People assume that if someone is living in a care home surrounded by other residents and caring staff that they cannot possibly be lonely. However one study from 2020 concluded that the prevalence of both moderate loneliness and severe loneliness amongst care home residents is high enough to warrant concern(1).
Loneliness is a major problem as it impacts on:
- Psychological wellbeing of residents
- Increased workloads and stress on staff.
- Physical wellbeing because less interaction with staff, other residents and relatives can mean less chance of picking up early deterioration.
This work started in 2020 when concerns were raised around the impact of the COVID-19 pandemic. Residents were effectively cut off from communities and families, however on talking to colleagues working in social care it became apparent that loneliness amongst residents was not a new phenomenon.
Working jointly with colleagues supporting care homes in Sheffield Place, we started by looking at the themes that emerged from previous projects using the 15 steps(2) and Improvement Academy’s PET+ toolkit(3).
These themes were sense checked by care home managers and further strengthened by speaking to care home teams, relatives of residents, and once it was possible, the residents themselves.
This led us to conclude there were four main areas of focus to start to reduce loneliness:
- Adjusting to being in a care home – the importance of choice and fitting into the new regime.
- Getting to know the person and what matters to them – the importance of getting to know the person and personalisation of care within care plans.
- Experience of being in a care home – the range of opportunities and activities offered to residents that leads to feelings of accomplishment and self-worth, being valued for who they are.
- Contributors to a happy and contented life – the quality of connections with staff and other residents, having a sense of purpose and feeling valued.
Some key insights were generated through the work including:
- The importance of the home culture which was seen as important for welcoming new residents and their families, appreciating and valuing them as individuals and therefore providing true personalised care.
- The benefits for staff wellbeing from forming strong relationships with residents and relatives.
- Making every contact count: reducing loneliness will not happen by the simple provision of activities.
- The need to still feel useful and have a purpose, residents to play an active role in their lives and decision making wherever they could as part of the care home community they were living in. There are good examples e.g. My Home Life England(4), where partnering with schools was beneficial to both parties.
- New emerging roles under the enhanced health in care homes programme can help; consider care coordinators, social prescribers and supporting homes to improve links with the communities in which the homes sit.
A report of our findings to date has been written and we have started to test some ideas to reduce loneliness with colleagues at a care home in Sheffield. As we learn, we will share our findings via our Care Homes Network.
- What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis Clare Gardiner, Pete Laud, Tim Heaton,Merryn Gott Age and Ageing 2020; 49: 748–757 doi: 10.1093/ageing/afaa049 Published electronically 12 May 2020 (University of Sheffield)
- 15 Steps to Safety https://www.england.nhs.uk/get-involved/resources/15-steps-challenge/