With increasing numbers of people receiving care at home, loneliness and social isolation are real problems that can have devastating consequences if left unaddressed. Community care services are at the vanguard of connecting people to each other and to their communities. Marie Sansom reports.
Loneliness and social isolation are not a normal part of getting old and they can be beaten. That’s the heartfelt message to older Australians from BeyondBlue CEO Georgie Harman.
One in 10 Australians suffer from anxiety and depression and this is often higher in older Australians who live in their own homes and who also might be living alone and coping with health problems.
Harman says older people are particularly at risk of feeling isolated because of a combination of factors such as the death of a partner, friend or family member; retirement; no longer driving; reduced physical mobility or lack of confidence to go out or catch public transport.
Often older people do not want to admit they are struggling.
“It’s a generational thing as well with depression and anxiety. We know that the stigma and misunderstanding about it amongst older Australians is still quite prevalent,” Harman tells Community Care Review.
Loneliness among older Australians is a feature of seriously diminished informal care networks due to the combination of an ageing population and busy families, who are often stretched themselves, according to Susan Chessman, senior manager of home care at AnglicareSA.
“With more and more people staying at home it does make for a lonely existence for some people and that’s why the prevalence is so high,” Chessman says. “One day could feel like a week for some people…You can go days without any human contact.”
She says that mobility problems and reduced sensory ability mean some older people dread leaving the house and this could cut them off from social contact – as many live alone.
“Large crowded spaces can become quite overwhelming if your vision or hearing is deteriorating and they often won’t go out if they have a fear of falling. They often prefer to stay where they feel safe: in their home,” Chessman says.
Both Chessman and Harman are adamant that loneliness and isolation should be addressed, not only because they are detrimental to person’s quality of life and mental health, but because they also put people at greater risk of a heart attack, high blood pressure, poor nutrition and obesity.
Harman says that feeling cut off can make people question their value as a person and make them fixate on their family’s problems.
“It can have a really devastating effect on someone if they become increasingly turned in on themselves. It can add to compulsive and obsessional thoughts,” she says.
“The more you lift your head up and connect with others, the more things can be put in perspective. It gives you a lift and an extra reason to smile at people. It’s an incredibly important part of looking after your mind and body.
“We are innate social beings. There’s a growing body of evidence that says that the more socially connected you are, the more resilient you are and able to cope with life’s stresses,” says Harman.
Isolation can be tackled
The good news is that feeling disconnected does not have to be permanent. People can go on to forge new, strong relationships, re-establish old friendships and restore emotional balance to their lives.
Harman says feeling isolated or depressed can be tackled, with excellent results.
“People don’t need to put up with it. There is very effective support, treatment and therapy that you can use if you’re feeling depressed,” she says.
“It just doesn’t come with old age and there are many practical things you can do to help older Australians stay at home and protect their mental health.”
BeyondBlue’s recent publication Connections Matter is catalogue of practical advice for people experiencing isolation, and their family and friends. For those working in community care, the resource can help to identify when a client needs extra social support.
The booklet asks people to complete a checklist to identify their current level of social interaction, for example, how often they spend time with friends or family, stop for a chat with somebody or attend a group activity.
It provides tips on boosting social connectivity, whether it’s through technology like Skype, checking a local council website for groups and activities, joining a club or volunteering, and provides a template for an action plan to set small goals, such as walking around the block three times a week.
A continuing theme is the importance for older Australians who are struggling to start talking about it, says Harman. “There’s nothing to be ashamed about. Conditions like depression and anxiety are illnesses.”
She suggests the older person talks to someone they trust, such as a GP, relative or community care worker, and then draw up an action plan.
For friends and family of someone who seems lonely, Harman advises they introduce the subject gently, and to persist.
Chessman agrees it is vital for family and friends to check-in with loved ones, as well as offering to go with them to an event or group.
“Many older people don’t want to be seen as a burden to their families,” she says. “They often won’t reach out when perhaps they should.”
She praises consumer directed care (CDC) because people can set the reduction of isolation and loneliness as a therapeutic goal and include this in their package of care – for example, by asking for funding to access social activities.
Programs to beat isolation
AnglicareSA runs excursions, a number of interest and hobby groups, men’s sheds and community transport.
Chessman says that home care workers get people talking about what interests them and find them activities to match. “If they love trains, we find a train enthusiasts group and we go with them. It’s about baby steps and working with them.”
The provider also runs a computer group, Don’t Forget Your Tablet, to teach seniors about Skype, Facebook and FaceTime to link up with family and friends.
Similarly, Brightwater Group in Perth helps their home care clients make social connections.
Sandy Komen, manager of Brightwater’s at home services, tells CCR that technology can be a powerful way to connect people. The provider has an e-friends network and also teaches people to use social media to connect with loved ones.
Brightwater works with clients and their families to address barriers to social engagement. This can include rehabilitation to increase physical mobility, walking pets, teaching clients how to use public transport and their volunteer visitor program.
“The people that we support, we know we can make a different to their lives, just by turning up. People say they look forward to the day when our workers drop in. We try to build-up their strength and confidence,” Komen says.
The Booth’s big date
For their first date, Barry Booth took his sweetheart Beverly to Harry’s Café de Wheels for pie and mushy peas. They ate their pies out the front of Garden Island dockyard where Barry was stationed in the army.
Fast forward 50 years and two children, three foster children and eight grandchildren later, to Barry and Beverly’s more glamourous second date last September. This time they took a flight over Perth, followed by a romantic dinner.
The flight was paid for by Life’s Possibilities, a Brightwater program that provides excursions for home care clients.
Beverly says the second date was well worth the half-century wait.
“It was absolute magic. I was amazed at the number of swimming pools. I so enjoyed every minute of it. He was such a gentleman. God he was gorgeous,” she says.
Brightwater also provides the Booths with invaluable help around the house, which they need after Beverly suffered multiple brain aneurysms in 1998. Beverly also receives help with her personal care and goes shopping once a week with a support worker.
Barry has also had assistance in his role as a full-time carer for Beverly, which he says can sometimes feel lonely.
He says that just being able to talk to somebody else is invaluable.
“One of the sad things about our change of life was that prior to Bev’s falling ill we had lots of friends. When Bev came out of the hospital we didn’t see anybody at our place. No-one came,” Barry says.
The couple say the support they receive from Brightwater, which also includes attending regular lunches and other social events under Brightwater’s Brighter Moments program, has changed their lives.
Barry says daily visits from support workers “brightens your day” and he enjoys gardening and swapping stories and recipes for pickles and jams.
“I like the social events too. You meet people in the same circumstances. As long as they don’t make me dance! This lot will be friends for life.”
Beverly says it has made her “very content and very happy”.
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