Emerging from the shadows: Social isolation amongst older people and the importance of interventions Presented by Dr Debbie Faulkner As a member of the research team (Beer A., Lewin G., Buys L., Tinker A., Bentley R., Watts A., Squires B., Chessman S., Baker S., McKechnie S. and Morgans A.) Illawarra Research Symposium: Working Together to Live Well, Longer 10 April 2015 The Centre for Housing, Urban and Regional Planning

National Collaborative Project RESEARCHERS & UNIVERSITIES Professor Andrew Beer and Dr Debbie Faulkner, (The University of Adelaide) Dr Rebecca Bentley, (The University of Melbourne) Professor Laurie Buys, (QUT) Professor Gill Lewin, (Curtin University of Technology) Professor Anthea Tinker, (King’s College, London). ARC Linkage Project No LP LINKAGE PARTNERS

Background

Questions to Answer What are the predictors of success in addressing social isolation? Does the form of intervention affect the likelihood of success? Are interventions more effective or successful with particular groups defined on the basis of particular characteristics such as gender, housing arrangement, age, presence of disability or socio-economic status? Is there a measurable difference in how effectively low, medium and high intervention programs address social isolation? What impact does time have? What if any, is the impact of the institutional setting – for example local government, service organization, housing provider?

Methodology Review of the literature Longitudinal quantitative survey of older Australians affected by social isolation and fall within three service provision categories Wave 1: 1500 surveys ( 300 surveys- 100/intervention X 5 states); Wave 2: 1200 surveys (240 surveys – 80/intervention X 5 states); Wave 3: 900 surveys (180 surveys – 60/intervention X 5 states).

Longitudinal Study - Service Provision Developed by E. Kennett- Smith based on Raymond et al 2013

Methodology –longitudinal survey To be conducted across five states represented by researchers and linkage partners Qualifying criteria for inclusion of older person: o Aged 65 years and over; o Not suffering advanced cognitive impairment or in the final palliative stages of a terminal illness; o They are new to a service or program or have been assessed and assigned to a program are not yet participating or have just started; o The person is willing to be involved in the project; and o Upon completing The Friendship Scale the person is identified as being isolated Potential participants to be introduced to the project by service providers Interviews at initial contact, 3 months later and in another 3 months

Methodology - Qualitative data collection in-depth interviews with 30 older people from each intervention category Focus groups: Small group of clients from each intervention group service providers and policy makers active in area

Enthusiasm of the service providers “ I’ve got some preliminary figures through from the two SI project officers. The number of referrals to the program in the last 12 months exceeds 70 clients (I’m still waiting on 6 months worth of figures from one region which in theory should boost the numbers by another 20 or so). The program has also expanded into a new region, so it is likely that the referral numbers will increase. That means that if we started recruiting research participants from the beginning of July then we should be able to almost fill the quota of 100 research participants.”

Longitudinal Survey Sample Size Wave 1 Target 1500Actual Responses 79 Wave 2 Target 1200Actual Responses 69 Wave 3 Target 900 Actual Responses 55 (+5)

Methodological Issues Anticipated numbers of new people entering aged care services declines Parameters for inclusion too restrictive Paperwork detail Filtering of information from management to frontline workers Frontline service provision staff busy Service providers need time to develop trust with clients Difficult to engage social isolated people in research People reluctant to see themselves in way asking to identify themselves for the research

Reframing of the methodology Continuation of longitudinal survey One off self complete survey Qualitative interviews to gain a life course perspective Focus groups with service providers

Preliminary Findings Longitudinal Study – friendship scale scores Wave 1 range 0-15; mean 11.2 Wave 2 range 7-24; mean 15.2 Wave 3 range 1-24; mean 15.3

Preliminary Findings Longitudinal Study – Period of time felt lonely/isolated

Preliminary Findings Longitudinal Study – Living arrangements

Preliminary Findings One off study – Over last 5 years ever felt lonely or isolated

“Mary” age 69 Wave 1 – Friendship Score =3 Very busy working life (confessed workaholic) until struck down by cancer has no friends outside of work. Moved to ILU - Lonely in new residence, is a distance from previous home. Doesn’t know anyone. Wave 3 - Friendship Score =15 “The program has improved my life by making me more open and able to talk to people. They've given me an insight into where I can go and what I can do.” Preliminary Findings

“June” age 70: Wave 1 – Friendship Score =3 health problems. Disappointed with services offered - couldn’t provide her with transport or any other services that she required. Wave 3- Friendship Score-13 Now receiving services from different provider. a cleaner comes fortnightly for 4 hours, BUT person takes her shopping; AND helped her to join a lunch club where she socialises with other women then plays bingo in the afternoons. Preliminary Findings

Conclusion The older population are vulnerable to loneliness and social isolation There is considerable interest in how to plan programs that best assist people There are substantial difficulties in undertaking an exercise of this kind Preliminary results are indicative of improvements in people’s lives with some form of regular contact outside family We have a long way to go in analysing the data Progress on the project and summary findings will be available at