Loneliness and its impact on older people

The Alzheimer’s Society have made a clear effort with their second annual report on people living with dementia to look, in particular, at how loneliness affects that section of the population.

But the report also reflects on the more general picture affecting dementia sufferers and their care, and despite of the report’s title, offers much more on these wider issues than it does on the theme of loneliness.

On the numbers front:

• The report estimates that there are around 800,000 people in the UK who have dementia
• Including around 665,000 in England, 44,600 in Wales and 18,900 in Northern Ireland
• 670,000 people in the UK are said to act as primary carers for people with dementia
• On current projections, the report suggests that, by 2021 there will be over 1 million people living with dementia in the UK
• Current overall service costs are put at £23 billion a year, expected to grow to £27 billion, by 2018
• The report suggests that, at any one time, up to a quarter of hospital beds are occupied by people with dementia

Strong association between loneliness and limitations in performing daily activities

On its more general evaluative points, the Society’s report highlights a number of areas where it believes progress is being made, but suggests that much remains to be done, to further improve services.

In looking at people’s experience, the report uses the outcomes headings from the Society’s, National Dementia Declaration for England. These cover the need for:

• personal choice and control
• services designed around the individual
• effective support
• user knowledge and know-how
• an enabling and supportive environment
• a sense of belonging
• on-going research

I have to say, that, in looking some of the detailed commentary on what Alzheimer’s studies have suggested, in relation to these outcomes, I found the headline tone of cautious optimism a little hard to understand. On some outcomes, it seemed that experience was worsening rather than improving.

Juts for brief example, the figures seem to me to suggest that:

• Fewer people feel they are living well with dementia (P.5)
• The proportion of people saying they were able to make choices about everyday life has fallen (P.7)

But, in more general terms:

• The report points to continuing wide variations in the rate at which people with dementia are given a formal diagnosis
• Overall, the rate of formal diagnosis is said to have risen by 3% in the last year (to 44%)
• The report notes that dementia care and treatment is become a growing policy priority
• It says the number of inappropriate prescriptions for antipsychotic medication to people with dementia fell by 52% between 2008 and 2011
• And that there are now 64 Dementia Adviser services in England compared to 35 in 2013

In its findings of specific relevance to the issue of loneliness the report suggests that:

• People continue to lose friends as a result of (or don’t tell them about) a diagnosis of dementia
• Nearly two thirds of people with dementia who live on their own feel lonely
• Nearly 40% of all people with dementia feel lonely, compared to 24% of those aged 55 and over
• Although people with dementia said they relied on relatives and friends for social contact, just over a fifth speak to friends or family on the telephone less than once a month

The other report, published, this week, Measuring National Well-being – Older people and loneliness, provides an analysis of reported feelings of loneliness by people aged 52 and over using 2009–10 data from the English Longitudinal Study of Ageing. That report’s key findings point out that:

• Two thirds of respondents hardly ever or never felt lonely
• Only 9 per cent said they often felt lonely
• A higher percentage of those over 80 reported feeling lonely some of the time or often
• People who report feeling lonely are much more likely to report a lower level of satisfaction with their lives as a whole
• There is a strong association between reported feelings of loneliness and reported limitations in performing daily activities
• 40% of people who live alone reported that they hardly ever or never felt lonely
• People who had been widowed, separated or divorced or those who were in poor health, were more likely to report feeling lonely
• More women than men report feeling lonely, but this may be partly explained by the sample used which included more, older women (reflecting the general population profile)

I must admit that I am slightly surprised and a little relieved by this study’s findings on loneliness amongst older people (being one myself). I had thought that the fragmentation of family and other structures might have produced more worrying statistics than these. Presumably another indication of the infinite adaptability of human beings…?

And, returning to the Alzheimer’s report – and with apologies to the Society – I have to say that, from the headlines, I had expected to find their report focusing a great deal more on the particular problems caused by loneliness amongst dementia sufferers. But, while some of the findings point to added difficulties, I didn’t think the depth of analysis merited the emphasis given to loneliness in the title of their report – one for further study and analysis, I suppose, since I’m sure it’s an element of life experience that we all need to understand better, for the future…