Facilitating Meaningful Social Inclusion
with Older People
Samantha Saunders. Occupational Therapist - Senior Commissioning and Project Manager
[email protected]
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
Guided
Conversation
Independent
Living
Outcome Star
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.
Goal Based
Action Plan
Social
Reablement
Approach
Support to
Access
Community
Independent
Living
Outcome Star
Meaningful
Social
Engagement
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.
Project Results:
• Project Cohort
Cohort 50 / Control 50 - 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: 65-74 20% , 75-84 26%, 85 + 54% .
• 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.
Older Adult Barriers
Condition management
19.5%
38%
Lack of Confidence
28.0%
9.8%
Transport options
17.1%
4.9%
Lack of Group to meet… 0.0%
2.4%
14.0%
Unable to define / unclear
2.4% 14.0%
Other specific activities
SIP clients
0.0%
Controls
Visits
Email
46.5%
44.9%
11.0%
Finance
25.4%
2.4%12.0%
2.4%
8.0%
Controls
31.7%
Visbuzz
SIP clients
Housing
Safeguarding
0.0%
17.1%
Telephone call
7.7%
18.0%
PA
2.4% 14.0%
No Goals - happy with current…
CN Activity
Letter
Conclusion
Older Adults reported positive change in the three key areas
• This project was able to evidence that a personalised approach with
relating to their social inclusion;
layers of support can reengage Older Adults with their community
Outcome Star Results
Positive change
How you
feel
No change
56.8%
and report positive outcomes as a result.
Negative change
24.3%
• To be effective CNs need to be knowledgeable about their local
18.9%
Star Assessment
Research/Other
23.2%
2.4% 14.0%
12.0%
The CN time was focused on client engagement;
10.7%
Other
Increase mobility / Strength
6.8%
24.0%
19.5%
12.0%
Health / ASC Referral
24.0%
9.8%
Transport
10.0%
7.3%
Family Dynamics
2.4%
40.0%
34.0%
Keep in touch with family
14.0%
2.4%
9.8%
Increase Confidence going out
16.0%
2.4%
Other
No barriers
24.0%
20.0%
22.0%
Cognitive Impairment
Understand what's available
VSO / Community
Group
Transport
46.0%
51.2%
Keep in touch with friends
24.0%
19.5%
Lacks Motivation
Behaviour / Presentation
56.1%
2.4%
Engaging Activity
51.20%
30.0%
Accompanied to go out
Sight Impairment
Meet likeminded people
40.0%
Reduced Mobility
Unaware of groups
Client Outcomes
Goals % of all clients & controls - multiple goal
provide Older Adults with time needed to support appropriately.
• The comparison between the cohort and control groups evidenced
Social Life
64.9%
29.7%
5.4%
the significant impact mobility and condition management can have
on Older Adults motivation to engage. This provides evidence for the
Referral
Assistance (forms etc)
community, be skilled in motivating others and have the capacity to
Activity
51.4%
45.9%
2.7%
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
References:
• SCIE (2012) At a glance 60: Preventing loneliness and social isolation amongst older people. http://www.scie.org.uk
• 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 ©. www.outcomesstar.org.uk
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.