1. Facilitating Meaningful Social Inclusion with Older People
Samantha Saunders. Occupational Therapist - Senior Commissioning and Project Manager
Local Context
This project was undertaken by the London Borough of Havering’s Joint Commissioning Unit in response to a number of key demand issues. Havering is the oldest borough in London, with 32% of Older Adults living alone. Social Isolation can have significant impact on a person’s quality of life, wellbeing and health; resulting in an increased use of services, (SCIE 2012). This Project’s objective was to develop a preventative, community asset based, approach to support this community group.
Social Isolation and Occupation Therapy
Social Isolation is an objective state that is defined in terms of the quantity of social relationships and contacts, (Victor, C. 2015).
‘Loss’ and ‘Change’ are key risk factors which can result in Older Adults feeling social isolation. Through the OT process, this project adopted a Social Reablement Approach to manage these risk factors and support Older Adults to realise positive changes; by addressing the barriers relating to their isolation and facilitating meaningful social relationships.
Project Approach: Community Navigators (CN) worked alongside the Older Adults applying the following approach;
Social Reablement
Goal Based Action Plan
Guided Conversation
Support to Access Community
Social Reablement Approach
Meaningful Social Engagement
CN supported the Older Adult through a guided conversation to understand their social interests and current needs.
Captured Older Adults current perception of their situation. This provided a baseline for intervention.
CN provided information and advice to enable the Older Adult to make an informed decision in their goal setting.
The CN approach was dependant on their needs and barriers; compensatory, adaptive or graded approach
A new routine was developed and the Older Adult was supported to take increased steps towards social independence.
The Older Adult reviewed and rescored the Outcome Star once a new routine is established.
The Older Adult was able to make informed choices and use their new skills to engage in meaningful social networks.
Independent Living Outcome Star
Project Results:
Project Cohort Cohort 50 / Control Older Adults aged 65year +, known to Adult Social Care. All of the Cohort and Control group were offered
personalised advise and information. Older Adults who did not want to engage in the process further, became the control group.
Demographics 92% of Cohort lived alone. Age: % , %, % .
Conditions Mobility Issues 44% , Neurological 32%, Mental Health Needs 28%, Sensory 28%, Respiratory 14% , Frailty 10%, Cardiovascular 10%.
Self reported barriers provided a framework for the Approach.
Translating client goals into practical outcomes, the project supported Older Adults into community resources.
The CN time was focused on client engagement;
Conclusion
This project was able to evidence that a personalised approach with layers of support can reengage Older Adults with their community and report positive outcomes as a result.
To be effective CNs need to be knowledgeable about their local community, be skilled in motivating others and have the capacity to provide Older Adults with time needed to support appropriately.
The comparison between the cohort and control groups evidenced the significant impact mobility and condition management can have on Older Adults motivation to engage. This provides evidence for the need to work with Older Adults earlier in their journey of aging to increase positive outcome .
This approach is dependent on a diverse and accessible range of community activities, affordable transport options and a personal assistant offer, that can support Older Adults varied needs.
This is valuable data to enable intelligent commissioning when developing new services to meet our community’s needs.
Older Adults reported positive change in the three key areas relating to their social inclusion;
References:
SCIE (2012) At a glance 60: Preventing loneliness and social isolation amongst older people.
Victor, C. (2015) ‘Isolation and loneliness’ in Improving later life. Vulnerability and resilience in older people
Jopling, K. (2015) Promising approaches to reducing loneliness and isolation in later life. Campaign to End loneliness. Age UK
Triangle Consulting Social Enterprise Ltd. Outcome Star ©.