Over 1 million older people say they always or often feel lonely, with Age UK’s Loneliness heat map showing that residents of Brent aged 65 and over currently have a medium to very high risk of experiencing loneliness.
ICHP have been working in North West London with Brent Clinical Commissioning Group (CCG) this year to better understand issues around loneliness, and examine whether technology can help provide a solution to this challenge.
There are a number of evidence-based initiatives already in place to combat loneliness and social isolation in Brent, including befriending and day centre services, though we found little more than anecdotal evidence behind technological solutions. Of the seven people we interviewed, no-one owned a mobile device or a computer and only one person indicated that they would be interested in learning how to use one. However, all owned or were happy to use a landline phone. We inferred from this that it is not the technology itself creating a barrier to adoption, it is the learning process and a fear of failure. We felt that with a carefully designed intervention, which provided dedicated support tailored to individual needs, we could help people overcome this.
We piloted technology in two care homes in Brent – Birchwood Grange and Riverview Lodge – and targeted the pilot towards residents who spent a greater proportion of time in their room than their peers.
We worked with care home staff to carefully select ten residents to participate, based on the residents’ desire to do so, as well as their expected ability to physically operate smart devices. We provided two Amazon Fire 10” devices to each care home, which are tablet computers with inbuilt smart-speaker functionality. We spoke to the participant residents before the pilot begun, configuring the devices with apps to suit their interests. Once the devices had been set up, we ran a training session with staff in each home and handed over the devices and a short user manual to the staff, for them to then lead the initiative.
We made weekly visits to each care home, providing additional tutoring to the residents and making tweaks to the study design as required.
We also evaluated the impact of the project by talking to residents and staff. As well as asking questions about engagement with the tablets, ease of use and implementation, we used the Campaign to End Loneliness Measurement tool to measure changes in feelings of loneliness.
The greatest benefit from the pilot was how using the technology encouraged residents to become more mentally active, and the sense of achievement that it brought. There was a partial impact on levels of loneliness: residents did spend more time interacting with each other, playing multiplayer games using the tablets, and spending more time in the lounge.
It did not prove possible over the period of the pilot to increase the amount of contact residents have with friends and family, via video calls and emails. Rebuilding social connections requires staff support in engaging the friend or family member; this will take a longer period to materialise.
We discovered that under the right conditions, residents can be encouraged to use technology. The conditions were as follows:
Certain actions required to operate tablet and smart speaker devices, for example swiping or saying a command word, do not come easily to all residents. It is important to understand the physical faculties of the user at the outset. For residents to gain competence to operate the devices independently, regular practice is required, i.e. daily or every other day.
“This project is fantastic, and more mentally stimulating than our existing activities”
Care Home resident
“We didn’t originally think this would work in engaging the residents, but now look at what you’ve started! The staff are warmed by the number of smiles, because people have achieved something. Residents are amazed by it, and curious. We couldn’t have done it without the ICHP project manager”
Activity and Wellbeing Manager, Care Home
We have retained the tablets in the two care homes and will be performing reviews of their impact over the next six months. Of the ten participants, the two who have used the tablets more than once a week were the only ones who learnt to operate the devices independently.
Due to limited capacity of care home staff to provide the required level of tutoring in addition to their existing responsibilities, the potential for volunteers to support is being explored.
There could be potential for sixth form students to provide this added capacity. We are aware that students often visit care homes as part of their enrichment or citizenship activities, but we feel a structured programme of support here around digital skills for residents could be hugely beneficial to both groups.
Research has shown that adults who experienced close inter-generational interaction are less prone to depression and have better physical health, and there are a growing number of inter-generational projects being run in the UK. ICHP is committed to continuing this piece of work, and are finalising how we do so, in what could be an exciting and mutually beneficial initiative for residents and students.
We want to make sure we fully capture the benefits of the project through our evaluation. In the next phase we will evaluate whether the project is:
• helping residents to use digital technology and the internet in ways they want to
• increasing residents’ feeling of connection with others
• encouraging residents to stay mentally active
• helping students to gain valuable experience in health and care
We will review the tools that we use, such as the Campaign to End Loneliness Measurement tool, to ensure that we are using the right ones in the right way, suitable for a care home setting and based on what we have learned to date.