in this area has developed incrementally and although it tells us that services like befriending, community navigators and social groups work well, research methodologies could certainly be strengthened.
One particular area in which we need more work is cost effectiveness evaluation. At a time when local authorities are required to make unprecedented savings, we need to provide compelling evidence that investment in often inexpensive services can deliver improved outcomes for people and prevent or delay their need for more costly ongoing support.
To learn more about the research evidence on services to reduce social isolation and loneliness access SCIE Research briefing 39. To see some real life examples of the impact of those services, see ‘at a glance’ 60 and the Social Care TV film on promoting wellbeing.