Tag Archives: loneliness

Reaching out: tackling loneliness in older people

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As we’ve previously reported, loneliness is a growing epidemic with significant consequences for many groups in society. One of these groups is the elderly – loneliness has been seen to affect around 10-13% of older people, and has been found to increase the risk of premature death by 30%.

Making connections

Creating relationships and connections is an important way of tackling loneliness, and the Rural Services Network has highlighted some good examples of bringing people together

These include “Village Agent” schemes, which link people in rural areas with advice and support services for independent living. Another initiative –  the “Rural Coffee Caravan Information Project” – specifically targets rural areas of the country, where there may be fewer opportunities to meet through shopping, meeting for food or simply seeing other people. This project allows older people to meet at a caravan where they are given coffee, tea and homemade cakes, as well as providing information on helpful services.

Along these lines is also the “Talk Eat and Drink” (TED) project launched in 2015, which was initially funded by the Big Lottery’s “Fulfilling lives: ageing better” programme. This allowed older people to become involved in activities such as ‘Sing For Your Supper’, ‘Fish and Chips Friday’ and a Sunday pub lunch, which not only enabled people to bond with others, but also ensured that they were being fed properly, especially if they were struggling with cooking at home or getting food for themselves.

Artistic endeavours

Another way to tackle loneliness in older people is through the arts. A report from the Baring Foundation has found that it is important for older people to have a range of activities and opportunities to connect them to others; the arts can be effective not only in keeping people in touch with others, but also in helping with health-related issues like dementia.

The arts exemplifies the principles behind ‘five ways to wellbeing’: connecting, being active, learning, taking notice and giving. Being able to create things allows older people to use their minds and skills to express themselves. They can also have enhanced self-confidence from the feeling of doing something for themselves.

Organisations such as Arts4Dementia and Artz (Artists for Alzheimer’s) have been able to help people living with dementia, including help with their co-ordination and wellbeing. Other companies like Spare Tyre use theatre to create multi-sensory productions, while the Library Theatre Company in Manchester delivers sensory workshops for people living with dementia which provide fun with props and music.

One of the biggest issues with this form of help is that the arts tend to be overlooked by local authorities and therefore don’t have enough funding. However, Manchester City Council, has been working to make their city more ‘age friendly’ and in particular to provide cultural activities for older people.

There have also been examples of “arts by prescription” where GPs have referred patients to arts projects to improve their mental health. This is part of the wider ‘social prescribing’ approach which our blog has previously covered.

Everyday skills

Other forms of tackling loneliness in older people include helping them develop skills through, for example, volunteering. Projects such as Touchstone in Yorkshire allowed people to self-refer themselves, or be referred through GPs and Age UK, where they could learn practical skills with other older people. 91% of those taking part felt they were more involved or connected with their community, and 86% felt they had more confidence to meet people.

Another programme by the charity Open Age, in London, created opportunities for older people to keep up with the performing arts, physical activity, digital skills, lunch groups, and trips. While these did cost money, they were only £1 an hour and were pay-by-session and drop in, which made it slightly more accessible. However, even these small amounts may be out of reach for those already struggling to make ends meet.

Final thoughts

Overall, there seems to be a range of activities and opportunities for older people to not only meet others and form connections, but learn new skills they can utilise for themselves.

However, it’s important to remember that older people are not a homogenous group, and no single approach will work for everyone. But as long as careful thought goes into ensuring that the needs of older people are at the heart of initiatives to tackle loneliness, the chances of success will be all the greater.

Photo by leah hetteberg on Unsplash 

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Co-housing: the promises and the pitfalls

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Over the past two years, the coronavirus pandemic and the cost of living crisis have eclipsed the UK’s chronic housing shortage. But the housing challenges of 2019 are still with us in 2022, and in many ways they have worsened. According to the housing charity Shelter, over 17 million people are living in overcrowded, dangerous, unstable or unaffordable housing.

There’s no single solution to Britain’s housing emergency. But one idea that’s gaining increasing attention is co-housing.

A London School of Economics report has given a good definition of co-housing:

“A co-housing group is formed by a community of people typically with similar needs and interests. Co-housing is owned by the group and usually contains private rooms or houses with communal areas such as living rooms and kitchens, where people will come together to share meals and spend time together. The residents are responsible for the management and maintenance of the site, and they are run in a non-hierarchical way, giving all residents an equal say in how they are organised.”

The modern co-housing movement began in Denmark in the 1970s, and has since spread to other European countries, including Sweden, Germany and the Netherlands. There is now a growing number of co-housing projects in the UK, and although these are small in scale, they are pointing the way to alternative models of housing, and also to addressing other social issues, such as isolation and loneliness.

The promises of co-housing

The proponents of co-housing suggest that it has multiple benefits for residents:

  • affordability: by pooling resources such as cooking, childcare, and household expenses, co-housing residents can cut costs;
  • security: co-housing provides safe spaces for residents to live and socialise;
  • sustainability: sharing resources increases efficiency and reduces waste;
  • community: co-housing residents make decisions together, and co-housing can also reduce the chances of isolation.

The multiple faces of co-housing

There is no single template for co-housing. Some projects have a mixture of generations, singles, couples and families, while others focus on the needs of particular communities. In the United States, intergenerational co-housing projects have brought together retired people, families and foster children. Another scheme, in Berlin, has been designed for older gay men, but also welcomes older lesbian women, trans and inter persons, as well as younger LGBTQ+ people.

In 2016, the UK’s first co-housing project for older women opened in Barnet, north London. The New Ground scheme has been successful in developing a mutually supportive community of women over the age of 50. In addition, New Ground has worked to encourage policy makers, planners and housing associations to recognise the social and economic benefits of co-housing, and to respond to the demand that exists for senior co-housing.

Because co-housing is often seen as being reserved for communities who are affluent and predominantly white, Housing 21, a leading provider of retirement properties for older people, has recently launched a co-housing initiative with a focus on older Black and Asian people of modest financial means.

Tackling isolation: how co-housing can address loneliness

The communal nature of co-housing makes it a natural fit for people who are isolated and lonely. This was one of the themes of a recent webinar hosted by Housing LIN. One of the participants was Kath Scanlon, a researcher from the London School of Economics, who highlighted her work exploring the links between loneliness and participation in community-led housing.

Kath’s research has underlined the importance of social connection with neighbours and sharing spaces with others as ways of preventing loneliness:

“Broadly, we found that the most tight-knit places, where members knew and trusted each other most, performed best as supportive communities… Emotional loneliness was countered by fostering meaningful relationships and ‘belonging’ through physical proximity, sharing similar values, a reciprocal commitment and care, looking out for and supporting each other.”

A resident’s perspective

One of the most engaging and powerful contributions to the Housing LIN webinar came from Alison Cahn, who has been a resident at Lancaster Cohousing scheme since 2012.

Alison was one of the first residents of the scheme, which is an intergenerational co-housing community of households in the village of Halton, three miles from Lancaster in the North West of England.

The Lancaster scheme was designed by the people who live there. It consists of private homes, community facilities and shared outdoor space. Shared facilities include a laundry, food store and a car share scheme.

As Alison explained, the scheme is an eco-housing community, designed to make sustainable living easy. The homes are built to Passivhaus standards, which means they use about 15% of the energy to heat compared to conventional housing. Electricity comes from the scheme’s own microgrid. And if Alison needs anything, from a drill to a tent, she can borrow it from her neighbours. Overall, the scheme is estimated to save around 540 tonnes of CO2 every year (a single tonne of CO2 is equivalent to a 500 m3 hot air balloon).

Alison also highlighted the social aspects of co-housing. The scheme has been designed to enable residents to meet and interact. As well as sharing facilities, the residents get involved in communal activities, such as art, camping and wild swimming. They also work together and make decisions on the future development of the scheme.

Alison watched her mother grow old alone, and was determined that this shouldn’t happen to her. She feels supported by her neighbours, something that was especially important when her husband fell ill. Alison also spoke very movingly about another resident called Roger, who found support from the co-housing community in the final weeks of his life. As she explained: “Roger said he came to this co-housing scheme to die, but he didn’t. He actually came here to live.”

The pitfalls of co-housing

While Alison was keen to stress the attractions of co-housing, she also described the challenges. “Different people need different levels of social connections. Not everyone is keen to spend much time with their neighbours, and some prefer their privacy.” While decisions are taken together, reaching a consensus can take time, with general meetings sometimes getting heated. “Some bitter conflicts have fractured relationships, and some people have left.”

And although co-housing can reduce isolation, some residents have the impression that it will solve all their problems – “We’re neighbours, not carers or psychotherapists.”

Final thoughts

As things stand, co-housing schemes in the UK are too small to tackle the enormous challenges of the country’s housing shortage. But existing schemes demonstrate the great potential of this model of housing. And with more support from housing associations and local authorities, co-housing in the UK could really take off.

It was thanks to an imaginative collaboration between Hanover Housing Association and the Older Women’s Co-Housing group that the New Ground co-housing scheme became a reality. The housing association financed purchase of the land and construction of the properties, and the homes were presold or pre-let by the co-housing group before construction started.

Co-housing isn’t for everyone. It requires commitment from residents to participate in the management of a scheme, and to sacrifice some of their privacy for the benefit of their neighbours. This model of housing presents particular challenges, some of which might be hard to overcome. But the rewards of co-housing can be substantial.

Or, as Alison Cahn puts it: “When it works, it’s awesome.”

Photo by Dylan Gillis on Unsplash

Further reading: more on housing from The Knowledge Exchange Blog

“All the lonely people” – tackling the epidemic of loneliness

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Prior to the coronavirus pandemic, the UK was already experiencing what had been described as an ‘epidemic’ of loneliness.  The various lockdowns and social restrictions that were put in place to reduce the spread of the virus have exacerbated this already troubling situation.

Indeed, according to recent research by the Mental Health Foundation, 1 in 4 UK adults (25%) have felt lonely some, or all of the time, over the previous month; and 1 in 4 UK adults (25%) felt ashamed about being lonely.

With the huge impact this can have on mental health, it’s no surprise the theme of this year’s Mental Health Awareness Week was loneliness.

In its new report, “All the lonely people”, published as part of Mental Health Awareness Week, the Mental Health Foundation explores the clear links between loneliness and mental health, looking at what it’s like to be lonely, the causes, consequences and the groups of people who are more likely to experience severe and enduring loneliness.

All the lonely people

Through sharing the stories of nine individuals who often or always feel lonely, “All the lonely people” highlights the circumstances, situations and life events that can increase our risk of loneliness. It also investigates how well people understand loneliness and suggests ways that we can respond as individuals and across society.

While it is acknowledged that anyone can feel lonely, there are a number of risk factors that can increase the chances of severe and lasting loneliness that can impact mental health:

  • Being widowed
  • Being single
  • Being unemployed
  • Living alone
  • Having a long-term health condition or disability
  • Living in rented accommodation
  • Being between 16 and 24 years old
  • Being a carer
  • Being from an ethnic minority community
  • Being LGBTQ+

The health and financial impact of loneliness

Loneliness can have a huge impact on health, life expectancy and mental wellbeing. Research has shown that loneliness can be as harmful as smoking 15 cigarettes a day or having alcohol use disorder. Moreover, it has also been found to be more harmful than obesity. Not only does this have implications for individuals but also for wider society and the economy.

Recent government research estimated that the wellbeing, health and work productivity cost associated with severe loneliness (feeling lonely “often” or “always”) on individuals was around £9,900 per afflicted person per year. Other research has estimated that loneliness costs UK employers between £2.2 and £3.7 billion a year and that an estimated £1,700 per person (2015 values) could be saved over 10 years if action could be taken to reduce loneliness.

Given the significant health impacts and associated costs, the Mental Health Foundation report argues that preventing the development of loneliness should be a key priority and that a greater awareness of the risk factors and triggers needs to be created.

Public understanding but stigma remains

In terms of public understanding, the report asserts that the public has a good understanding of the link between loneliness and mental health. However, there is still significant stigma surrounding loneliness. Of the adults surveyed, 76% thought ‘people often feel ashamed or embarrassed about feeling lonely’. Only 29% of respondents agreed that ‘people who feel lonely are likely to talk about it, if they get the opportunity’. And people who experience loneliness themselves were more likely to recognise this sense of shame.

This stigma makes it difficult for people to talk about due to fears of discrimination or prejudice. Stereotypes about loneliness also still persist which can lead to some lonely people being overlooked. The findings show that despite the public’s understanding, there is a tendency to overlook certain at risk groups such as students, carers and LGBTQ+ people. People also tend to overestimate the link between loneliness and ageing or living in rural areas.

The survey found that people tended to believe that older people were more likely to feel lonely than younger age groups – 63% thought that being older (over 65) might contribute to someone feeling more lonely, whereas only 12% of respondents identified that being younger (aged 16-25) might contribute to someone feeling more lonely. This contradicts recent ONS data, which found that there were higher rates of reported loneliness among younger age groups.

Similarly, people tended to believe people living in rural areas would be more likely to experience loneliness (40% of people thought that living in a rural area could contribute to loneliness, compared to just 23% for living in a city). However, once again, the evidence suggests the opposite, with people living in urban areas reporting higher levels of loneliness than those in rural areas.

The report notes that stereotypes such as these can inhibit people from recognising and responding to their own loneliness, further exacerbate existing stigma and potentially limit the support offered to those who feel lonely.

Broader awareness

The report argues that a wider understanding of the factors that can lead to severe and enduring loneliness is needed to successfully combat the stigma and stereotypes associated with loneliness.

The stories of the individuals who experience loneliness demonstrate just how complex it is and how difficult it is to spot those who may be ‘lonely in a crowd’. It is therefore also important to understand the different barriers to connection for different people. These can be practical (lack of time, access to transport), structural (discrimination or prejudice) or emotional (lack of confidence, anxiety).

The report argues that a broader awareness of these factors could help people to stop blaming themselves for being lonely, encourage creative ways of supporting people and enable tailored support being developed for groups who are particularly at risk of long-term loneliness.

Previous research has also highlighted the importance of tailored approaches and developing approaches that avoid stigma.

Tackling loneliness

While highlighting what individuals can do to help combat loneliness, the Mental Health Foundation also highlights the need for action on the different barriers to connection if it is be tackled long-term. To this end, it has identified five UK-wide policy recommendations to address loneliness in society:

  • taking a strategic approach to loneliness;
  • developing the community resources needed to tackle loneliness;
  • building a greener lived environment that supports social contact;
  • supporting children and young people with interventions in education settings;
  • ensuring that everyone has access to digital communication technology, and the skills to use it, and respecting preferences for non-digital forms of communication.

Each of us can play a part too. By sharing stories of loneliness and shining a spotlight on the issue, we can all help to promote wider awareness and break the stigma of loneliness.

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A home for life? Developing lifetime neighbourhoods to support ageing well in place

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Photo by Pixabay on Pexels.com

The UK population is ageing. A 2019 report from AgeUK using data from the ONS highlighted that there are nearly 12 million (11,989,322) people aged 65 and above in the UK of which: 5.4 million people are aged 75+, 1.6 million are aged 85+, over 500,000 people are 90+ (579,776) and 14,430 are centenarians. By 2030, one in five people in the UK (21.8%) will be aged 65 or over, 6.8% will be aged 75+ and 3.2% will be aged 85+.

Allowing people to live well in old age in their own homes is something which housebuilders and planners are giving increasing thought to, both from a wellbeing perspective for residents, and a financial perspective for services, including the NHS and social care. The creation of “lifetime neighbourhoods” – spaces where people can live well from birth to retirement – brings together a number of elements: providing easy access to services; creating physical spaces which are suitable for people with disabilities and mobility issues to navigate; and allowing people to maintain those social and community ties which are associated with wellbeing, which can sometimes be lost with forced moves to residential care or a prolonged stay in hospital.

Homes for life

Building homes that are suitable for an ageing population is an important first step in creating lifetime neighbourhoods. However, planners and developers are starting to realise that one size doesn’t necessarily fit all when it comes to housing for older people. As with the general population, older people are not a homogenous group, and while some may need the support provided by extra care or sheltered housing projects, or may need single-storey open plan living to accommodate mobility aids or telecare packages, others simply want to live in a space which enables them to live comfortably in a community which suits their needs in terms of location and availability of services.

Designing and building a range of different housing types, which includes single-storey homes, extra care and sheltered housing, as well as stock which is suitable for people looking to downsize, is a key part of the development of effective lifetime neighbourhoods. This can free up larger family homes for people with children to move into and ensure that people are not kept unnecessarily in hospital because housing cannot be adapted to meet changing needs. A 2014 Age UK report showed that the scarcity of suitable and affordable retirement housing is a barrier to downsizing, highlighting that retirement housing makes up just 5-6% of all older people’s housing. Now groups like the Housing Made for Everyone coalition (HoME) are calling on the government to make all new homes accessible and adaptable as standard to help meet growing need in the future.

Social infrastructure such as libraries, community centres, local shops and good transport links are also a key aspect to planning effective lifetime neighbourhoods, as is ensuring accessibility of services such as GP appointments. Effective infrastructure planning can help enable the whole community, not just older people to feel connected to their local area, both physically and socially which can really help to support the idea of lifetime neighbourhoods and enable people to live well regardless of age.

Preventing loneliness and isolation in older age

Preventing loneliness and isolation in old age by creating spaces which facilitate engagement and encourage people to have positive social interactions is important to ensure that everyone within the community feels respected, involved and appreciated. However, the challenges are different depending on the nature of the community in question. In rural areas, social isolation can be compounded by a lack of appropriate transport infrastructure or the removal of key services at a local level in favour of “hubs” which are often located in towns and cities; in urban areas, loneliness can be exacerbated by the chaotic, hostile or intimidating environment that living in a densely populated area can have, a flip side to the benefits of density.

Ambition for ageing is a programme which aims to discover what works in reducing social isolation by taking an asset based approach to creating age friendly communities. Asset based approaches seek to identify the strengths and the abilities of people and communities, rather than their deficits. The asset based approach to creating age friendly neighbourhoods also seeks to use the experiences and  attributes that all members of the community have to help make the community better. To create effective age friendly neighbourhoods older people need to have opportunities to participate and feel that they are making a positive contribution.

A space for all ages

While much of the research and literature on lifetime neighbourhoods focuses on older people, it is also important to ensure that spaces meet the needs of all groups in the community, including children and young people and people with disabilities. Creating places which balance the needs of all groups within the community is an important consideration for planners.

The physical environment can be as important as the built environment and infrastructure development when it comes to developing lifetime neighbourhoods. Spaces which make use of natural and green infrastructure with lots of green and open public spaces have been shown to help improve mental health and wellbeing, as well as encouraging people of all ages to be more active. A number of design factors such as good paving, effective street lighting and easy access to seating and public toilets make neighbourhoods accessible to older people and people with impairments. Poor design can ‘disable’ people in their immediate environment and act as a barrier to participation in local activities.

adult affection baby child

Photo by Pixabay on Pexels.com

Final thoughts

For lifetime neighbourhoods to be successful, it is necessary that there is access to a range of appropriate housing options. In addition, the planning of public, open and green spaces, availability of transport links and local community infrastructure like libraries, police stations and local shops are all vitally important to ensure communities can thrive.

It is clear that while there is demand for more suitable housing for people in older age, the location and type of housing being built must also meet the needs and expectations of older residents, including good connections to local infrastructure, and safe accommodation. Projects which bring a range of ages together can be effective in strengthening community cohesion, can help challenge stereotypes and can reduce feelings of loneliness and isolation. Collectively these different elements feed into the creation of lifetime neighbourhoods which can support people to live well into retirement and beyond.

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‘Digital prescribing’ – could tech provide the solution to loneliness in older people?

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Notruf und Hilfe für Rentner und Kranke

The number of over-50s experiencing loneliness could reach two million by 2026. This compares to around 1.4 million in 2016/7 – a 49% increase in 10 years.

It has also been estimated that around 1.5 million people aged 50 and over are ‘chronically lonely.’

With an ageing population and increasing life expectancy, it would seem likely that loneliness among older people is set to continue; unless something significant is done. According to Age UK, tackling loneliness requires more than social activities. A new report from Vodafone suggests technology could be the answer.

Impact

The impact of loneliness in older people can be immense, not only for the older people themselves but for those around them. It can also put strain on the NHS, employers and organisations providing support to people who are lonely; and have a negative impact on growth and living standards.

Research has suggested that those experiencing social isolation and loneliness are at increased risk of developing health conditions such as dementia and depression, as well as increased risk of mortality. The damaging health effect of loneliness has been shown to be comparable to smoking 15 cigarettes a day. Older people who are lonely are therefore more likely to use health services than those who are never lonely.

The economic impact is also significant. It has been estimated that increases in service usage create a cost to the public sector of an average £12,000 per person over the medium term (15 years). Vodafone’s report suggests that loneliness has a £1 billion a year impact on public services. It has also been found to cost employers £2.5 billion per year.

How tech can ease the burden

According to Vodafone, “new technologies are a key part of the solution” alongside more traditional public and community services. Two key routes through which technology can be used to reduce loneliness are highlighted:

  • by supporting older people to remain independent in their home and community; and
  • maintaining and building networks and contacts.

From wearable devices and touchscreens to personal robots that act as the eyes, ears and voice of people unable to present physically, these are all highlighted as viable and positive uses of tech to ease the burden of loneliness. And there are already a number of examples of innovative use of technology that can benefit older people.

1024px-AV1

No Isolation AV1 robot. Image by Mats Hartvig Abrahamsen, via CC BY-SA 4.0

Good practice examples

One such example is Vodafone’s smart wearable wristband, the V-SOS Band, which supports independent living while also increasing the wearer’s safety. It can directly alert family members via their phone if the wearer needs help. It also uses fall detection technology so that families can be alerted automatically if the wearer falls either in the home or when they are out.

Kraydel is another example. Its smart TV-top hub links elderly people to their carers or family members, through their TV screens, helping people be more independent and remain in their own homes for longer as well as helping them be more socially connected. It provides for user-friendly video calling via the TV and can help people return home from hospital earlier. Via connection to the cloud, the device interprets the data it receives to build up a picture of the user’s daily activities, health and wellbeing. It issues medicine and diary reminders, and alerts caregivers if it sees something amiss, or identifies potential risk.

Although aimed at children, No Isolation’s AV1 – a smart robot designed to reduce the risks of children and young adults with long-term illness becoming socially isolated – demonstrates the positive impact innovative technology can have on social isolation and loneliness. The robot avatar, with its 360 degree camera, acts as the child’s eyes, ears and voice in the classroom or at other events, keeping children closely involved with school and in touch with their friends.

Of course, loneliness is particularly prevalent among people who don’t use smart technology such as smart phones and tablets, one of the reasons cited by Kraydel for using the TV – probably the most familiar and widely used screen globally. This issue also led No Isolation to develop KOMP, a communication device for seniors that requires no prior digital skills. It enables users to receive photos, messages and video calls from their children and grandchildren, operated by one single button.

Another new project recently launched in Sweden – considered one of the world’s loneliest countries – uses a unique conversational artificial intelligence which enables older people to capture life stories for future generations while providing companionship. Memory Lane works with Google Voice Assistant and is able to hold meaningful conversations in as human a way as possible. A pilot test showed that the software “instantly sparked intimate conversations” and led to stories that hadn’t been told before.

Final thoughts

With a significant number of older people lacking confidence in their ability to use technology for essential online activities, support for digital skills is obviously still important. In response to this issue, Vodafone has launched free masterclasses across the UK, as part of a programme called TechConnect.

Many of the above innovative examples bypass the traditional barriers to realising the potential of technology in reducing loneliness as most:

  • don’t rely on older people engaging directly with the technology; and
  • are based on mobile technology that can be constantly connected, whether inside or outside the home.

However, there is still the issue of awareness of such technologies and their accessibility to older people. The Vodafone report suggests that access could be improved through social and digital prescribing and revitalising support for independent living, and calls for a challenge fund to support innovation. It is suggested that these innovative ideas are just the start and that combined action is needed from across all levels of government, business and community groups, amongst others.

Perhaps if such action is taken to address existing barriers, we will see a reverse in the loneliness trend over the next 10 years.

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Writing and recovery: creative writing as a response to mental ill health

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“You don’t put yourself into what you write, you find yourself there.”
Alan Bennett

Mental illness, for so long regarded as secondary to physical health, is now being taken more seriously. Media stories about loneliness, anxiety and depression have highlighted increasing concerns about mental ill health, and the issue has also been rising up the political agenda.

In 2017, a survey by the Mental Health Foundation found that only a small minority of people (13%) reported living with high levels of good mental health, and nearly two-thirds of people said that they had experienced a mental health problem.

Prescribed medication is one response to mental health problems, and it’s been reported that the NHS is prescribing record numbers of antidepressants.  But while psychiatric drugs can be of real value to patients, especially those whose condition is very severe, the mental health charity Mind has suggested that alternatives, such as physical exercise, talking therapies and arts therapies, are often more beneficial.

Last month, a conference at the University of Glasgow explored ways in which creative writing is being used to respond to mental ill health, and discussed what makes writing interventions helpful for coping and recovery.

Voices of experience: coping and recovery through writing

“Making and consuming art lifts our spirits and keeps us sane”.
Grayson Perry

Several speakers at the Glasgow conference testified to the effectiveness of writing in dealing with mental ill health and in finding a way to recovery.

In 2012, James Withey experienced a set of circumstances which brought him close to taking his own life. In the darkness of his depression, James felt that he might never recover. But after spending time at Maytree, the UK’s first “sanctuary for the suicidal”, he found that writing about what he was going through offered an antidote to the lies being spun by his depression.

He started a blog, and when he posted a letter to himself, beginning “Dear You.” James found that writing the letter gave him space to express his feelings and to listen to himself.

Before long, readers of James’s blog were responding with their own “Dear You” letters. The word spread that the letters offered a different perspective on recovery, and in some instances, had prevented suicide.

Today, The Recovery Letters project is still going strong, with a website, one published book and another in the pipeline. James is realistic about the project:

“The letters are not a cure for a chronic illness, but they do provide support in helping sufferers of depression accept where they are.”

Policy positions: the view from Wales

“If poetry and the arts do anything, they can fortify your inner life, your inwardness.”
Seamus Heaney

Another speaker at the conference was Frances Williams, a PhD candidate at Manchester Metropolitan University, where she is studying arts and health. In her presentation, Frances explored some of the policy frameworks and public discourse surrounding the field of therapeutic writing in Wales.

She highlighted a recent report, Creative Health, The Arts, Health and Well-being, which  makes a case for the healing power of the arts in many different healthcare and community contexts.  In this report, a creative writing tutor explained some of the ways in which writing can help people experiencing bereavement, including keeping a journal, writing unsent letters, describing personal belongings and resolving unfinished conversations:

“Writing can be a valuable means of self-help, with the page as a listening friend, available any time of the day or night, hearing whatever the writer wants to say. The results of this can be powerful, and include people being able to return to work and adjust more effectively after their loss, acquiring skills for their own self-care which will serve them through the rest of their life.”

Frances also noted that the battle of priorities between impact and value-for-money has driven advocates of arts therapy programmes to defend them in terms of cost effectiveness and social value.

A mapping project by the Arts Council of Wales has taken this to heart, producing in 2018 an audit of the principal arts and health activities currently taking place in Wales.

Writing to the rescue

“By writing, I rescue myself”
William Carlos Williams

The Glasgow University conference underlined the health-giving properties of creative activities and the potential for creative writing to support people suffering with mental ill health. There was no pretence that writing offers a quick-fix solution. As James Withey noted, “…writing is just one element in a toolkit of responses to mental ill health.”

The All-Party Parliamentary Group on Arts, Health and Wellbeing fully supports this concept, and has recommended that policymakers recognise its importance:

“…the arts can make an invaluable contribution to a healthy and health-creating society. They offer a potential resource that should be embraced in health and social care systems which are under great pressure and in need of fresh thinking and cost-effective methods. Policy should work towards creative activity being part of all our lives.”

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Is technology really the answer to social isolation and loneliness?

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Old man sitting on a benchBy Steven McGinty

As we head towards Christmas, the media is filled with images of families coming together and enjoying the festivities. However, the reality is that many people will not be spending the Christmas period with loved ones, and will be spending the festive season alone.

In April, Future Cities Catapult produced a report into the impact of social isolation and loneliness. They highlight that those experiencing social isolation and loneliness have an increased likelihood of developing health conditions such as dementia (1.9 times more likely) and depression (3.4 times more likely). In addition, there is a 26% increased risk of mortality.

The report also included findings from the Mormont Review, highlighting that in emergency situations social networks have a significant impact on recovery.

“Individuals who are socially isolated are between two and five times more likely than those who have strong social ties to die prematurely. Social networks have a larger impact on the risk of mortality than on the risk of developing disease, in the sense it is not so much that social networks stop you from getting ill, but that they help you to recover when you get ill.”

It’s this substantial impact on people lives’ – and the costs to the health service – which has led to many public bodies looking for ways to tackle social isolation and loneliness.

Technology-based interventions, in particular, are some of the most innovative approaches to addressing the issue that affects over half of all people aged 75 and over who live alone, as well as increasing numbers of young people. Below we’ve outlined some of the most interesting examples.

CogniWin

CogniWin provides support and motivation for older people to stay active and in employment by providing smart assistance and well-being guidance. It helps people to adapt cognitively with their work tasks through their interactions with a system (which collects information using an intelligent mouse and eye tracking software). A virtual Adaptive Support and Learning Assistant then provides feedback, which helps the older person adapt their working lifestyle or have the confidence to take up a part-time job or become a volunteer.

Casserole Club

Casserole Club is a social enterprise that brings together people who enjoy cooking and who often share extra portions with those who may not be able to cook for themselves. Founded by FutureGov and designed in partnership with four local authorities, the service uses its website to allow volunteers to sign up and search for diners in their area (most of which, are over 80 years old). Overall, there are 4,000 cooks nationwide, and 80% of diners highlight that they wouldn’t have much social contact without the Casserole Club.

Family in Touch (FIT) Prototype

The Family in Touch (FIT) prototype was developed by a team of Canadian researchers who noticed that elderly people in care homes and retirement communities often touched photographs in an attempt to connect with family members. Based on this, the team created a touch screen photo frame which sent a message to a relative to say that they were thinking of them. The relative was then able to record a video message, which could be viewed by the elderly person in the photo frame. It was found that elderly people appreciated the simple design and tactile user experience.

Final thoughts

These are just some of the innovative tools being used to tackle social isolation and loneliness. And although technology is not the whole solution, it can certainly provide new opportunities for projects seeking to provide friendship and support to those who feel disconnected.

Individually, we can also make a difference. Even just making a phone call to an elderly relative, sending a message to an old friend, or visiting a neighbour, can brighten up someone’s day.

The Knowledge Exchange provides information services to local authorities, public agencies, research consultancies and commercial organisations across the UK. Follow us on Twitter to see what developments in policy and practice are interesting our research team. 

Maggie’s Centres: wellness through building design and the environment

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In March 2017, the 20th Maggie’s Centre was opened in the grounds of Forth Valley Royal Hospital in Falkirk. Designed by architects Garbers & James, it is expected to receive 3000 visits in the first year.

Maggies Centre Forth Valley, Garbers and James

Maggie’s provides free practical, emotional and social support to people with cancer and their family and friends, following the ideas about cancer care originally laid out by Maggie Keswick Jencks and co-founded by her husband Charles, who is a landscape architect. Among Maggie’s beliefs about cancer treatment was the importance of environment to a person dealing with cancer.

She talked about the need for “thoughtful lighting, a view out to trees, birds and sky,” and the opportunity “to relax and talk away from home cares”. She talked about the need for a welcoming, reassuring space, as well as a place for privacy, where someone can take in information at their own pace. This is what Maggie’s centres today aspire to.

A number of high profile architects have designed Maggie’s Centres across the UK – from the late Zaha Hadid to Frank Gehry, Richard Rogers and Rem Koolhaas.

The Maggie’s Centre in Kirkcaldy, Zaha Hadid Architects

Promoting wellbeing through the natural environment and effective design

Drawing on research which considers the significant impact that environment can have on wellbeing, Maggie’s Centres are designed to be warm and communal, while at the same time being stimulating and inspiring. The interiors are comfortable and home-like. Landscape designers and architects are encouraged to work closely together from the beginning of a project as the interplay between outside and inside space, the built and the “natural” environment, is seen as an important one.

“A building, while not wholly capable of curing illness, can act as “a secondary therapy”, encouraging wellness, rehabilitation and inspiring strength from those who move around it.”

Each of the centres incorporates an open kitchenette where patients can gather for a cup of tea, airy sitting rooms with access to gardens and other landscape features, and bountiful views. There are also private rooms for one-on-one consultations; here Maggie’s staff can advise patients on a range of issues relating to their condition, whether that is dietary planning, discussing treatment options (in a non-clinical setting) or delivering classes such as yoga.

Spaces to promote mental wellbeing as well as physical healing

Maggie’s Centres are also about offering spaces to people to help improve their mental wellbeing. As well as quiet tranquil spaces for reflection and meditation, there are also central areas, focused on encouraging the creation of a community between the people who use the centre. Wide-open spaces, high ceilings and large windows, with lots of opportunities to view the outside landscaping and allow natural light to enter are a key feature of many of the Maggie’s Centres.

The locations also try as far as possible to provide a space free from noise and air pollution, while remaining close enough to oncology treatment centres to provide a localised base for the entire treatment plan of patients.

Fresh air, low levels of noise and exposure to sunlight and the natural environment, as well as designs that provide spaces that promote communal interaction to reduce feelings of isolation and loneliness, have all been shown to improve mental as well as physical wellbeing. In this way, the physical attributes and design of the Maggie’s buildings are helping to promote mental as well as physical wellbeing of patients and supplement the care being given by the cancer treatment centres located nearby.

Interior of the Maggie’s Centre in Manchester, Foster and Partners

Award-winning architecture and design

In 2017 Maggie’s Manchester was shortlisted for the Architects’ Journal Building of the Year award. And many of the individual centres have won regional design awards for their innovative use of space and incorporation of the natural environment into their designs.

A Maggie’s garden was also featured at the 2017 Chelsea Flower show, highlighting the importance of environment, and the role of the natural environment in rehabilitation and promoting wellness among those who are ill.

Final thoughts

How design and landscape can aid and empower patients is central to Maggie’s Centres. They are a prime example of how people can be encouraged to live and feel well through the design of buildings and the integration of the surrounding natural environment. These environments are the result of a complex set of natural and manmade factors, which interact with one another to promote a sense of wellness, strength and rehabilitation.

They demonstrate how the built environment can contribute to a holistic package of care – care for the whole person, not just their medical condition. Other health and social care providers can learn from them in terms of supporting the wellbeing of patients, carers and their families.

You can find out more about Maggie’s Centres though their website.

Keep up to date with what is interesting our research officers on Twitter.

Read more about innovative building design in our other blog articles.

The Men’s Sheds revolution spreading around the world

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by Stacey Dingwall

Last week I attended ‘Men’s Sheds: the movement in Scotland and the big picture internationally’, an event, organised by the Centre for Research & Development in Adult and Lifelong Learning (CR&DALL) at the University of Glasgow.

Our blog on the Men’s Sheds movement was one of our most popular last year. The movement originated in Victoria, Australia in the 1990s, as a place for men to socialise and take part in practical activities. 23 years later, there are now close to 1,000 such spaces in Australia. Sheds have also proven popular in Ireland (350 Sheds and counting) and Scotland (at least 38 up and running, with 30 in the start-up phase).

Research has indicated that loneliness and isolation are a particular issue for certain groups of men, which is reflected in higher suicide rates. Evaluations of Men’s Sheds have found participation to have a range of positive effects for these groups of men, predominantly in terms of their mental health and wellbeing.

The movement in Scotland …

The first speaker of the day was Willie Whitelaw, Secretary of the Scottish Men’s Sheds Association (SMSA). Willie highlighted two key points, which were themes throughout the rest of the afternoon:

  • The importance of Sheds not being regulated by outside agencies, e.g. government – this was something that those involved in Sheds felt particularly strong about. As noted by Professor Mike Osborne, the Director of CR&DALL, at the start of the afternoon, the reduction in government support for adult education has created a need for people to organise themselves in order to access lifelong learning opportunities. Thus, those who attend Sheds feel strongly about preserving the independence of the space, as well as its democratic dynamic.
  • How to ensure the sustainability of Sheds, and community projects in general – Willie described how the SMSA can support Sheds across Scotland by offering advice on applying for funding, how to keep things like rental costs low, and using mechanisms such as the Community Empowerment Bill and Community Asset Transfers to their advantage. Noting the difficulty that many community projects face in sustaining themselves long-term, Willie highlighted the Clydebank Independent Resource Centre (CIRC), which has been running for over 40 years, as a rare but good example of how sustainability can be achieved.

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…and the big picture internationally

The second speaker of the day was Professor Barry Golding from Federation University Australia. Barry is the most prolific researcher in the area of Men’s Sheds, and published The Men’s Shed Movement: The Company of Men last year. Barry described the origins of the movement in Australia, and suggested it took off due to its provision of the three key things that men need: somewhere to go, something to do, and someone to talk to.

Barry also emphasised the importance of not formalising Men’s Sheds, and particularly not promoting the spaces as somewhere where men with health issues go (not a very attractive prospect to an outsider!) This point was also picked up by David Helmers, CEO of the Australian Men’s Shed’s Association. David described the experience of one Australian Shed who had a busload of patients arrive after being referred by health services. The point of the Shed is to create a third space for men (other than home or work) where they can relax and socialise with their peers. Any learning or health improvements that arise from this is coincidental and not forced.

Barry and David were followed by John Evoy of the International Men’s Shed Organisation (IMSO). John focused on the experience of Sheds in Ireland, noting the impact of the recession as a particular reason why the movement has taken off in Ireland. The IMSO’s aim is to support a million men through Sheds by 2022.

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Strengthening the movement and using evidence

To finish the afternoon, two panels comprising Shed members and researchers considered the questions of how to strengthen and sustain the Men’s Sheds movement, and how research might be beneficial to this.

Shed members on the panel and in the audience suggested that changing the stereotype of Sheds as spaces for older men with health (particularly mental) issues is important. In fact, men of any age are welcome to attend their local Shed, and current members are particularly keen to encourage this in order to support the intergenerational transmission of practical skills that are otherwise at risk of being lost.

In terms of available evidence, it was noted that research on Men’s Sheds is still scarce, and focused on the Australian experience. Catherine Lido, a lecturer in psychology in the university’s School of Education, discussed the pros and cons of carrying out a systematic evaluation of the movement in the UK. Again, the importance of the democratic nature of Sheds was raised – allowing outside agencies, particularly government, to come in and carry out research would involve the loss of some control. Any research conducted would have to be participatory, in order that Shed members did not feel like they were the subject of an ‘experiment’. Barry Golding highlighted, however, that there is currently almost no data on UK Sheds available; rectifying this could strengthen Sheds’ chances of being successful in applications for funding to support their running costs.

If you enjoyed reading this, you may also be interested in our previous blog on ‘makerspaces‘, which have drawn comparisons with the Men’s Sheds movement.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Shedding light on a serious issue: how Men’s Sheds are tackling social exclusion

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by Stacey Dingwall

Promoting awareness of health and social issues among men, and particularly older men, has always been a tricky challenge. According to research, the longstanding stereotype of men who actively avoid visiting the doctor is true: significant numbers of older men may be experiencing loneliness and isolation due to their reluctance to join clubs for older people, a fact which may explain why suicide rates are higher among middle-aged and older (white) men.

One initiative that has tried to tackle this issue is the Men’s Sheds movement, which originated in Australia in the 1990s after concerns were raised over the lack of opportunities for older men to socialise and discuss any issues they were having with their peers. This led to the emergence of numerous Men’s Sheds across the country, in the form of workshops where men could come together to engage in traditional shed-orientated activities such as woodwork, as well as form new social connections and access health information.

The benefits of Men’s Sheds

Evaluations of Men’s Sheds have identified a range of benefits for the men who participate in them, as well as for the wider community. Older men and social activity: a scoping review of Men’s Sheds and other gendered interventions published in Ageing and Society in April 2015 identified a range of positive effects of the initiative on older men, particularly in terms of improvements in their mental health and wellbeing status. While limited evidence was found of a positive impact on the men’s physical health, the review did find that belonging to a Men’s Shed provided participants with both a personal and social sense of accomplishment – through learning and sharing skills and contributing to their local community – as well as a sense of purpose, through social engagement with their peers which enabled opportunities for fun and camaraderie.

Men’s Sheds in the UK

Between 2010 and 2012, Age UK ran a ‘Men in Sheds’ pilot project, initially limited to Kendal, Bildworth and South London. The popularity of the pilot saw it covered in the national press and other ‘Men in Sheds’ projects soon opened in other areas, with one participant expressing his regret that the initiative had not been established in his area years ago.

In 2013, the UK Men’s Sheds Association was launched. They provide information on how to start a new Men’s Shed, or develop an existing organisation, and have helped form regional networks of Sheds.

One of these networks is in Glasgow, which is now home to the Glasgow Area Men’s Sheds (GAMS) group. We spoke to current GAMS secretary Charlie, who became involved in Men’s Sheds after illness led to him experiencing unemployment and social isolation. After coming across the UK Men’s Sheds Association website, he met up with six other men who were also interested in starting a Shed in Glasgow. Fast forward a year, and there are now at least six separate Sheds in the Glasgow area, at which Charlie estimates there are around 80 regular attendees. For Charlie personally, involvement with Men’s Sheds has allowed him to “build a portfolio of work experience, gain possible references, meet new people, go to new places and do new things”.

Charlie also pointed to research published by the Joint Improvement Team (JIT) in February 2015 which highlights the rapid spread of Men’s Sheds throughout Scotland over the last two years, with Sheds now in 18 of the country’s 32 local authority areas. The report also looks at the development paths of Men’s Sheds, as well as drawing out lessons for other community capacity building initiatives and outlining the local and community support needed to develop a Shed.

What about the women!

According to GAMS, the question of why the Sheds are men-only affairs is a common one. Their response is that “Men’s Sheds address specifically male issues involving male social isolation, men’s health both physical and psychological, re-defining of masculinity in modern society […] women have much more and highly developed socialising group opportunities”.

As well as highlighting a tendency towards loneliness among older men, research has also indicated another trend – the decline of men’s social networks as they age, particularly after the death of a partner. Thus, the importance of Men’s Sheds in “promoting social engagement and healthy, active ageing among older men” is perfectly demonstrated.

The Idox Information Service can give you access to a wealth of further information on active and healthy ageing. To find out more on how to become a member, contact us.

Further reading:

The experiences of older male adults throughout their involvement in a community programme for men, IN Ageing and Society, Vol 35 No 3 Mar 2015, pp531-551

Tackling men’s health: implementation of a male health service in a rugby stadium setting, IN Community Practitioner, Vol 84 No 4 Apr 2011, pp29-32

One hundred not out: resilience and active ageing

Active ageing: live longer and prosper – realising the benefits of extended healthy life expectancy and ‘disability compression’ in Europe

Ageing, health and innovation: policy reforms to facilitate health and active ageing in OECD countries