Tackling loneliness in rural areas
Project Background
This IMPACT project focused on tackling loneliness among older people in Moray, Scotland. The project engaged with older people local to Moray to review the factors that lead to isolation.
In rural areas, loneliness is more common, and therefore this project helped uncover mechanisms to overcome the challenges and re-engage older people within the wider community.
Pre-project Evidence
A lack of definition as to what constitutes ‘older people’, ‘rural’, ‘loneliness’, and ‘social isolation’ has been identified in academic research.
Older People
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.
Rural Communities
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.
Loneliness and Social Isolation
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”
Ageing and Loneliness
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.
Project engagement
Along with the host organisation, Health and Social Care Moray, and particularly their Shared Lives Service, a local Theory of Change was developed. The Theory of Change set out the local context and the initial aims of the project.
The first stage of the project involved mapping the approaches currently available in Moray that aim to reduce loneliness for older people. We undertook mapping via web searches, visiting communities (exploring notice boards and in conversation with local people) and speaking with people involved in delivering services and approaches (local authority, NHS, church and community). Approaches explored included signposting, Health and Social Care Moray services, third sector befriending as well as community approaches.
Nicola then went on to meet with older people, their families and those who provide support to seek their views om factors which lead to loneliness; what helps people feel connected; what would reduce loneliness in Moray.
The next stage of the project focused, initially, on Speyside and Buckie and their surrounding areas allowing for comparison between a rural farming and a coastal fishing community. This was then widened to include Elgin due to the concentration of services and activities for specific groups of people in the town.
Other comparisons were made, such as by exploring services and activities from across the UK and reviewing their effectiveness – meetings were held, when possible, with those delivered services or activities. Nicola also compared and contrasted the experiences and views of other groups of people, for example, people with learning disabilities or sensory impairment, individuals living with dementia and their carers and other minority groups such as the LGBTQ+ community.
Outcomes
The views of people in Moray on this topic have been synthesised into four themes which form the basis of recommendations for service development:
- Signposting and Connecting: Work with individual communities to develop innovative ways of sharing and connecting people with services and resources available.
- Meeting Places: Promote and support the creative use of accessible, affordable and welcoming meeting spaces in everyday community places.
- Activities: Empower communities to develop varied, inclusive and regular opportunities for connection and shared purpose.
- Support the development of community relationships and trusted support.
Summary
This project has highlighted the diversity of resources and formally arranged services that are available across Moray. They are inevitably clustered around larger populations and many of these services are not necessarily for older people alone. This suggests that a focus on building community strengths and making smaller contributions to existing services to expand their remit a little, rather than creating a new service should be considered. Where populations are more diverse and people interact less naturally with other community members, these areas might need more effort and a co-produced approach to explore what might be wanted there, how it might be set up and how it can be supported to become self-sustaining in the longer term.
Such community-based development takes time and effort so Health and Social Care Moray might wish to target an area where there is little existing support or provision. There are a number of NHS, Moray Council and community approaches to signposting which perhaps could work together with localised connecting support to reducing loneliness.
Interestingly, some of the evidence that came from the IMPACT project and the subsequent recommendations are not all directly linked to loneliness but demonstrate a real desire for wider community connection across all ages in Moray in turn enriching the lives of everyone, including those experience loneliness.
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