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Loneliness and social isolation interventions for older adults: a scoping review of reviews

FAKOYA Olujoke A., MCCORRY Noleen K., DONNELLY Michael
2020

Background: Loneliness and social isolation are growing public health concerns in our ageing society. Whilst these experiences occur across the life span, 50% of individuals aged over 60 are at risk of social isolation and one-third will experience some degree of loneliness later in life. The aim of this scoping review was to describe the range of interventions to reduce loneliness and social isolation among older adults that have been evaluated; in terms of intervention conceptualisation, categorisation, and components. Methods: Three electronic databases (CINAHL, Embase and Medline) were systematically searched for relevant published reviews of interventions for loneliness and social isolation. Inclusion criteria were: review of any type, published in English, a target population of older people and reported data on the categorisation of loneliness and/or social isolation interventions. Data extracted included: categories of interventions and the reasoning underpinning this categorisation. The methodology framework proposed by Arskey and O’Malley and further developed by Levac, et al. was used to guide the scoping review process. Results: A total of 33 reviews met the inclusion criteria, evaluating a range of interventions targeted at older people residing in the community or institutionalised settings. Authors of reviews included in this paper often used the same terms to categorise different intervention components and many did not provide a clear definition of these terms. There were inconsistent meanings attributed to intervention characteristics. Overall, interventions were commonly categorised on the basis of: 1) group or one-to-one delivery mode, 2) the goal of the intervention, and 3) the intervention type. Several authors replicated the categorisation system used in previous reviews. Conclusion: Many interventions have been developed to combat loneliness and social isolation among older people. The individuality of the experience of loneliness and isolation may cause difficulty in the delivery of standardised interventions. There is no one-size-fits-all approach to addressing loneliness or social isolation, and hence the need to tailor interventions to suit the needs of individuals, specific groups or the degree of loneliness experienced. Therefore, future research should be aimed at discerning what intervention works for whom, in what particular context and how.

Loneliness and isolation in long-term care and the COVID-19 pandemic

SIMARD Joyce, VOLICER Ladislav
2020

Editorial. In all countries affected by COVID-19, the message that is being sent by government officials and medical experts is “stay at home” and “isolate in place.” The isolation is especially difficult for people living in nursing homes and assisted living communities. This article provides some easy to implement ideas, with little or no cost or hiring additional staff, and can decrease the loneliness of residents in nursing homes or assisted living communities The article concludes that preventing loneliness in institutionalized persons is at least as important as helping them with personal hygiene. This is especially important during the COVID-19 pandemic when residents must be protected from contact with other individuals to reduce the risk of infection. Implementation of some of the strategies listed in this article requires education of staff members and supply of required items; however, this effort can significantly improve the quality of life of residents affected by pandemic restrictions.

Delivering neighbourhood-level integrated care in Norfolk

COMMUNITY NETWORK
2020

This case study illustrates how integrated services are being delivered in Norfolk. Norfolk Community Health and Care NHS Trust’s vision is to improve the quality of people’s lives in their homes and community through the best in integrated health and social care. The trust works predominantly with 14 primary care networks (PCNs) across the area served by Norfolk and Waveney Clinical Commissioning Group (CCG), and with the Norfolk and Waveney Health and Care Partnership at system level. This includes collaborating with three acute trusts, one mental health trust, Norfolk County Council and the East of England Ambulance Service Trust. Examples of collaborative working include rapid assessment frailty team; early intervention vehicles, involving occupational therapists working with emergency medical technicians; Norfolk escalation avoidance team; and a high intensity user service. Key lessons emerging from this case study are: effective collaborative working requires good relationships across the board; do not underestimate the differences in culture and working practices between different organisations; invest in ensuring there is the right technology available for staff to use; engage with staff in a meaningful way to develop strategies to improve their health and wellbeing as this in turn will lead to improvement in services; and invest in pilot projects to test out integrated working between organisations but plan for how they can be maintained long term.

Rapid review of reviews: what remotely delivered interventions can reduce social isolation and loneliness among older adults? Executive summary

BOULTON Elisabeth R., et al
2020

Background: During the 2020 coronavirus (COVID-19) crisis, millions of older adults (70+) across the UK (and elsewhere) are being advised to be particularly stringent about social distancing, and to avoid contact with those outside their household. Social distancing places them at even higher risk than normal of social isolation and loneliness, which can adversely affect quality of life, wellbeing and mental health, and are associated with physical ill health and mortality. Methodology: the researchers followed a ‘review of reviews’ methodology to synthesise evidence from related (but differing) remote interventions for social isolation and loneliness, to help inform decisions about different approaches. Findings: the review reports on the following interventions: supported video-communication interventions; telephone befriending; online discussion groups and forums; social networking sites and multi-tool interventions (PC, training, messaging, chat groups). Interventions vary greatly, making it difficult to isolate the effective elements. Concepts of loneliness and social isolation vary, making comparisons and conclusions challenging. Conclusion: the findings from this review do not lead to recommending particular modes of delivering befriending, social support, or low intensity psychological interventions (e.g. videoconferencing, telephone calls, chat rooms or forums), but they do suggest that the characteristics identified through the detailed analysis of components should be incorporated into the delivery of an intervention.

Haven: sharing receptive music listening to foster connections and wellbeing for people with dementia who are nearing the end of life, and those who care for them

GARABEDIAN Claire, KELLY Fiona
2020

This paper reports on research exploring the effects of music played for 12 dyads: a care home resident (‘resident’) with dementia and someone closely connected to him/her (‘carer’). Six individualised music interventions (3 live and 3 pre-recorded) were played by the first author on solo cello within five Scottish non-NHS care homes. All interventions were video-recorded. Semi-structured interviews with carer participants, key staff, and managers explored their responses to interventions. Thick descriptions of video recordings and interview transcripts were thematically coded using Nvivo. A key finding was that structural elements of the interventions combined with characteristics of the music played facilitated an internalised experience of ‘haven’; sonically transporting listeners away from their present reality and fulfilling the basic human needs for inclusion, comfort, identity, occupation and attachment.

Reducing falls among people living with dementia: a systematic review

PEEK Kerry, et al
2020

People diagnosed with dementia are at greater risk of falls. Given the increasing incidence of dementia globally, high quality and methodologically rigorous research is needed to inform evidence-based practice initiatives. Aims: To describe the published literature related to describing, reducing or preventing fall incidences for people living with dementia including: (1) trends in the total number of intervention and non-intervention studies between 1997 and 2016; (2) the methodological quality of identified intervention studies; and (3) the effectiveness of interventions designed to reduce the incidence of falls among people living with dementia.Methods: A systematic review of five databases was conducted to identify studies reporting any aspect of falls incidence for people with a diagnosis of dementia. Studies meeting the eligibility criteria were coded as intervention or non-intervention studies. Intervention studies were assessed using Cochrane’s Effective Practice and Organisation of Care tool. Data about the effectiveness of interventions meeting Effective Practice and Organisation of Care criteria were extracted. Results: Seventy-two eligible studies were identified; 57 were non-intervention studies, and 15 were intervention studies. The number of published studies increased between 1997 and 2016, peaking in 2013 (n = 10). Of the 15 intervention studies, seven studies met Effective Practice and Organisation of Care design criteria with one study rated low risk on all eight Effective Practice and Organisation of Care risk of bias domains. One high-risk exercise-based intervention study demonstrated a significant reduction in falls among people living with dementia. Conclusions: There is currently insufficient evidence to endorse any intervention to reduce falls for people living with dementia in any setting. More high-quality intervention studies are needed. Keywords

The Community Navigator Study: results from a feasibility randomised controlled trial of a programme to reduce loneliness for people with complex anxiety or depression

BRYNMOR Lloyd-Evans, et al
2020

Background: Loneliness is common among people with mental health problems and predicts poorer recovery from depression and anxiety. Needs for support with loneliness and social relationships are often under-addressed in mental health services. The Community Navigator programme was designed to reduce loneliness for adults (aged 18 and above) with complex depression or anxiety who were using secondary mental health services. Acceptability and feasibility of the programme and a trial evaluation were tested in a feasibility randomised controlled trial with qualitative evaluation. Methods: Forty participants with depression or anxiety using secondary mental health services were recruited from mental health services in two London sites and randomised to receive: the Community Navigator programme over six months in addition to routine care (n = 30); or routine care (n = 10). Measures of loneliness, depression, other clinical and social outcomes and service use were collected at baseline and six-months follow-up. Levels of engagement in the programme and rates of trial recruitment and retention were assessed. Programme delivery was assessed through session logs completed by Community Navigators. The acceptability of the programme was explored through qualitative interviews (n = 32) with intervention group participants, their family and friends, programme providers and other involved staff. Results: Forty participants were recruited in four months from 65 eligible potential participants asked. No one withdrew from the trial. Follow-up interviews were completed with 35 participants (88%). Process records indicated the programme was delivered as intended: there was a median of seven meetings with their Community Navigator (of a maximum ten) per treatment group participant. Qualitative interviews indicated good acceptability of the programme to stakeholders, and potential utility in reducing loneliness and depression and anxiety. Conclusions: A definitive, multi-site randomised controlled trial is recommended to evaluate the effectiveness and cost-effectiveness of the Community Navigator programme for people with complex anxiety and depression in secondary mental health services.

Video calls for reducing social isolation and loneliness in older people: a rapid review (Review)

NOONE Chris, et al
2020

A rapid review to assess the effectiveness of video calls for reducing social isolation and loneliness in older adults. The review also sought to address the effectiveness of video calls on reducing symptoms of depression and improving quality of life. Selection criteria: Randomised controlled trials (RCTs) and quasi‐RCTs (including cluster designs) were eligible for inclusion. Main results: Three cluster quasi-randomised trials, which together included 201 participants were included in this review. The included studies compared video call interventions to usual care in nursing homes. None of these studies were conducted during the COVID-19 pandemic. Each study measured loneliness using the UCLA Loneliness Scale. The evidence was very uncertain and suggests that video calls may result in little to no difference in scores on the Geriatric Depression Scale compared to usual care at three months' follow-up. Conclusion: Based on this review there is currently very uncertain evidence on the effectiveness of video call interventions to reduce loneliness in older adults. The review did not include any studies that reported evidence of the effectiveness of video call interventions to address social isolation in older adults. The evidence regarding the effectiveness of video calls for outcomes of symptoms of depression was very uncertain. Future research in this area needs to use more rigorous methods and more diverse and representative participants.

Falls Management Exercise implementation toolkit

NIHR CLAHRC. East Midlands, NATIONAL INSTITUTE FOR HEALTH RESEARCH
2020

This toolkit provides a suite of resources that commissioners can use to plan, implement and monitor the Falls Management Exercise (FaME) programme. FaME is an evidence-based tailored strength and balance exercise programme that has been shown to reduce the rate of falls, increase physical activity levels and improve wellbeing. The toolkit is an output of the PhISICAL study (Physical activity Implementation Study In Community-dwelling AduLts). Sections of the toolkit cover: Building the case for implementing FaME which includes evidence summaries for commissioners, a costing tool, a business case and real life case studies from FaME class participants; Planning the implementation of FaME, which includes an implementation Gantt chart, a service specification, example delivery models, videos, logic model and key learning from the PhISICAL study; Implementing the programme, which includes sample promotional materials and templates; and Monitoring, evaluation and quality improvement, which provides quality assurance guidance and suggested monitoring tools and schedule.

Social prescribing could empower patients to address non-medical problems in their lives

NATIONAL INSTITUTE FOR HEALTH RESEARCH
2020

This NIHR Alert reports on a review carried out by researchers on the NIHR Evidence Synthesis Working Group to understand how GP social prescribing schemes work and when they are most effective. Researchers reviewed 118 documents evaluating social prescribing schemes and the link worker role in the UK. They found social prescribing schemes increase patients’ confidence, motivation and the skills to manage their own wellbeing - which may reduce their reliance on GPs. These positive outcomes were only achieved when patients, GPs and healthcare managers were clear about the value of social prescribing schemes and when link workers had sufficient time and resources to form a connection with patients, with the voluntary/community sector and with healthcare staff.

Results 1 - 10 of 670

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News

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

KOMP

KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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