Minutes:
For this witness session, the Committee was provided with evidence from Sarah Durner - Senior Officer, Sport and Physical Activity, Daniel Waller - Senior Library Services Manager, Jackie Westbrook - Manager, Yiewsley and West Drayton Community Centre, Vivian Ellis - Arts and Health Researcher, and Christopher Geake - Director, Hillingdon Mind.
Reducing loneliness in older people through wellbeing activities and events.Sarah Durner - Senior Officer, Sport and Physical Activity
The Committee was informed that the current Wellbeing events model began in 2012, with tea dances held at the Civic Centre. Feedback to the dance was good, and efforts were then made to look for creative ways to further engage with older people. Following focussed promotion within sheltered housing, care homes, social care and local organisations such as Age UK and Hillingdon Carers, the programme of events was expanded and a database of older people was compiled, to enable residents to be invited to future events. The database was maintained and added to, and currently held details of over 300 people, of whom approximately 180 regularly attended events each month.
The aim of such events was to promote local opportunities and provide access to
try new things in a fun, safe, and socially engaging way, to offer
information and advice about other services available, and to
develop new locally based activities such as chair exercise and
dementia coffee mornings. A more targeted approach included events
for the housebound, the Ghurka
community, and for residents living with dementia or Alzheimer's.
Attendees were often invited via referrals from partners and
agencies such as social care, and if necessary, transport to the
venue was included. Venues included libraries, community
centres, and the Civic
Centre.
Events included:
· Tea dances
· Day of the Older Person
· Dance for the over 65's
· Art Workshops
· Drumming sessions
· Coffee mornings
· Healthy walks
· Intergenerational reminiscence
· Music and flower festivals
Variety of events was felt to be key.
From experience running the events, and feedback from attendees, officers had learned that older people wanted a regular, safe, local and fun activity, where they got to know people, and where they were not asked too many questions. In addition, it was requested that older residents receive assistance when they wanted it, and when they needed it, with particular reference to receiving help with booking event attendance, arranging transport, inviting friends, being referred, or obtaining information on other available services. Continuity of attendance was key, as it was important for the older people to see the same faces and forge lasting relationships.
Flexible booking systems were of paramount importance, and while online booking forms were available, it was understood that older people may not have access to a computer, or have the confidence in using online tools. Additional telephone booking was therefore available, whilst officers would also accommodate verbal requests in person, which was useful in building rapport and trust between the Council and its residents.
Officers had noted that transport was notalways needed, for example transport provision had been made available for a number of tea dances, but the uptake was small. However, for events targeted at housebound residents, transport was required. Officers recognised that once someone had made the initial step to come to one activity, it was likely that they would come to more activities, and that making an attendee feel welcome was most important. The Council was actively promoting opportunities to those residents who were the most isolated, for example through GP navigators, social care referrals, or word of mouth. It was important that older people had something to look forward to.
The Committee was shown feedback from a number of older people, including video testimony, all of which was very positive. Highlights showed that attendees valued laughter, physical exercise, meeting former friends, and making new friends. The events were particularly valued in instances where attendees had experienced the loss of a partner. Feedback to activities such as intergenerational reminiscence had shown that the older people liked to feel valued, and to feel that their knowledge and experience was useful in helping younger people to learn skills.
Officers made recommendations for further improvement to events, which included:
• More regular wellbeing events for older people (e.g. targeting Housebound, Dementia)
• Leveraging services that provide transport, e.g. Dial-A-Ride
• Continuing to develop more social and fun activities that link into services without any obligation, (such as coffee mornings)
• Developing volunteering opportunities for young people to engage with older people, (e.g. through the Scouts, Duke of Edinburgh Award, links to school curriculum)
• More events held within schools (e.g. Coffee Mornings)
• Exploring how Spare Chair Sunday could work in Hillingdon
• Exploring opportunities with animals (e.g. Hen Power - animal therapies within care homes had been shown to effective in lowering violent incidents and the need for medication.)
• Continuing to promote existing activities (Group cycling, allotments, adult education, volunteering)
Members sought further information on a number of points, including:
How was Hillingdon targeting the lonely early, and could this be sped up?
Targeted events had been developed within the last five years. Engagement was now in place with bereavement services, GP's, Hillingdon 4 All, and via newspapers, leaflets, flyers, and transport services. School engagement was felt to be a big opportunity for further improvements, and schools were interested in engaging with the Council with a view to increasing intergenerational events. However, this needed more promotion.
How was the Council engaging with different community groups, e.g. the Somali community?
The Safer Neighbourhoods team was helping to engage with such communities. In Hayes, the Somali community was approached and invited to coffee mornings, whilst contact had been made with Asian women's groups. In addition, targeted events were being promoted to appeal to specific cultural groups, such as Bollywood Dances as an alternative to the tea dances. Groups who had limited English language were challenging to engage with, and it was recognised that further work to engage with these communities was required.
Members suggested that the Telecare line could be used to promote events and services, together with increased contact with Brunel University to obtain student volunteers.
Jackie Westbrook - Manager, Yiewsley and West Drayton Community Centre (YWDCC)
Ms Westbook confirmed that her presentation was supplemental to the comprehensive information provided by Sarah Durner, and would therefore focus on YWDCC.
Members were advised that community centres were important social hubs for older residents. Attendees would often promote the Centres via word of mouth, for example when speaking to people they had met on public transport. In the last two months, YWDCC had registered 4 new members.
Brunel University had recently supplied four student volunteers who had attended one of the tea dances held at TWDCC. The older people had enjoyed the students' company, and had encouraged them to dance. In instances where the students did not know how to dance, the older people had taught them. Feedback from the older people was that this had made them feel useful, and that their contribution was valued.
Recommendations for Hillingdon Council:
· It was recommended that consideration be given to how to leverage other skills that the older people may have
· Use of the Telecareline to find volunteers
· Exploration of befriending services, such as Age UK's telephone service
· Increased intergenerational events, such as Stockley Academy 6th Form singing groups
How Libraries activities and events mitigate social isolation amongst older residents including those with mental health issues - Daniel Waller, Senior Library Services Manager
The Committee was given an introduction to Hillingdon's Library services. This comprised 17 Libraries, a Mobile Library, and a Home Library Service. The libraries contain free computer use and wi-fi, together with a wide range of stock including large print, talking books, e-books, newspapers and magazines. Libraries were open 6 days a week, for long hours. Two libraries were open on Sundays, and many online services were accessible from home.
Library usage was not specific to age or communities. General usage figures showed total visits of 1.6 million per year, with an active membership of 67,000 (22% of population). Over 5,000 events were hosted by Libraries per annum, attended by over 100,000 people (many of whom were older people.) Data on the ethnic diversity of attendees was not available, though it had been recognised that events were appealing to a wide variety of residents.
Libraries were popular due to being a safe, trusted, accessible space, that promoted a sense of community and belonging that often became a community hub. Staff would get to know and forge relationships with regular attendees. Staff were provided with training to ensure an awareness of mental health and dementia, in order to better help residents.
Partners using libraries to hold events included:
· Adult Learning
· Sport and Physical Activity Team
· Green Spaces
· Hillingdon Dementia Alliance
· Mind
· Dash
· Alzheimer's Society
· Other council services needing to meet residents
Events held at libraries included:
· Coffee mornings
· Knit and Natter groups
· Chairobics
· Zumba
· IT for older people
· Reading Groups
· Writing Groups
· Author talks – including Culture Bite
· Reminiscence sessions
· Local History Talks
· Healthy heart month
The Silver Sunday, held at Botwell Green library, was part of a national campaign to combat social isolation in older people and celebrate their contribution to society. Held on the first Sunday in October, a group of 30 older residents from Age Link were invited. Children made cards for the older people which were gratefully received. The event included singing, refreshments and health checks from a local pharmacy.
IT for Older People was a free session held at Northwood Hills library, to help older people become proficient with computers. Run by volunteers, users were helped with hand and eye co-ordination (vital to use a tablet or computer mouse), before being helped to use the internet to explore their particular interests or hobbies. Information was provided to help guard against cyber-crime which may help to allay any fears that a newcomer might have about use of the internet. The sessions helped to create an opportunity for interaction between the participants, as well as the staff. Similarly, the Uxbridge Digital Drop-In Session provided informal help with computing and technology via volunteer students from Brunel University.
The Sow and Grow cross-generational scheme had been operating out of Yeading Library for the last 9 months, and allowed residents to grow their own fruit and vegetables. Public consultations were often held on library site, which gave older residents a chance to engage with their community, have their voice be heard, and make a contribution to the workings of the town.
Specialised library services, aiming to mitigate loneliness and isolation, included the Mobile Library, which delivered to 23 roadside sites every week, as well as schools, nurseries, day centres and residential and sheltered homes.
The home library service visited 150 housebound users, with visits every 4 weeks. The services provided vital social contact for the most isolated residents, and helps people to continue to live at home and maintain independent living.
Recommendations for further actions to address social isolation and loneliness via the library service included:
• Increase awareness among staff to enable more informed signposting
• More training in assisting with mental health issues
• Increase older male participation in library activities
• Increase inter-generational activities
• Explore opportunities to use new technology, for example the Tovertafel (Magic Table)
• Increase data capture to better assess impact of events held and actions taken
Members suggested that more libraries be open on Sundays. Mr Waller confirmed that limited Sunday openings were due to budgetary reasons. If further sites were opened on Sunday, it was likely that operating hours on the other days of the week would have to be reduced.
Members also requested that the feasibility of commissioning an additional mobile library vehicle be reviewed.
It was requested that figures for library membership of over 60's be circulated to Members.
Singing for Social Connection - Vivian Ellis, Arts and Health Researcher
The Committee was informed that Ms Elis was an arts & health researcher, choir leader and professional singer, and was an Associate of the Sidney De Haan Centre for Arts & Health Research at Canterbury Christchurch University.
Ms Ellis had been commissioned by the Director of Imperial College GP Training to run an education in arts for health for Hillingdon GP's. Originally trialled, the training was repeated for 48 student GPs in years 1, 2 and 3 at Guys & St Thomas (Nov 2016), as well as via workshops in arts for health with GP trainers from South London (Sept 2016) and South West London (June 2017).
Two monthly singing groups for health were being run in Northwood: 'Singing for the Soul' (singing for wellbeing) and 'Memory Matters' (for people with dementia living at home) both at Northwood and Pinner Liberal Synagogue.
A free, weekly drop-in singing group for mental health at The Dragon Cafe, is held in St George the Martyr Church in Southwark. The Dragon Cafe was user-led, and delivered by a small paid team plus volunteers, with the aim of providing a relaxed, social, non-medical, diverse, multi-generational setting.
The groups provided singing, dancing, and chatting, as well as chair-based yoga which had been seen to increase movement, which in turn allowed individuals to regain their independence. Health benefits of singing groups included fast social bonding and positive experiences, which helped to mitigate against loneliness, isolation, and the resulting depression that this caused.
Suggested recommendations for Hillingdon Council:
As the Council was aiming to reach as many older people as possible across the Borough in order to alleviate social isolation, GPs, with whom 90% of people were registered, could be well placed to guide patients towards beneficial interventions and activities.
For example, an arts hub for wellbeing in Hillingdon could be an effective forum and space to create more joined-up provision across the diversity of services and providers, to alleviate the suffering of social isolation, and provide pathways for people to access what they need. Such a hub could even be mobile, like a travelling library or arts & social wellbeing bus.
"Only Connect" - Loneliness, isolation, and mental health in later life - Christopher Geake, Director - Hillingdon Mind
Mr Geake, Director of Hillingdon Mind, set out the mental health in the context of social isolation and loneliness.
The Committer was informed that the World Health Organisation defined mental health as:
· A state of complete physical, mental and social well-being,
· and not merely the absence of disease,
· in which every individual realizes his or her own potential,
· can cope with the normal stresses of life,
· can work productively and fruitfully,
· and is able to make a contribution to her or his community.
According
to the Social Care Institute for Excellence (SCIE)'s report from
2016, mental health and emotional well-being were as important in older age as at any other time of life.
Most older people had good mental
health, but older people were more likely to
experience events that affect emotional well-being, such as
bereavement or disability.
The Department of Health estimated that:
40 % of older people seeing their GP
50 % of older people in general
hospitals
60 % of care home residents
have a mental health problem.
For the purposes of the review, the mental health issues most commonly seen in older people, due to loneliness and isolation, were depression and anxiety.
According to a report titled (“Look after your mental health in later life” by the Mental Health Foundation: 2016), helpful approaches to mental and emotional wellbeing included:
· Being prepared for changes
· Talking about problems and concerns
· Asking for help
· Thinking ahead and having a plan
· Caring for others
· Keeping in touch
· Being active and sleeping well
· Eating and drinking sensibly
· Doing things that you enjoy
· Relaxing and have a break
'Connecting' was seen as the fundamental and principle antidote to loneliness, isolation, and mental health issues. This included connecting with the self, connecting with others, and connecting with support.
Connecting with self:
|
Issues |
Recommended Action |
|
· feeling of low esteem and worthlessness · loss of family or social role · disappointments and disillusionment · loss and bereavement · physical ill-health · addictions
|
· reminiscence work · dealing with loss and bereavement · working through positive and negative experiences and feelings · replacing shame and assumptions of guilt with compassionate acceptance · counselling and talking therapies · volunteering
|
Connecting with others:
|
Issues |
Recommended Action |
|
· social isolation and emotional isolation · isolation through rejection · self-isolation as distraction · feeling of inadequacy or low self-esteem · ill-health, disability, abuse addictions, low self-esteem |
· keeping in touch or reconnecting · social clubs, recreational activities, learning activities · befriending · social media – Facebook, Skype · volunteering |
Connecting with support:
|
Issues |
Recommended Action |
|
· Independence · not acknowledging need for support · not knowing where to go for support · not being physically or emotionally able to engage |
· motivational work · planning for later life · drawing upon social capital and community networks.
|
When people with mental health issues were asked where they went for support, feedback showed that the most valued support received was from family members, neighbours, friends, colleagues, local community associations, college classes, libraries, and faith communities. It was important to recognise that whilst there were appropriate medical responses to clinical conditions; most of the issues of loneliness and isolation were not clinical.
People say they wanted the following support:
· how to maintain good integrated health and well-being
· support at the right time – the earlier the better
· where to go for the right support
· how to get support quickly
· how to self-manage their health and well-being
· how to address social isolation and its causes
· peer support from other people with “lived experience”
· challenge stigma and discrimination
Hillingdon MIND offered the following:
· groups and social clubs
· culturally specific support
· (South Asian, Somali, Afghan, Nepalese, Tamil, LGBT)
· befriending
· counselling and psychotherapy
· information and sign-posting
· mental health awareness
· anger management
· volunteering
· peer-support
· (women’s and men’s groups, Creative Minds, “Hearing Voices”, Creative Writing, walking)
· substance misuse and addictions
· carers
Suggested Priorities and recommendations for Hillingdon Council included:
· public awareness of the relationship between loneliness and isolation, and mental health
· amplify the voice and engagement of older people in co-production
· attention to diverse culturally specific needs (BME, LGBT)
· investment of businesses and employers to help people prepare for life beyond employment
· development of social capital
· promotion of befriending and volunteering
RESOLVED:
1. That the witness testimony be noted;
2. That the figures for library membership of over 60's be circulated to Members.