NHS needs to tackle debilitating loneliness in older people

Early identification and treatment of health conditions that increase loneliness are crucial to improving the lives of older people, according to a new report published by the British Geriatrics Society and the Royal College of Psychiatrists.

The report calls on the government and NHS commissioners to improve identification of and treatment for health conditions – such as frailty, incontinence, chronic pain, and dementia – that limit independence and are proven to contribute to and exacerbate loneliness in older people.

Older people are often more susceptible to feelings of loneliness than younger adults for a range of reasons that include bereavement through loss of a spouse or partner, longevity (having outlived friends), or poor health and mobility making it difficult to get out and do the things they used to do. These feelings of loneliness are often most acutely felt during the Christmas period, making this a particularly difficult time of year for the 1.4 million chronically lonely older people in England.

Loneliness is now a significant public health risk and has been shown to increase the likelihood of frailty, care home admission and mortality. Recent research found its impact on mortality is the equivalent of smoking 15 cigarettes a day.

The report argues initiatives to reduce loneliness must ensure that provision is made for the specific needs of older people, who often have differing needs to younger people related to physical health, mental health and social needs.

Loneliness is now a significant public health risk

President of the British Geriatrics Society, Professor Tahir Masud, said: €œFeelings of loneliness should not be inevitable part of growing old, especially at Christmas. There is much that all of society “from government right through to community groups and individuals”“ can do to better support older people.

“This position statement charts the role that healthcare professionals can continue to play in identifying older people experiencing loneliness and ensuring that they are able to access the appropriate support and services to help them.

“While we may remain proud that people are living longer lives, this alone is not sufficient. We must also ensure that they have a good quality of life and that they are enabled to live fulfilling and happy lives into their later years.”

Supporting carers to access support

Key elements of the position statement include improving the process of identifying older people suffering from loneliness, the role of social prescribing and voluntary sector interventions, and advice for commissioners.

There are opportunities for professionals in primary care, community health, mental health and hospital settings to make a difference to the risk and impact of loneliness, and key recommendations include:

Provision of adequate treatment for health issues that limit independence such as chronic pain, visual impairment, incontinence, foot health, malnutrition and oral health; such treatment has significant benefits in terms of older people’s well-being and independence.
Identification of depression, cognitive impairment and dementia and provision of relevant treatment including talking therapies, psychosocial interventions and, where appropriate, medication.
Clear and open lines of communication between primary care, community health, mental health, inpatient care and social care professionals to ensure that people experiencing loneliness are able to access all available opportunities for help and support.
Supporting carers to access support as they often overlook their own needs while focusing on those of the person they are caring for. This often leaves carers feeling lonely and isolated.

Dr Amanda Thompsell, Chair of the Faculty of Old Age Psychiatry at the Royal College of Psychiatrists, added: “Christmas is a time of year when older people are more aware of their loneliness.

“Loneliness is fast becoming a public health pandemic. The government must increase the number of specialists in health and care working with older people so health issues that can limit independence and contribute to loneliness are identified early and addressed quickly.

“The report defines loneliness as ‘an emotional state’ and describes the subjective sense of ‘lacking affection, closeness and social interaction with others’. The combination of mental illness and loneliness forms a vicious circle.”