Tackling loneliness in rural areas

The United Nations defines older adults as persons over 60 years of age, while in the UK a person over 65 years is considered an older person. The World Health Organisation (WHO) provides global statistics for persons over 60 years, but also states that health and mental capacity changes relating to ‘old age’ “… are neither linear nor consistent, and they are only loosely associated with a person’s age in years.” WHO also points out that the diversity seen in old age is not random, and that beyond biological changes, ageing is often associated with other life transitions such as retirement, relocation to more appropriate housing, and the death of friends and partners.

From speaking to people in Moray, many of those over 65 do not identify themselves as ‘older’ whilst Health and Social Care Moray, with whom the project is based, tend to traditionally consider the over 65 age group but the focus most recently has moved towards need rather than age, as for instance for people with learning disabilities the effects of ageing can be felt sooner.

There is an underlying recognition of the support that an ageing population requires in Moray as 30.2 % of people in Moray are aged 60 and over, in comparison to 24.2% nationally in Scotland. According to the National Records of Scotland, it is predicted that by 2039 the numbers of people over 65 will have increased by 73% in Moray compared to 66% nationally.

In the UK the Office for National Statistics (ONS) defines an area as ‘urban’ if its population is over 10,000, a minimum area of 200,000 square metres, and settlements within 200 metres of each other being linked. All remaining areas are considered rural with a low population density where economic activity includes farming and forestry.

In Scotland the definition of rural is a settlement with a population of less than 3,000. Although 17% of the population in Scotland is aged >60, they make up 21% of the rural population in several rural local authority areas. In Moray, 42% of the population live in rural areas, with 25% of people in one of the most rural areas, Keith and Speyside, being aged over 65.

The terms ‘loneliness and social isolation’ are often used as a single concept or viewed as interchangeable. However, researchers have made a distinction between the separate concepts of loneliness and social isolation as findings suggest that each concept may have independent impacts on health and therefore should be viewed as individual. An individual can be socially isolated, but not identify as lonely and another person may be ‘lonely in a crowd’.

Loneliness means different things to different people. For the people of Moray who have been involved in the project so far it means:

• “being stuck in the house”
• “having no one to speak to”
• “some people like being on their own”
• “feeling unconnected to your community”
• “you can be lonely in a group”
• “seeing people socialising but you’re not part of it”

A UK Government review to identify gaps in research into loneliness found that previous and current work was based on individual factors that predict loneliness with an absence of research on community level risk factors, or place-based impacts. This is in line with the research we have conducted where there was a lack of research focusing on loneliness in rural areas.

It raises questions around what factors cause transient loneliness to become chronic loneliness. People are living longer with complex conditions and multi-morbidities. Loneliness can occur in any location, urban or rural, and can be caused by losing a partner, divorce, ill health, and/or lack of mobility.

In Moray, some of the reasons for loneliness shared by older people include:

• retirement
• loss of a loved one
• having to stop driving
• mobility issues
• lack of reliable public transport
• reliance on technology
• health and disabilities- eg hearing impairment
• weather and dark nights
• not having family close by
• caring responsibilities
• cost of socialising

There are issues around low numbers of men attending community approaches, lack of engagement and difficulties with recruitment in extremely rural areas as well as wating times, financial constraints and eligibility criteria for formal support.