Evaluation of services seeking to address loneliness and isolation in older people

The Close Encounters project aimed for Age UK Portsmouth and Gosport Voluntary Action to work together to reduce loneliness through a community engagement plan involving four strands: (a) befriending and facilitated support, (b) Come Here And Talk (CHAT) groups, (c) advocacy and (d) information and advice provision. Each strand on its own was not new, however, by combining them into one collaborative project with intensive personalised support, they aimed to integrate older people back into their communities so that they
could meet others and enjoy life to the full.

This project provided evidence on the impact of the Close Encounters project on loneliness and quality of life among older people. The Close Encounters project ran from December 2018 to December 2021 and therefore was affected by the COVID-19 pandemic which caused closures of buildings and suspended face-to-face delivery of support.

When people accessed the service, an advisor took details about their health and support available. After a discussion about possible ways the service could help and what the person wanted to concentrate on, some goals were agreed so that support could begin. The objectives of this evaluation were to estimate the impact of the Close Encounters service on individuals’ feelings of loneliness over time; and to explore how participant characteristics together with the types of support influenced the relative success of the service on improving feelings of loneliness.

Five main themes were identified from the interviews with service users and service providers. These were: (1) The pandemic: a service in context; (2) Personalisation: a driver to success; (3) Promoting health: an empowerment and user-led approach; (4) Diversity and equality; and (5) Growth. We relate these themes to the quantitative findings below.

Overall, the loneliness scores improved across the course of the evaluation. This was reflected in a declining proportion of participants feeling dissatisfied with their relationships, friendships and having enough people to talk to. These data were echoed in the interviews, which highlighted that the service’s user-led and empowering approach led to goals being achieved and satisfied service users (theme 3).

While all groups improved from baseline, we identified two sub-populations in the data: one group had a persistent and large improvement over the time they engaged with the service, but the other group stagnated after an initial improvement.

We identified the factors that predict membership of these groups: older people (80 years and over) are more likely to be in the second group with their loneliness stagnating at a higher level. The interviews highlighted the personalised nature of the service being a driver to its success, and how loneliness can be experienced in many different ways (theme 2). Some people’s loneliness scores would not improve despite feeling helped by the service in other ways, because their loneliness related to a bereavement, or because mobility problems left them housebound. Some people also found the loneliness tool challenging to understand. These issues may have been related to why those in the oldest age groups tended to have stagnating loneliness scores.

Despite this, we do find an effect of support on loneliness scores: facilitated support was statistically significant in improving loneliness for the stagnating group and has a large estimated effect, reducing loneliness substantially. The interviews highlighted how the service built on the learning and experiences of staff, volunteers and clients to develop and grow, however there were concerns about what learning could be gained from using the loneliness tool, as staff felt it was not fully reflecting what they had been able to achieve (theme 5).

We identified a significant effect of COVID-related national lockdowns: loneliness scores were statistically significantly higher during periods of lockdown. The interviews highlighted how the service had to adapt to the pandemic, and how certain groups (such as those hard of hearing or with cognitive impairments) were particularly disadvantaged by the pandemic (theme 1).

Of 1624 service users’ goals set, approximately 80% were achieved; others were not achieved (7%), partially met (5%) or ongoing (8%). The interviews emphasised the supportive approach taken towards the needs of service users and the ability of the staff and volunteers to treat everyone with equal understanding (theme 4). Enabling service users to feel comfortable and unjudged, was key to establishing the goals and provide a successful service.