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Results 21 - 30 of 636

The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review

MA Ruimin, et al

Purpose: Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation. Methods: Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary. Results: In total, 30 RCTs met the review’s inclusion criteria: 15 included subjective social isolation as an outcome and 11 included objective social isolation. The remaining four evaluated both outcomes. There was considerable variability between trials in types of intervention and participants’ characteristics. Significant results were reported in a minority of trials, but methodological limitations, such as small sample size, restricted conclusions from many studies. Conclusion: The evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. This study highlights the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.

Evidence scope: loneliness and social work

GREAT BRITAIN. Department of Health and Social Care

This evidence scope looks at the role of social workers in preventing and reducing loneliness and isolation. It draws on a literature review and a survey of social work practitioners which was commissioned by the Chief Social Worker for Adults and carried out by Research in Practice for Adults. The scope provides key messages from research and practice in identifying people who are experiencing, or at risk of, chronic loneliness. It also presents evidence of effective interventions to prevent and reduce loneliness in the following areas: social activities, technology, partnership working with other agencies, human relationships, and being person centred and understanding every individual’s different experience of loneliness. Key messages for social workers and employers to inform the development of resources to improve practice are included.

Evaluating social care prevention in England: challenges and opportunities


Context: The Care Act 2014 placed a statutory duty on adult social care (ASC) to prevent and delay the development of needs for care and support. There is little clarity about how to translate this national obligation into effective local practice. Objectives: This exploratory study sought to lay the foundations for understanding approaches to this new duty by identifying: emerging local understandings of prevention; associated implementation strate­gies; and the potential for designing evaluation frameworks. Methods: Local perspectives were secured through: in-depth interviews in six English local authorities; reviews of local strategy, implementation documents and reviews of data sources; and methods for evaluating local initiatives in sampled authorities. Findings: The findings indicate important differences between and within local authorities in conceptuali­sations of prevention. Although willingness to commission services was strongly linked to the availability of evidence on what works in prevention, council conducted limited local evaluations. This study also found limited collaboration between ASC and Health in developing joint prevention approaches, in part due to differ­ences in conceptualisation and also constraints arising from different priorities and information systems. Limitations: The exploratory nature of the study and the small sample size limits the generalisability of its findings. Overall, the number of local authorities and respondents allowed us to explore a range of local views, opinions and practices related to the prevention agenda in a variety of contexts, however the findings are not generalisable to all English local authorities. Implications: This study suggests that the limited local evidence about prevention, combined with finan­cial austerity, may lead to disproportionate investment in a small number of interventions where existing evidence suggests cost-savings potential, which, in turn, may impact authorities’ ability to fulfil their statutory duties related to preventing and delaying the needs for care and support. In this connection, this study highlights the potential for developing local evaluation strategies utilising existing but largely unexploited local administrative data collections.

A systematic review of interventions for loneliness among older adults living in long-term care facilities

QUAN Nicolas G., et al

Objectives: This study aimed to review loneliness interventions for older adults living in long-term care (LTC) facilities over the past 10 years, to categorise interventions by type, and to compare effectiveness of loneliness interventions in these settings. Methods: Systematic review followed PRISMA guidelines. Articles matching search criteria were collected from PubMed, PsycINFO, and Web of Science from 2009 to 2019. The inclusion criteria were as follows: 1) English language, 2) intervention studies with a quantitative measure that compares pre-trial to post-trial changes, 3) loneliness as a primary or secondary outcome 4) subjects age >65, and 5) subjects living in a LTC facility, such as a nursing home, assisted-living, or hospice. Results: A total of 15 intervention studies qualified for systematic review. Most of these interventions were psychological therapies and leisure/skill development interventions. Approximately, 87% of studies reported significant decreases in loneliness following intervention. Laughter therapy, horticultural therapy, and reminiscence therapy were associated with the greatest decreases in loneliness. Discussion: Results suggest that, although less common than interventions in the community, there are several effective interventions to reduce loneliness among older adults living in LTC facilities. Lack of standardised measures and high-quality studies limits comparisons between intervention types and generalizability to different populations.

The effect of music on wellbeing - case studies


This article reports on a small scale study of the impact of personalised music on residents living with dementia in a care home. Three care homes (Fremantle Trust's Lent Rise House, Lewin House and Meadowside care homes) and nine people living with dementia took part in the two week study. Care staff and activity organisers selected times of day (and night) to play music or a radio station with the resident. The researchers collaborated with Unforgettable (now part of Live Better with Dementia), a company allied to the non-profit organisation Music and Memory which donates iPods to people living in care homes to deliver the intervention. Findings:Qualitative statements from the care homes were invariably positive. Personalised music was found to reduce agitation and improve mood. None of the people living with dementia were able to initiate music themselves, so it required either staff or visitors to play it. Conclusion: the findings suggest that, when compiled in a person-centred way, music can be a source of comfort and calm. It can counter distressing events, alleviate anxiety, and increase sociability. The paper also includes some implications for practice or tips on how to provide personalised music in care homes.

Day centres for older people: a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived


With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005 to 2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified 77 relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people's mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.

Community-centred public health: taking a whole system approach. Briefing of research findings


A summary of research findings into current practice on approaches to community-centred public health, which are important to reducing health inequalities. Community-centred approaches mobilise assets within communities, encourage equity and social connectedness and increase people’s control over their health and lives. The briefing summarises the key elements, core values and principles that are needed to make a shift to whole system approaches to community-centred public health. It provides information on scaling approaches, involving, strengthening and sustaining approaches. The research briefing is one of a suite of resources to help local authority, NHS and voluntary and community sector (VCS) decision makers to implement and embed community-centred approaches to health and wellbeing at scale. Accompanying resources include a slide-deck presentation of main findings, practice examples and a list of alternative whole system frameworks.

The older adults’ NHS and social care return on investment tool: final report


This report summarises the evidence on nine identified interventions to support older people. It is the final report of a project to provide a return on investment (ROI) tool to help stakeholders and decision-makers to compare the cost-effectiveness of interventions to reduce the need for services in older adults. The focus is on the use of social care services, but the report also reviews interventions which also reduced the need for health services. The ROI includes nine interventions, identified though a literature review. They are: community singing; a help at home scheme; a befriending service; the WHELD intervention for people living with dementia in nursing home; the INTERCOM intervention providing hospital discharge support for COPD patients; voluntary and community sector (VCS) services aimed at patients with long-term conditions, which use social prescribing and other approaches to put patients in touch with services; health coaching; the BELLA intervention providing self-management support for COPD patients; and a home care reablement service. An accompanying technical report provides further detail of the literature review, selection of the interventions for inclusion in the tool and the modelling methods. The return investment tool is available to download. It can be adapted to local conditions and presents results showing the economic benefits of each intervention.

Animal-assisted therapy for dementia (Review)

LAI NM, et al

Background: A range of new therapeutic strategies has been evaluated in research, and the use of trained animals in therapy sessions, termed animal‐assisted therapy (AAT), is receiving increasing attention. Objectives: To evaluate the efficacy and safety of animal‐assisted therapy for people with dementia. Search methods: Medical databases were searched for this review to September 2019. Key characteristics of included studies: This study included nine randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups), involving 305 people with dementia, which compared AAT to a control treatment (either usual care or an alternative treatment). All studies took place in Europe or the US. Seven studies compared AAT to usual care or to another activity which had nothing to do with animals. Two studies compared AAT (using live animals) to the use of robotic animals. One study compared AAT to the use of a soft toy cat. Key findings: this study found evidence from two studies with 83 participants that people with dementia who had AAT were possibly slightly less depressed at the end of treatment than people who had standard care or other interventions not related to animals. The study also found evidence from three studies with 164 participants that people who received AAT had no clear difference in their quality of life compared to those who did not. However, the study found no evidence of an effect on social functioning (interactions with their environment and families), behaviour, agitation, activities of daily living, self‐care ability or balance. There were no clear differences when AAT was compared with the use of a robotic animal in two studies, or with the use of a soft toy cat in one study. Conclusions: AAT may slightly reduce depressive symptoms. Otherwise, no conclusions can yet be drawn on whether AAT is beneficial or safe for people with dementia. The small size of the included studies, and the diversity of outcomes and outcome measures, were major issues. The researchers recommend further well‐conducted studies with the inclusion of important outcomes such as emotional and social well‐being, quality of life, side effects, and effects on the animals.

Compassionate communities and collective memory: a conceptual framework to address the epidemic of loneliness

SIME Caroline, COLLINS Stephen

In recent years, tackling loneliness has become the focus of increased scholarly debate, social intervention and the development of international policy. One response to the ‘epidemic of loneliness' has been the development of the compassionate communities model. The diversity of compassionate communities approaches has led to scholars such as Allan Kellehear (2005; 2017) to highlight a lack of a cohesive underpinning theory to support and drive policy development. This paper proposes the use of ‘collective memory’ as a novel approach to linking loneliness, memory and identity in a way that draws out conceptual links between the role compassionate communities play in tackling social isolation and loneliness. This paper suggests that the service-led approach that seeks to identify and transpose strategies from one community to another is ineffective; instead, the need to develop bespoke community-centred models that can be used by community nurses is emphasised.

Results 21 - 30 of 636


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 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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