Intervention programs aimed at reducing social isolation

I have been serving on a committee that is focused on reducing isolation and loneliness in my town. The work is slow and difficult but very rewarding. There are many groups addressing this issue in the larger community and they all believe they are doing a good job. One of the issues that I found interesting was the idea that our group would steal funding from them. Dealing with seniors is a very competitive business as the government talks about how much it wants to solve the problem but it does not put any money into solutions. Or if it does the government makes the charity groups fight each other for the few dollars they give out, which is in my mind, counterproductive. 

What I did find out is that the most common type of program aimed at reducing social isolation and loneliness found in my community was a type of peer (volunteer) helping/ visiting outreach model. Several examples of these types of programs are ones that involve peer support groups and programs that recruit seniors to volunteer with other populations such as children. 

While our group is moving forward albeit slowly we realize that when we are planning interventions for socially isolated and lonely seniors a good understanding of the target group, or of an individual’s need for acceptance and social support is necessary before employing we suggest interventions.  I believe that feeling supported is, in fact, an outcome the caring interpersonal transactions among individuals who trust each other and that is seen in the successful interventions we have looked at since we started back in July.

Isolation and loneliness during the Xmas season

Christmas is coming, the goose is getting fat... goes an old English rhyme. Well it is coming and this time of the year for many is joyous and a time of celebration with family, for many it is a time of heartbreak and loneliness and social isolation.

The concept of social isolation is complex and overlaps with other associated ideas such as loneliness, social vulnerability, social inclusion and exclusion, social connectedness, and social capital. 

Social isolation is commonly defined as a low quantity and quality of contact with others and includes the number of contacts, feeling of belonging, fulfilling relationships, engagement with others, and quality of network members.d

Data from the Canadian Community Health Survey, which was a large-scale study with a range of social isolation indicators, provide an overall sense of the magnitude of the problem. The study found that:

• 16% of seniors felt isolated from others often or some of the time.
• 6% of seniors reported spending little or no time with someone with whom they could complete enjoyable activities.
• 5% indicated having someone to listen to them none or little of the time.
• More than 8% reported having someone to receive advice about a crisis none or little of the time.
• 3.9% of seniors reported having someone who shows love and affection to them none or little of the time.
• 6% reported having someone to do something enjoyable with none or little of the time.
• 6% reported never or not often participating in activities with family and friends.
• 17.3% reported feeling excluded often or some of the time.

These findings suggest that a significant portion of seniors experience social isolation in a variety of different ways. Preliminary results from the Canadian Longitudinal Study on Aging (CLSA) support these findings

The research has identified 9 risk factors are embedded within several overarching social contexts, including ageism, discrimination, limited access to resources and services, and marginalization. These risks factors are:

1.  Age and gender: being 80 or older; being a woman (since women, on average, live longer).

2. Ethnicity: being an immigrant (specifically, having a different cultural and linguistic background from the general Canadian population or community in which you live); being from an official language minority community.

3. Geography: living in a rural or remote area where service provision and distance between individuals and families is less proximate; living in a deprived neighbourhood; living in a community where there has been a loss of community or neighbourhood values; living in a low-density neighbourhood.

4. Health and disability: having health issues (mental and/or physical) including having multiple chronic health problems (e.g., vision, hearing, incontinence, speech/cognitive impairment); lifelong health problems or late-onset or age-related condition such as incontinence; mental illness (e.g., dementia, depression); stigma associated with mental illness, poor health or a disability; low access to health care; minimal walking time; poor perception of one’s own health.

5. Knowledge and awareness: challenges relating to technology (costs, literacy, comfort); lack of information on services; lack of awareness or access to community services and programs

6. Life transitions: loss of a spouse; loss of sense of community; disruption of social networks; lack of family and friend supports; loss or restriction of drivers’ license; entry into care; caregiving and associated factors (intensity of care-giving, low levels of care satisfaction, inability to leave the care recipient alone); divorce; living in a nursing home.

7. Poverty and lack of access to resources: lack of affordable housing and care options; living with low income; lacking access to transportation (no license or public bus system); financial dependence; living in a deprived neighbourhood (also considered a geography factor – see above).

8. Sexual and gender identity: being lesbian, gay, bisexual or transgendered (LGBT); a history of discrimination; having a weak primary social network; lack of social recognition; discrimination in the health-care system; fear of coming out in older age.

9. Social relationships: low quality of relationships; having no children or contact with family; living alone (greater likelihood among women, gay men and lesbians); not being married or common-lawed; loss of friends and social network; experiencing ageism.

In general, there is sufficient evidence to identify several common characteristics of successful interventions – such as involving seniors in the planning, implementation and evaluation stages – as well as different types of interventions, from group activities to educational phone chats.

Training programs for frontline workers delivering programs is essential, as well as adequate resources. More generally, socially-isolated seniors could benefit from increased efforts to raise awareness of the underlying causes of isolation and to fight ageism. These are not easy issues to resolve, and addressing social isolation will require not only the coordinated and concerted action of multiple stakeholders but also increased understanding of the importance of this issue among the Canadian public. 

At this time of year, if you know of a person who is isolated or who may be lonely, reach out and share. This is the season of giving after all.

10 Quotes by Carl Jung

Loneliness does not come from having no people around you, but from being unable to communicate the things that seem important to you.

To be normal is the ultimate aim of the unsuccessful.

The first half of life is devoted to forming a healthy ego, the second half is going inward and letting go of it.

If our religion is based on salvation, our chief emotions will be fear and trembling. If our religion is based on wonder, our chief emotion will be gratitude.

What usually has the strongest psychic effect on the child is the life which the parents have not lived.

There is no coming to consciousness without pain.

People will do anything, no matter how absurd, in order to avoid facing their own soul.

One does not become enlightened by imagining figures of light, but by making the darkness conscious.

A man who is unconscious of himself acts in a blind, instinctive way, and is, in addition, fooled by all the illusions that arise when he sees everything that he is not conscious of in himself coming to meet him from outside as projections upon his neighbour.

The artist is not a person endowed with free will, who seeks his own ends, but one who allows art to realize its purposes through him. As a human being, he may have moods and a will, and personal aims, but as an artist, he is "man" in a higher sense: He is "collective man," a vehicle and moulder of the unconscious psychic life of mankind.

I am not what happened to me, I am what l choose to become.

As far as we can discern, the sole purpose of human existence is to kindle a light in the darkness of mere being.

How not to get to the top and stay there

A turkey was chatting with a bull. "I would love to be able to get to the top of that tree," sighed the turkey, "but I haven’t got the energy."

"Well, why don’t you nibble on some of my droppings?" replied the bull.  They’re packed with nutrients."

The turkey pecked at a lump of dung, and found it actually gave him enough strength to reach the lowest branch of the tree.

The next day, after eating some more dung, he reached the second branch.

Finally, after a fourth night, the turkey was proudly perched at the top of the tree.

He was promptly spotted by a farmer, who shot him out of the tree.

Moral of the story:

Bull Sh*t might get you to the top, but it won’t keep you there...