Sense Checking the Social Isolation Index for Older people

Executive Summary

Overview

CIRCLE (Centre for International Research on Care, Labour and Equalities), University of Leeds was commissioned by Leeds City Council to sense check a

social isolation index of people aged over 65. Two social isolation indexes have been developed and each includes data on ‘sub-groups’ of older people: those

who are non-white; those with a long term health condition; those known to have dementia; those who are widowed, and people claiming pension credits. The

first index additionally includes older people who had received an Adult Social Care referral, assessment or review in the last 365 days. The main focus of

this report is on the second index, which produced social isolation scores at the street level (the first index provided a score at ward level only). The report

draws on qualitative empirical research findings from three selected localities; Armley, Gipton and Wetherby. This includes data relating to interviews with

90 older people in their homes, who were asked questions on levels of social contact, participation in community and leisure pursuits, and self reported levels

of isolation. In additional to the intevriews: documentary analysis; detailed observations in each locality; three stakeholder focus groups; and 14 stakeholder

interviews were carried out. A discussion of the effectiveness of the sense check is provided, alongside suggestions for further research.

Levels of social isolation

None of the older people interviewed could be assessed as socially isolated overall. None were viewed as isolated due to a lack of social contacts, and

relatively small numbers on the basis of participation in activities or groups outside of the home. Further just over a handful of those interviewed referred to

themselves as being isolated ‘all’ or ‘most’ of the time, and in all except one case this did not appear to be related to the number of social contacts or activities

interviewees were involved in. Alongside this a number of older people reported preferring to be alone, or choosing not to get involved in outside activities..

Effectiveness of the social isolation index

Based on the 90 older people interviewed across the three localities, the second index tested for this research did not provide a particularly useful indicator of

social isolation, as levels of social contact and participation in community led, or other leisure activities did not differ between those who were, or were not,

on the index. The first index, which gives a total score at ward level, appeared to provide a more accurate indicator of social isolation. This is suggested

because Armley and Gipton both score fairly low on the first index, with Wetherby scoring high due to the number of older people involved with social care

services. Yet whilst none of the individuals interviewed in Wetherby were listed on the second index, they were more likely, overall, to be classed as socially

isolated as they did not take part in outside activities (either community or leisure based). It was found that of the measures used to inform the indexes, only

disability appeared to be an indicative factor, whereby reduced mobility and cognitive impairment, in particular, were reported as barriers to socialising.

Factors relating to broader concerns, such as property type or locality were often referred to in the interviews as significant, suggesting that an index may

need to look at ‘place based’ concerns, such as ensuring suitable community based activities and facilities are available, or anti social behaviour is reduced.

Alongside this, general comments around a loss of sense of community or ‘neighbourliness’ touches upon concepts that work at the broader level, relating to

all members of the community.

Stakeholder interviews and focus groups

The stakeholder focus groups and one-to-one interviews identified a number of factors perceived as impacting on social isolation. The main area based factors

across the three localities included: local services and activities; housing accommodation; weakened community links; and reduced levels of family support.

Regarding the individual level, disability was assessed as a particularly important factor, as was cost, and though mentioned by only one older person, gender

was also frequently referred to. Factors highlighted which were not identified during the interviews with older people (or the two indexes) included the

younger old and those with complex needs (such as substance misusers or prison leavers). The main suggestions provided by stakeholders around how to

tackle social isolation included: the adoption of a more coordinated, inclusive approach between local organisations in all sectors; improving community

cohesion overall; and ensuring activities are accessible (this relates to both emotional and physical support needs) and suitably varied to attract a broad range

of older people.

Main methodological issues

The number of older people interviewed for the sense check of index two was lower than expected. The research team encountered a number of challenges

during this project, particularly in gaining access to research participants. The key methodological issues related to: gaining access to properties (such as high

rise flats); and an unwillingness of some older people to take part, such as due to illness, cognitive impairment, or not identifying themselves as socially

isolated. There were also difficulties in gaining information from specific community level professionals, such as nurses and GPs, due to reported time

pressures, and an unwillingness to talk over the telephone.

Conclusions

If a social isolation index is to be developed, it may be worth investigating further the factors identified by stakeholders and older people themselves as

potentially contributing to it, which are not included in the first or second index. These include: gender, the ‘younger old’, and those with complex needs,

such as substance misusers or prison leavers. It is further recommended, based on the findings, that when developing activities for older people a person

centred approach is adopted, which focuses on what older people want to get involved with. Overall, this research suggests that attempting to predict social

isolation at the individual level alone may be problematic, though some factors, such as disability, seem to be highly relevant. It is recommended that

individual factors determining social isolation are considered but alongside broader issues within specific communities.

Contacts

Lucy Jackson

Consultant in Public Health

The Office of the Director of Public Health

Leeds City Council

Dr Andrea Wigfield and Dr Sarah Alden

CIRCLE (Centre for International Research on

Care, Labour and Equalities)

Care-Connect

University of Leeds