How do you identify the loneliest?
This is a question that we receive from charities, local authorities, social care and public health teams, and others. Your approach to identification will vary depending on your organisation. Organisations should seek creative solutions to identifying the people most likely to benefit from their support.
Recognising loneliness
Loneliness is a very subjective and personal experience and there is no ‘set’ way to act. However, when thinking about whether older people around you might be feeling lonely (they could be your friends, neighbours or family), you might want to have a think about:
- Whether they live alone
- Whether they have recently been bereaved
- Whether are or have recently been ill
- How mobile they are
- Whether they are sensory impaired (perhaps hearing or sight loss)
- How regularly they leave the house
- Whether close family lives nearby
Understand and identify key risk factors:
There are a number of risk factors that increase someone’s vulnerability to, and likelihood of experiencing, loneliness in older age. By considering these factors, organisations can build a better understanding of who might be lonely or interested in their service.
Risk factors can be:
Demographic/social group – Although some studies suggest that women report higher levels of loneliness than men, others have found no difference, or that men were at greater risk of social isolation. However, it is possible that men may be less likely to admit to feelings of loneliness. Men may be particularly vulnerable to isolation and loneliness after the death of a partner, as they are more likely to depend on their wives to connect them to a social group.[1] Research also suggests that being part of an ethnic or other minority social group, for example LGBT individuals, can make people more vulnerable to loneliness.
Rural or urban environments – focus groups and interviews conducted as part of our Hidden Citizens report also highlighted that lack of transport (associated with rural living), and living in an urban area with a high population turnover and a booming younger population could lead to fewer opportunities for social interaction and to loneliness.
Lack of nearby family – Focus groups involved in our research told us that living far from family was a factor in developing loneliness.12% of older people say they would like to visit their family more often.[2]
Having a caring responsibility – More and more older people are in caring roles. While the number of carers of all ages in the UK has risen by 11% since 2001, the number of older carers has risen by 35%.[3]
Caring for a partner or relative has been shown to negatively impact wellbeing. Recent data from Carers UK showed that 57% of carers had lost touch with their friends. Over three quarters of carers ages 60–69 say that caring has had a negative impact on their mental health.[4]
Having a dementia diagnosis – A third (33%) of people with dementia have lost friends following their diagnosis, while more than a third (39%) of people with dementia feel lonely. This is more than the figure for older people without dementia, among whom only a quarter (24%) have felt lonely in the last month.[5]
Living on a low income – Poverty and loneliness are linked. Our literature review as part of ‘Hidden citizens’ identified that living on a low income a risk factor in developing loneliness. The Department for Work and Pensions’ survey of households below average income showed that poverty is prohibitive: 24% of pensioners go out socially less than once a month.[6]
Bereavement – After having lost a loved one, people are more vulnerable to loneliness. Bereavement is a trigger for loneliness and also an indicator that someone might be, or become, lonely.
Poor mobility – Not being able to get out and about can limit an older person’s social contacts. 9% of older people feel trapped in their own[7] home and 6% leave the house once a week or less[8]. 76% of older people say that transport or mobility issues prevent them from visiting family. 56% of older people have difficulty using a bus, 53% report problems using trains and 42% report difficulties walking or cycling.[9]
Hearing or sight loss – Difficulties with communication and social interaction can contribute to people with sight loss feeling socially isolated, and social isolation is a known risk factor for loneliness. While hearing or sight loss is not a prerequisite for loneliness, people’s experiences of sensory loss can lead them to loneliness.[10]
Ways to identify lonely or isolated older people
Door knocking – To improve success, consider pairing your door to-door advertising with another organisation. Examples of this include North London Cares teaming up with Islington Council and Age UK Islington to knock on doors to deliver leaflets on winter warmth. The volunteers would give information about how to keep warm, but also about social activities, and offer to accompany the older person to various activities.
Surveys – If you are a local authority, including a measure of loneliness in your JSNA will help identify which areas, communities and groups are experiencing the greatest levels of loneliness. Practitioners are advised to use our guidance on measuring loneliness which they can find here: http://www.campaigntoendloneliness.org/wp-content/uploads/Loneliness-Measurement-Guidance1.pdf and to use our guidance for local authorities and commissioners: http://campaigntoendloneliness.org/guidance/
Some local authorities undertake their own lifestyle or behaviour surveys. These surveys may already include questions relating loneliness and isolation, or could do so in the future. For more information, take a look at our guidance for local authorities and commissioners: http://campaigntoendloneliness.org/guidance/
Partnership working between organisations – Collaborative working approaches with a number of organisations could help you identify people who experience the above risk factors. You could develop partnerships or referral systems with Police Community Support Officers, fire services, community nursing teams or other NHS services. Age UK Cheshire and Cheshire Fire and Rescue Services (CFRS), for example, have combined forces to pool information on the local older population. This data is used to identify older, vulnerable people who are visited by CFRS and Age UK Cheshire at the same time.
Mass media, local press and magazines and mail outs – Advertising your services that help people to address loneliness in GP surgeries, council-funded publications and local and national press might help people experiencing loneliness identify themselves to your organisation.
Word of mouth and personal recommendations – In our research, older people in focus groups said they knew that they knew of peers who were lonely. However, relying on word of mouth of self-referrals might exclude the most lonely or isolated older adults whose social networks may have disappeared entirely.
The above is based on our report, Hidden citizens: how can we find the most lonely older adults, produced with the University of Kent.
References
[1] B. Beech and S. Bamford (2014) Isolation: the emerging crisis for older men, ILC-UK and Independent Age
[2] Department for Transport (2001) Older people: Their transport needs and requirements – Main report. Technical report, Department for Transport
[3] Facts about carers, Carers UK Policy Briefing, May 2014
[4] Always on call, always concerned: A survey of the experiences of older carers. The Princess Royal Trust for Carers, 2011
[5] http://www.alzheimers.org.uk/dementia2013
[6] Households Below Average Income 2012/13, Chapter 6, DWP, 2014
[7] One Voice: Shaping our ageing society, Age Concern and Help the Aged, 2009
[8] TNS Loneliness survey for Age UK, April 2014
[9] Department for Transport (2001) Older people: Their transport needs and requirements – Main report. Technical report, Department for Transport
[10] http://www.pocklingtontrust.org.uk/researchandknowledge/publications/rf44lonelinessandsocialisolation.htm
