Managing the social recession: how are services that aim to reduce isolation and loneliness among older people responding to Covid-19?
14 May 2020
Dr Ruth Naughton-Doe, Research Associate at the Centre for Loneliness Studies
Our daily lives have changed beyond recognition in the past few months. Just as no person is immune to Covid-19, no part of our society is immune to the disruption of a global pandemic. The UK response has enforced social distancing, shielding, social isolation and the temporary suspension of non-essential business; the economy is on sleep mode to mitigate an otherwise potentially disastrous burden on the NHS.
In addition to the inevitable economic recession, some media sources have started to refer to an emerging ‘social recession’, an increase of loneliness and isolation as a consequence of preventing face to face interaction. This is concerning considering that loneliness is already a growing problem, particularly for older people. An early report by Camden Carers claimed that despite the health risks posed by Covid-19, ‘elderly people can fear social isolation more than the virus’ (1)
This post reflects on how existing services set up to address isolation and loneliness amongst older people in the UK have been responding to the pandemic.
The Time to Shine Programme
For the past five years, the Time to Shine Programme has been operating in Leeds with the goal to reduce isolation and loneliness among older people. As of March 2020, 69 organisations in Leeds have been funded to deliver 101 projects to 9,186 older people, ranging from a community project bringing men together on a canal boat, to befriending schemes, LGBT focussed groups and projects in residential homes. Currently in its final year, the programme has recently celebrated success; an evaluation by the University of Sheffield demonstrated that 66% of respondents improved their well-being, and 42% of respondents experienced a reduction in loneliness. At a time when the programme managers were thinking about legacy and sharing learning, suddenly their whole social context has been changed overnight. The organisation, like many others around the country, has been forced to overhaul its aims, priorities, the way it works and the services it delivers. How has the organisation responded?
Flexibility
A long praised characteristic of the voluntary sector has been its ability to be creative and flexible in response to emerging needs and this has been evident in Time to Shine in the past few weeks. Normal contractual requirements mean that organisations are funded to deliver pre-defined programme outcomes. However, their funders, the National Lottery Community Fund, gave permission to use resources to support any required response, relaxing the usual regulation. Time to Shine immediately passed this flexibility onto the organisations it funds. It told its delivery partners:
"We trust you to do what is best to meet the needs of your beneficiaries at this time. The current priority is keeping your beneficiaries safe and well and to maintain contact with them wherever possible."
The message was clear, business is no longer as usual, and delivery partners were free to develop a response based on immediate need.
How projects have changed
One of the challenges facing organisations was adapting their staff to work whilst social distancing. In most projects, staff are now either working from home or have a reduced rota servicing the office. This rapid restructure of voluntary sector services, that often have limited resources, whilst staff are also adjusting to changes in their personal lives, has not been easy. Despite this, in just two months, there has been huge change.
Many projects have moved face-to-face interactions to telephone support. Where older people may have come to a public space to participate in a group activity, staff can now phone them. Others have started to link two project members together in a telephone buddy system to maintain connections between older people. There has also been a huge boom in projects offering online support, from using facebook groups, to setting up online meetings and courses on Zoom, online exercise classes, to promoting the use of social media and networking apps such as Whatsapp. Time to Shine had already invested in improving digital literacy among older people throughout their programme, so was able to draw quickly on these resources.
Some projects have diverted their work to providing the practical help most needed. One project changed its focus on running social activities to asking participants to help them set up food deliveries for isolated older people. Another that was already delivering food parcels prior to Covid-19, diverted more energy onto emergency food parcels. Groups are having conversations about sharing important resources such as vans, minibuses. One member of staff has offered a change in normal job role to provide minibus driving and counselling. Staff are striving to use their skills to support isolated and lonely older people in whatever ways are necessary, and have been sharing good practice to support each other.
Identifying problems and challenges
One of the challenges of switching to telephone and online methods of service delivery is that not everyone will have equal access to these resources. It is assumed that most people have access to a phone or the internet, but for a great many isolated and lonely older people, this is not the case. We can predict that those with the least financial resources will be most affected by loneliness and isolation during of Covid-19 (2). Time to Shine and Leeds Older People’s Forum have actively addressed this problem through the creation of ‘Shine’; a new magazine to collect and share older people’s stories (3). Shine magazine is hand delivered to over 4,000 households via ward hubs and an online version is also available. The first issue was launched last week, and is an incredible example of the fast-paced innovation taking place to meet the needs of isolated older people.
People who have disabilities or are cognitively impaired will also be disproportionately affected Sensory impairments, such as loss of sight, or hearing, may prevent older people from easily accessing online and telephone support. Older people who are digitally excluded and rely on face to face activities in community spaces, will be cut off from social contact. With shop closures, many do not even have the opportunity to purchase new technology.
Co-production
One challenge facing Time to Shine is co-production. Co-production is a way of working that encourages people who are using services to contribute their skills and knowledge rather than defining them only as people who ‘need help’. Time to Shine involves a group of older people who actively contribute to key decisions about programme delivery. An unfortunate side effect of Covid-19 is that suddenly older people have been branded as ‘vulnerable’ in the media and prevented from participating in society. This has the unintended consequence of contributing to a perception of older people as dependent on services, passive recipients of other people’s help, and is detrimental to the age positive message Time to Shine is promoting. The programme managers have been finding ways to continue to promote co-production at this difficult time, such as challenging age-stigma, setting up video conferences to continue the steering groups, and redeploying their volunteers to help others.
Moving forward
In the face of enormous challenges, the Time to Shine programme and partners, along with many other Voluntary Sector Organisations addressing isolation and loneliness, have achieved an incredible amount in a short space of time. Service delivery is changing and the voluntary sector is living up to its reputation as being responsive in a crisis. It is now imperative that we continue to think of ways to reach those most vulnerable older people at risk of further isolation and loneliness during this crisis.
References
- Chapman, H. (2020) Elderly can fear social isolation more than Covid-19. Article in the Camden New Journal Newspaper. Accessed online at 13/05/2020 from http://camdennewjournal.com/article/elderly-can-fear-social-isolation-more-than-covid-19
- Armitage, R. and Nelums, L. (2020) Covid-19 and the consequence of isolating the elderly (2020). The Lancet, 5 (5).
- Shine Magazine First Issue (2020) available online https://timetoshineleeds.org/projects/shine-magazine