Low-level support for socially isolated older people: An evaluation of telephone befriending

In May 2005 Help the Aged and Zurich Community Trust launched a two year national programme ‘A Call in Time’. The purpose of the programme was to provide low level support and befriending services via the telephone to older people who are lonely, isolated or vulnerable. Eight projects were funded across the country. Following the launch of the programme, Help the Aged commissioned the Centre for Health Promotion Research at Leeds Metropolitan University to undertake an evaluation of the programme and to investigate the direct impact of low level support on older people who are vulnerable, isolated or lonely using the telephone as a specific tool of befriending. The main objectives of the evaluation were to: * Measure and identify the effectiveness of telephone befriending services for older people with regards to their mental and physical well-being and their quality of life and the extent to which services were of preventive value. * Examine the components parts of each model of telephone befriending and identify ‘models of good practice’. All eight telephone befriending schemes functioning within a variety of different parameters were included in the evaluation. The participants in this research included project co-ordinators, project volunteers and older people who were in receipt of the services

The use of telephone befriending in low level support for socially isolated older people--an evaluation.

There is increasing policy recognition that the alleviation of social isolation and loneliness in older people should be prioritised. Recently, technology, such as telephone networks and the Internet, has received attention in supporting isolated and lonely older people. Despite lack of evidence, telephone befriending has been considered an effective low-level method to decrease loneliness among older people. This study evaluated the impact of a national befriending scheme for isolated and/or lonely older people, involving eight project sites across the UK 2007-2008. The purpose was to assess the impact of different models of telephone-based befriending services on older people's health and well-being. A mixed methods approach was used. This paper reports on the findings from 40 in-depth interviews with older service recipients. The most important finding was that the service helped older people to gain confidence, re-engage with the community and become socially active again. Three topics were identified: why older people valued the service, what impact it had made on their health and well-being and what they wanted from the service. In addition, nine subthemes emerged: life is worth living, gaining a sense of belonging, knowing they had a friend, a healthy mind is a healthy body, the alleviation of loneliness and anxiety, increased self-confidence, ordinary conversation, a trusted and reliable service, the future--giving something back. In conclusion, the findings present in-depth qualitative evidence of the impact of telephone befriending on older people's well-being. Befriending schemes provide low-cost means for socially isolated older people to become more confident and independent and develop a sense of self-respect potentially leading to increased participation and meaningful relationships

Transport and Older People: Integrating Transport Planning Tools with User Needs

This study was funded through a pump-priming grant from the Strategic Promotion of Ageing Research Capacity (SPARC) programme. The purpose of the project was to bring together transport and public health research in order to demonstrate how the involvement of older people can help improve tools for transport planning. The study was unique in that it brought together public health and transport planning and engineering with older people to consider how services can be more responsive to older people’s transport needs. The project had five research objectives: 1. To investigate how accessibility problems impact on older people’s independence 2. To determine the extent to which currently available data sources and modelling tools reflect older people’s stated accessibility needs 3. To understand how the gap between expected and perceived accessibility problems varies across different categories of older people 4. To pilot techniques that could be applied to provide a more robust measure of accessibility for older people. 5. To build new research capacity across disciplines to develop a national focus on the interactions between ageing and transport planning. The methods were determined on the basis of ‘appropriate tools with maximum output’. Focus group interviews were selected as a useful tool for reaching a large number of older people within a limited time span, for providing an arena for discussion and debate about a topical subject and for generating ideas for improving transport planning. Following the interviews accompanied walks were undertaken with older people in a range of road environments and traffic situations. The purpose of these walks was to observe and explore the way older people interact with their environment. Data from the focus group interviews and the observations were compared with the outputs from an accessibility planning tool used by local authorities to plan accessible and acceptable transport routes (Accession™). The purpose of this exercise was to investigate whether or not such tools are able to take into account the varying needs of older people. The study was undertaken over eight months. Eighty one older people living in the Leeds district took part in the focus groups. They covered a broad range of mobility levels and used a variety of transport types, as such a reasonably rounded perspective on the issues concerned was offered. In addition six walks were undertaken with older people in their community

Promoting and maintaining health of people with sight loss: A scoping study

This study was undertaken in response to a request by the Thomas Pocklington Trust to identify and explore the following issues: • The needs and concerns regarding immediate risks to health and safety related to sight loss; • Additional risks arising from sight loss for those who are also managing a long term disease; • The difficulties in maintaining and promoting health; • Whether or not health promotion activities and policies sufficiently address perceived needs. Findings pertaining to these objectives have been generated from data collected in Leeds, UK, a city where innovative programming for sight loss has either been planned or is being incorporated into health planning and a review of the literature. Findings related to the last two issues indicate that gaps exist in service provision for maintaining health and emphasise the need for more explicitly targeted health promotion initiatives that could address current weaknesses. - A review of the literature; - Focus group discussions with a range of people who had experienced sight loss; - Interviews with professional practitioners engaged in service provision to this population; - An expert hearing with four professional practitioners, one of whom had sight loss, and two service users with sight loss. Most participants were from the West Yorkshire region and the services described in the study are largely located in Leeds. Evidence from the literature review suggests that people with visual impairment have increased risk of accidents within the home and that ensuing consequences include injuries incurred and decreased confidence. Rates of depression among people who are blind or partially sighted are far higher than in the wider population and the likelihood of depression increases with age, although psycho-social interventions and technological assistance can be successfully implemented to improve quality of life. Sight loss together with other long term health conditions exacerbates the impact of other health conditions and has particularly severe impact on the wellbeing of older people insofar as it may affect their mobility, which in turn increases their risk of falls and depression. The nature and level of support available to people is variable but it is clear that access both to the right information at the right time and to appropriate services is a critical issue. Focus group discussions, interviews and the expert hearing corroborated and extended the themes noted in the literature and discuss the differential impact of different risks to health and the difficulties of coping with these at different times in a person’s life. A simple typology was defined using two dimensions of experience (‘stage of life’ and ‘early/late onset of sight loss’) as a means of organizing findings and providing a means of making further distinctions in interpreting the data. Potentially, this scheme can allow health promotion initiatives to be targeted more effectively to stages at which people with sight loss are more likely to encounter specific difficulties in managing and maintaining their health. There was a clear consensus throughout the study that interventions to meet the needs of people with sight loss must be tailored to meet the specific needs of individuals: people with sight loss are not a homogeneous group and the way in which each person experiences the challenges of sight loss and of managing their health will inevitably vary from person to person. Recommendations generated by this study include: • The scope for more pro-active services and need for closer collaboration between service providers; • The need for provision and promotion of targeted information; • The need for greater awareness of the needs of people with visual impairments among generic service providers; and • Further research that explores the usefulness of the typology with a larger sample more representative of population demographics such as BME communities that are more likely to slip through the cracks of service provision

Diagnosis and Management of Field Pollution in the Case of an Organochlorine Pesticide, the Chlordecone

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How do older people with sight loss manage their general health? A qualitative study

Purpose: Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Methods: Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Conclusion: Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management

A conceptual model of organochlorine fate from a combined analysis of spatial and mid- to long-term trends of surface and ground water contamination in tropical areas (FWI)

In this study, we investigated the management of long-term environmental pollution by organic pollutants such as organochlorine pesticides. We set out to identify conditions that are conducive to reducing pollution levels for these persistent molecules and then propose a conceptual model of organochlorine fate in water. Our approach looked at spatio-temporal changes in pollutant contents in surface water (SW) and groundwater (GW) on a large scale, in order to decipher the respective roles of soil, geology, hydrology and past treatment practices. The case of chlordecone (CLD) on the island of Martinique (1100&thinsp;km2) was selected given the sampling campaigns carried out since 2007 over more than 150 sites. CLD, its metabolite chlordecone-5b-hydro (5bCLD) and the metabolite-to-parent-compound ratio were compared. As regards the spatial variability of water contamination, our results showed that banana cropping areas explained the location of contaminated SW and GW, whereas the combination of soil and geology factors explained the main spatial variability in the 5bCLD∕CLD ratio. For temporal variability, these conditions defined a high diversity of situations in terms of the duration of pollution, highlighting two groups: water draining old geological formations and ferralsols or vertisols vs. recent geology and andosols. A conceptual leaching model provided some key information to help interpret downward trends in CLD and 5bCLD observed in water. Lastly, a conceptual model of organochlorine fate is proposed to explain the diversity of the 5bCLD∕CLD ratio in water. Our conclusions highlight the combined role of soil and groundwater residence time for differentiating between conditions that are more conducive, or not, to the disappearance of CLD from the environment. This paper presents a model that provides an overall perception of organochlorine pesticide fate in the environment.</p