1. Social Isolation and Social Inclusion
Liz Birchall
Community Outreach Programs in Addictions (COPA)

2. Demographics
Canada’s population is aging, and the proportion of those aged 65 years and older has almost doubled in the last fifty years
Population projections indicate that by 2036 almost a quarter (24.5%) of the Canadian population will be 65 years or older (Statistics Canada, 2007)
The baby boomer generation, represent nearly one out of three Canadians, the largest age cohort in Canada and the oldest baby boomers are now entering their retirement years (Statistics Canada, 2007)

3. National Seniors Council
"Social isolation affects the health and well-being of seniors,"” said Minister of State Wong. “"That's why it's so important to address this issue by listening to seniors and consulting with key players from the non-profit, public and private sectors."”
‘Social isolation can lead to depression and increased vulnerability to elder abuse, among other concerns. As a complex and multifaceted issue, social isolation touches many policy areas affecting seniors, including active participation, healthy ageing, income security, caregiving, elder abuse and transportation.’ (from the Council’s press release August 8, 2013)
The National Seniors Council has been holding community consultations across the country on social isolation and seniors

4. Health and Loneliness
Feeling alone and being alone is associated with a more rapid rate of motor decline (Buchman et al, 2010)
“Chronic perceived isolation (i.e., loneliness) is characterized by impairments in attention, cognition, affect, and behaviour that take a toll on morbidity and mortality through their impact on genetic, neural, and hormonal mechanisms that evolved as part and parcel of what it means to be human.” (Hawkley, Cacioppo, 2010)
Loneliness is the social equivalent of physical pain, for those who do not have ‘rich and forgiving social environments’ interventions are necessary (Masi, Chen, Hawkley and Cacioppo, 2011)

5. Social Support and Health
Social support is positively associated with a higher degree of well-being, less distress and cognitive impairments among older people without a spouse. (Okabayashi et al, 2004 in Melchiorre et al 2013)
Reducing both social isolation and loneliness are important for quality of life and well being but efforts to reduce isolation would be likely to have greater benefits in terms of mortality. (Steptoe, Shankar, Demokakos, Wardle, 2013)

6. Social Isolation Interventions
Stimulating participation in leisure activities may be an effective tool in reducing social isolation among older adults. This could help reduce bad physical and mental health associated with social isolation, thereby reducing medical costs. (Toepoel, 2013)
High levels of social support may be a key factor in reducing and preventing vulnerability and isolation of older people and the risk of mistreatment. Policy makers and clinicians should, based on these results, develop intervention programs that promote opportunities for older adults to participate in social activities. (Melchiorre et al, 2013)

7. COPA Vision, Mission & Values
Our mission is to engage older adults with addictions, concurrent disorders and
problem gambling issues in the improvement of their quality of life.
Our vision is an empowered community where older adults with addictions,
concurrent disorders and problem gambling issues receive support and service to
enable them to achieve an optimum quality of life.
We value:
Respect: We are committed to a non-judgmental, inclusive approach that treats everyone fairly;
Empowerment: We are dedicated to fostering active participation in treatment and providing the necessary information to make informed choices;
Compassion: We believe in the dignity of every person and accept people as
they are.

8. COPA Pillars Our programs are delivered in accordance with the COPA
Model:
Outreach - service is provided where the clients are rather than requiring clients come to the program.
Harm Reduction - it is not necessary for clients to acknowledge addiction problems or reach complete abstinence in order for meaningful change to take place.
Independence – focus on quality of life and maintaining independence. 8

9. Best and Promising Practices
Research shows older adults are as successful in addiction treatment as their younger counterparts.
Health Canada (2002) states best practices identified through research demonstrates that treatment of high need older adults include:
a harm reduction and holistic problem solving approach,
home visiting known as “outreach”,
intensive case management and
social and recreational programs
Clinical experts have added to these principles the need to support those who form the “circle of care” for the older person

10. Older Adults, Addictions & Concurrent Disorders
COPA’s pillars include quality of life and independence so meaningful occupation and social connectedness are very relevant to recovery
Late onset issues with substance can be related to issues of loss, transition and loneliness
The recovery journey can mean leaving behind friends who use substances, finding new ways to occupy time and being social and sober
We are always looking for opportunities for health promotion and social inclusion activities as these are crucial for our clients’ recovery.

11. COPA and Social Inclusion
Health Promotion
Minding our Bodies
Bridge to Health
Health and Wellness Together
Urban Resiliency Garden

12. Health Promotion Minding our Bodies:
Develop nutrition and exercise workshops that can be delivered by front line staff are relevant and engaging for low income older adults in a format that can be easily downloaded and used by other not for profit agencies and health promotion organizations, Exercise, Healthy Food and Making a Meal
Funded though the Ontario Government and CMHA Ontarrio and with partners – COPA, Vintage Fitness, Seniors Peoples Resources in North Toronto (SPRINT), Good Neighbours Club, 4 Villages CHC

13. Health Promotion Bridging to Health:
A collaborative approach between COPA, Vintage Fitness, Good Neighbours Club and John Innes Community Centre, this project formed a bridge for marginalized older adults to access physical recreational activities in their local community centre located in South East Toronto
Funded through the City of Toronto and with partners, Vintage Fitness, Good Neighbours Club and John Innes Community Centre

14. Health Promotion Health and Wellness Together:
A health and wellness toolkit for seniors by seniors designed to cover a variety of areas of health promotion and wellness including, exercise, falls prevention, positive mental health, recovery and harm reduction.
Funded by the Government of Canada and with partners Vintage Fitness, LOFT, and Toronto Community Housing

15. Urban Resiliency Garden
The goal is to create a safe green outdoor space for older adults/seniors to engage in active leisure activities, learn through a series of workshops and education sessions and to contribute to the community in which they live.
This project is a community development project that will provide a leadership role for our steering committee of older adults/seniors in the design, development, implementation and maintenance of an urban garden for a large affordable housing complex.
We are excited to integrate gardening programs to increase social interaction, establish a positive leisure space, encourage cooperation and build a strong caring intergenerational community.
This is being funded by the New Horizons Seniors Program, Government of Canada and our partners include LPM (the property management company), Mainstay Housing and Evergreen

16. Policy Challenges
It can be difficult to access funding for initiatives to address social isolation through social activities, health promotion and wellness activities
The connection between health, quality of life and social inclusion is clear in the literature and we need to leverage this

17. In Summary... Being lonely matters to the health of older people
Activities that facilitate social connectedness are important in maintaining quality of life and the best health possible
Social inclusion must be part of our approach in the continued development of our health system

18. Contact Information
Community Outreach Programs in Addictions (COPA) Ste 200, 49 Bathurst St., Toronto, ON, M5V 2P