Saturday, April 9, 2022

A research review of seniors, isolation, and best practices in service provision

There is no doubt that while the need for and benefits of social connections and inclusion is clear for seniors, there are considerations in providing services to this group. A literature review that was part of a study on seniors and the impacts of leisure activity12 highlighted the following challenges:

·        Connecting to services

·        Perception of barriers to participation e.g., clothing, funding

·        Factors that contribute to social isolation such as loss, poor physical health, low morale,

·        being a caregiver, geographic isolation, and transportation difficulties are often beyond the

·        socially isolated person's control and therefore not obviously susceptible to improvement. Thus

·        designing effective interventions to address the problem may be difficult.

There have been numerous interventions implemented worldwide, but few systematic reviews have been done to assess the effectiveness of these interventions in addressing social isolation in seniors. In fact, research evidence to support the belief that intervention can counteract social isolation and its adverse effects on older people is almost non-existent. While research confirming the effectiveness of interventions is not easily available – what is clear are the positive benefits of social inclusion. Evidence consistently supports the idea that out of home activity levels affect health status, well-being and survival in old age. “Disengagement from out of home activities is associated with declines in cognitive functioning among elderly persons"

The core principles of the Canadian National Framework on Aging, developed through an extensive consultation with seniors and other stakeholders, provide a solid foundation on which to build programs:

·        Dignity: being treated with respect, regardless of the situation and having a sense of self esteem

·        Independence: being in control of one's life, being able to do as much as possible and making one's own choice

·        Participation: getting involved, staying active and taking part n the community, being consulted and having one's views considered by Government

·        Fairness: having seniors real needs in all their diversity, considered equally those of other Canadians

·        Security: having adequate income as one ages and having access to a sage and supportive living environment

A study done in 1998 identified the following characteristics of effective interventions:

·        Participation in group activities

·        Targeting common groups e.g., women, the widowed, retired firefighters,

·        Using more than one method of intervention and those that are effective across a broad range of

·        outcomes

·        Allowing participants some level of control

·        Ensuring the evaluation fits the intervention and includes a process evaluation

The effectiveness of various interventions with isolated seniors. These included one-on-one intervention, telephone support, gatekeeper programs, group interventions of teleconferencing, support provision, Internet groups, and support groups. While there was not enough commonality in the types of interventions to consider the results conclusive, the authors felt the results could provide guidelines for Future Development. They confirmed that it is very important to:

·        Have high-quality approaches to the selection, training and support of the facilitator or

·        coordinators of the intervention

·        Involve older people in the planning implementation and evaluation stages

·        Use existing community resources and build capacity

·        Evaluate and disseminate the research

It is difficult to quantify the exact number of isolated seniors in a community however in a survey of the empirical literature published between 1948 and 1991it was found that between 2 and 20 percent of people over the age of 65 were socially isolated.

In Halton, the ESAC Quality of Life Report for Seniors in Halton used national data to identify those levels of social support decline with age, and up to 8% of seniors have no close relatives and 14% no close friends putting them at risk of becoming isolated.

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