Loneliness is everyone's business
Janet Morrison OBE
Chief Executive, Community Pharmacy England - (PSNC) - representing Community Pharmacies in England to secure a sustainable future in healthcare
When we set up the Campaign to End Loneliness 6 years ago some people thought it was actually laughable that loneliness could be a policy issue. Everyone gets lonely right? What on earth can the government, or anyone else for that matter, do about it?
And of course that’s right. If we thought our own loneliness, or that of our elderly parents or neighbours was the state’s responsibility we’d be entirely wrong. We all have responsibility - to ourselves, to our family, friends and neighbours and within our communities, loneliness is everyone’s business. But sometimes, at key transitions in life, and particularly in older age, barriers to being connected, feeling valued and being able to share with others, combine and when that happens people may need help to climb the ladder back into a more sociable and fulfilling life.
When we established the Campaign we wrestled with the notion of the deficit model of ageing. We knew from the research that not all older people were lonely and we were wary of promoting pitiable images of sad old people on their own. We’ve had enough of the ‘demographic timebomb’, the ‘burdens’ on health and social care, dependency ratios, older people being done to and patronised. We recognised the fundamental truth that older people are just you and I except with added patience, experience and wisdom! And that a rich community is one in which everyone can contribute their skills, passion and joy and feel valued for it.
But we as we assimilated the research and the voices of experience we found the evidence – that there are greater risks in older age, with a number of causal factors combining (retirement, bereavement, onset of ill health, sensory impairment, disability, becoming a carer) that a temporary episode of loneliness could snowball into a long term chronic condition. And we felt passionate about sharing that evidence and making us all aware of how it can affect each and everyone of us.
So we set out to ensure that everything we said about loneliness was evidence based, that whilst raising awareness of the risks, prevalence, impact and cost of loneliness we were also equally focused on what sharing ‘what works’ - the interventions that older people themselves rated and that their experiences were at the heart of our campaigns.
In the past 6 years the Campaign has put loneliness on the agenda. We’ve raised awareness that 10% of older people say they are often or always lonely, that whilst that percentage hasn’t shifted in 40 years, the population it affects continues to grow. We have promoted understanding of the downstream costs of loneliness – that it has a worse impact on future health than smoking 15 cigarettes a day - and by so doing made the case for preventive services that reduce the downstream need for health and social care support. We have brought together a community of local activists, community groups, service providers and commissioners to share models of good service design and the learning, and we’ve shared the tools to measure impact. We have promoted understanding of how to identify hotspots of loneliness and the hard to reach in our communities, and helped forge local strategies with local champions and campaigners. Many organisations and individuals have been able to use this evidence to make the case for their vital services, to improve their practice or to establish exciting new social enterprises.
We’ve built the Campaign on the principle that it’s a network committed to sharing learning and taking action. Over 3,000 people and organisations have joined us, our learning network has shared best practice with over 900 organisations across the UK, with 95% of them saying they have improved existing services or activities to tackle loneliness as a result of the Campaign. 80% of Health and Wellbeing Boards have made a commitment to tackling loneliness, 73% say this is as a direct result of the Campaign’s work. We have been involved in national partnerships and trained local Ambassadors.
But we know there is still more to be done.
The irony is that we founded the Campaign at a unique moment of austerity and public spending being cut to the bone. Local authorities have been struggling with huge swathes of spending cuts just at the time when the case for preventive services was widely accepted. So we’ve had to think hard about how to sweat the assets of existing statutory services – joining them up through age friendly cities and age friendly museums through to the outreach work of the fire service, police and pharmacies to help identify and support isolated older people. We’ve looked hard at promising asset based approaches that signpost, catalyse and connect to existing community assets and that make the most of the assets of older people themselves in sharing skills and support.
My experience as a founder and now Chair of the Campaign has been profoundly enriching. I’ve spent time with older people who charm and touch me. I’ve seen so many groups alive with their energy, skills, knowledge and spirit. And I’ve learnt a lot.
One key area of learning is that people with low, medium and high levels of loneliness need different types of support, as do those experiencing a temporary dip – say after a significant bereavement or bout of ill health – from those who have experienced lifelong isolation and loneliness. A community navigator, reconnections or circle of support service will be absolutely relevant to someone with low or medium level need, or whose been going through a short term dip, but someone with entrenched loneliness is unlikely, even with the support of a volunteer, to simply set off to new activities or groups within the blink of an eye. Those people are more likely to need support that builds confidence and resilience, or one to one befriending to set them on a longer road of reconnecting with social activities and building social ties.
I’ve learnt too that users of a service can be really satisfied, value it, and would recommend it to their friends. Their family and friends might report obvious improvements in mood, in health and demeanour but it might still be much harder to shift their self evaluation of how lonely they are. It's obvious really why that is, because there’s a difference between isolation and loneliness. If it was just the number of social contacts we had you could just sit on the bus all day making small talk and never feel lonely. But real friendships, feeling valued and supported take longer to develop and these are the real things that help reduce loneliness and give emotional succour. Two ‘look forward’ to activities in a week – though prized, don’t fill the many other hours of feeling deeply alone. Simply knowing that someone cares how your day went, or wants to see you over the weekend when most of the services are closed, is vital to feeling more valued, supported and emotionally nourished and ultimately less lonely.
I’ve also reinforced my belief that the wellbeing of older people is not just delivered by washing and dressing or cups of tea. Not just sorted through befriending and lunchclubs – vital and valued as they are. Wellbeing also means learning new skills, staying active, being connected and having opportunities to work, volunteer and give.
And I’ve also fundamentally learnt that communities are not just the voluntary sector. They are not the local authority. For older people they are many things. They are friends, families and neighbours, shop keepers who say hello to you. They are places and spaces, benches to sit on and watch the world go by. They are supermarket cafes, Wetherspoons pubs and Greggs bakeries. They are community centres and care homes. They are football clubs and rugby clubs and watching the cricket. They are libraries and parks, bus stops and buses. They are book groups and birdwatching, the ramblers and sewing classes. They are reading in schools and working the allotment. They are painting, and dancing and singing in choirs. They are yoga and pilates and armchair aerobics. They are classes and lectures and learning new skills. They are local history groups and amenity societies, campaigns and petitions. They are web forums and chats and community radio. They are churches and temples, synagogues and mosques. They are street parties, fetes, festivals, weddings and funerals. They are everything that leave their doors wide open and a chance for a smile, a laugh and a chat. (There’s a rap there somewhere……)
In the next exciting phase of the Campaign’s life we will continue to deepen our understanding of the prevalence, costs and impact of loneliness and the many routes to reducing it. But more fundamentally, we are seeking to catalyse whole communities to address loneliness and build connections, led by the spirit and passion of older people themselves. Connecting the myriad assets and activities in our communities to lower the barriers and throw open the doors.
Like I said, loneliness is everyone’s business.
And the Campaign to End Loneliness is now looking for new management group members - visit the website for further information... https://www.independentage.org/help-put-an-end-to-loneliness
Six years?! Cripes, when did that happen?