Home' Community Care Review : CCR Jan-Feb 2015 Contents of cost was also identified as an
The report Your Life Your
Wellbeing said: "While guidelines
for home care packages include
social support and transport to
social activities, in practice these
may be difficult to provide within
the funding or hours available
to someone who also needs
assistance with, say, personal care
and household tasks."
While community care worker visits
were valued as a form of companionship,
the report's authors argued that increased
funding should be available to offer
substantial social support to clients and
carers, if needed, in a way that allows them
to connect with their wider community.
The study of 265 Benevolent Society
clients revealed that some clients and
carers had deep-seated psychosocial
needs and goals that were sometimes
unacknowledged by care staff.
For example, despite domestic
assistance clients showing broadly similar
levels of loneliness and higher levels of
psychological distress as other clients, case
managers were much less likely to classify
them as being socially isolated.
Social isolation among culturally and
linguistically diverse (CALD) clients was
also not as well identified, which could be
linked to staff overestimating the social
support networks of CALD clients.
In its recommendations, the report
called for holistic, comprehensive
assessment of clients' psychosocial needs
to be built into community care services
and for case managers and coordinators
to explore issues of social connection and
inclusion more fully during care planning.
To evaluate the effectiveness of various
intervention strategies, the University of
Adelaide is leading a national project
to study what works to reduce social
isolation amongst older people.
Dr Debbie Faulkner, deputy
director of the Centre for Housing,
Urban and Regional Planning at
the University of Adelaide, says
that anecdotal evidence suggests
around 30 per cent of aged care
clients are lonely or isolated and
studies have shown the mental
and physical health effects of this
can be dramatic.
In 2010, a review of 148 studies covering
around 300,000 people concluded the
absence of supportive social relationships
was equivalent to the health effects of
smoking 15 cigarettes a day or drinking
more than six alcoholic drinks daily. The
review said that social isolation was more
harmful than not exercising and twice as
harmful as obesity.
Faulkner's study, 'Emerging from the
Shadows', is currently tracking a group of 80
people receiving a community care service
over six months to measure the impact on
their social connectedness and sense of
belonging. The clients are receiving a mix of
targeted social inclusion programs, as well
as a home support or home care service in
order to draw comparisons.
Preliminary findings suggest that any
sort of contact on a regular basis may be
having an influence on a person's wellbeing,
a finding supported in the results of the
Benevolent Society research.
Faulkner says she has been shocked to
realise that many of the study's participants
have reported feeling socially isolated for
years, or say they cannot remember a time
when they did not feel lonely.
The study is a collaborative project
between a number of universities (the
University of Adelaide, Melbourne
University, Queensland University of
Technology, Curtin University and King's
College London), and industry partners
(ECH, Anglicare SA, Benetas, Silver Chain,
Resthaven, IRT and COTA Queensland.)
In the second phase of the project, a
national survey will capture the prevalence
of social isolation and loneliness among a
wider sample of Australia's older population.
Twenty people in each state will
then be interviewed to compare the life
histories of those who are well-connected
with those who report having poor quality
"We want to understand what have
been the factors in their life that led up
to where they are now," says Faullkner. "Is
their loneliness the result of a major life
event in late life such the death of a partner
or close friend, the loss of their driver's
license or downsizing into an unfamiliar
neighbourhood? Or are there lifetime factors
that may have made them more susceptible
to becoming socially isolated in old age?"
Faulkner says the ultimate goal is to
enable the planning of appropriate services
for this cohort and to understand how to
design and target aged care services to
make a difference to the social wellbeing
of older people.
Alone in a crowd
Supporting the conclusions of the
Benevolent Society research, Faulkner
agrees it can be difficult to identify who
is at risk of social isolation, and she says
it is important to note it is the quality
not the quantity of our relationships that
She tells the story of Margaret, a
woman in her early 90s who, despite
living in a retirement village surrounded
by people, felt deeply alone. As years
went by, her fellow residents passed away
and were replaced with new residents
20 years younger, who shared vastly
Margaret felt increasingly socially
disconnected, despite on the surface
appearing to have access to large
community networks. "You think they are
surrounded by people that they must be
okay, but it's a bit like that saying, 'you can
be alone in a crowd'," says Faulkner.
The findings of this large, national
project will help shed light on this common
but under-researched problem.
For more information or to participate
in the Emerging from the Shadows study
contact Dr Debbie Faulkner on (08) 8313 3230
or email firstname.lastname@example.org. n
CCR will carry updates on the project's
findings in future issues.
Dr Debbie Faulkner
The absence of supportive social relationships
is equivalent to the health effects of smoking
15 cigarettes a day or drinking more than six
alcoholic drinks daily.
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