The Platform

Lighthouse, community inclusion of older people suffering isolation and loneliness

Reports from the Field

10 December 2023

Summary

Lighthouse aims to reduce social isolation and improve the quality of life of older people, enhancing their social participation and developing tools that enable their empowerment. With a participatory methodology (co-creation) older people actively participate in all phases of design, intervention and evaluation. The beneficiaries receive individualized psychotherapeutic support through work with "Life History" and are accompanied to carry out activities for their reconnection and social participation. Firstly, we identify people in a situation of unwanted loneliness by working together with the network of local agents. Secondly, we draw up the Life History based on interviews with the person to detect the positive dimension of their biography and empower the person about their own preferences, wishes and interests. Next, we jointly design a map of interests and desires and a plan of activities (courses, cultural outings, etc.). Then the resources and the offer available are compared with the person and a feasible plan is drawn up: can the activities be paid for? Does the calendar make your attendance possible? Finally, the individual plan is executed and the degree of satisfaction achieved is assessed and shared with the rest of the professionals and volunteers. As a direct result, social participation and the quality of life of people in a situation of unwanted loneliness is increased, and as an indirect result, an innovative and replicable model is generated that demonstrates the benefits of supporting people through individual work of Life History.

Planning and Implementation
  • What was the challenge you were trying to address?

    The main challenge is to implement a care model based on a community approach to maintain the social connection and participation of the elderly as much as possible. The ultimate purpose is to fight against social isolation from a community perspective. As a community that looks after social justice, we have a duty to care and provide care services to all citizens. Administrations and civil society must work together to create support and avoid or minimize situations in which health and quality of life are diminished. The proposed intervention model involves the collaboration of all social and health agents (basic social services, home care, neighborhood, elderly associations, guardianship foundations, etc.). In a society increasingly immersed in the digital age, it is necessary to promote technological skills as facilitating tools for effective participation. Lighthouse takes advantage of the bond and trust of "Life History" work to promote both training and the use of technology. In the case of elderly people with disabilities or dependent situations, it will be very appropriate to train in alternative or augmentative communication technologies. Another challenge is to provide the reconnection service from a co-creative approach. Our experience in numerous projects has shown us that it is not easy to involve older people in participatory processes where decisions are made regarding the design, execution and evaluation of services. A representative of the beneficiaries is part of the Steering Committee and each beneficiary co-creates, approves and evaluates the actions of which he or she will be a part.

  • Who were you trying to impact?

    Older people with chronic health conditions or disability, Older people with vulnerabilities

  • What sectors were you targeting?

    Education, Health, Social protection

  • Who else was involved?

    Civil Society Organization, Academia, Social Care, Private Sector

  • How did older people participate?

    Older people were part of the process at multiple or all stages

Lessons learned
  • Please describe how collaboration worked in your initiative.

    Lighthouse is based on network work and therefore, the methodology involves collaborative and structured work with local agents. The identification of people is carried out based on the contact and referral protocols established with the basic social services of the municipalities and county councils. Cases are also identified working with residences, day centers, support foundations (guardianship entities), home care services, etc. These entities also help establish the first contact with the person, explain the project and provide sensitive information about each case. We also work in a network to facilitate the execution of the Reconnection Plans, since access to necessary resources is shared or facilitated (adapted transport, access to workshops from civic centers, etc.). Finally, networking helps to identify and specify the resources and procedures to maintain the person's level of participation (e.g. planning adapted transport to attend courses). This is how the results of the intervention are consolidated and maintained. Internally, we work as a team to be more efficient through what we call the "Improvement Spiral". The cases are shared by the group of technicians and volunteers in fortnightly meetings with a double objective: a) Identify common interests or activities to be carried out as a group; b) identify which types of actions are most satisfactory, or which barriers are encountered, in order to share knowledge and continuously improve future actions. A report summarizing the results of these sessions is sent to the Steering Committee, which is used as input material for the Committee's monthly meetings.

  • What was the impact of your initiative on older people, their families, and/or their communities?

    The direct recipients are elderly people in situations of isolation, loneliness or socialization needs who live at home or in residential centers (a very high percentage are women). The indirect impact falls on the network of collaborating agents. The professional and volunteer teams of these entities are directly benefited as the work with the elderly they work with decreases in complexity due to the increase in the well-being of the people served by the Far project. On the other hand, the community services of the territory with which we coordinate receive the impact of an increase in the participation of users among the elderly, a public that is often difficult to mobilize. Thus, numerous activities such as courses of the Network of Civic Centers of Girona see how their users increase. Territories with a high number of services and resources to alleviate loneliness and isolation will face this future challenge in better conditions and will be able to avoid a greater negative impact on the community. Among the negative impacts of loneliness and isolation, we highlight the increase in health resources to deal with the worsening of people's health, as well as the reduction in life expectancy. Thus, older people must have an active life by taking advantage of existing civic resources, achieving their active participation and fostering spaces for intergenerational relationships and multi-capacity in the territory.

  • What issues did you face, and how did you address them?

    The first difficulty we encountered was the lack of awareness about the decision-making capacity of older people. As we have discussed, LightHouse has a co-production approach at its core. Each user participates in the design of the Activity Plan that is going to be carried out with himself. In Spain we are not used to co-producing the services we receive, we are simple users of the services that are already configured. To overcome this obstacle, the main tool we use is the relationship of trust with the person and giving enough time for the person to reflect. Step by step, the evidence shows users that they can make decisions about how they want the intervention to be. Consolidating a work structure in which all stakeholders participate has also been a difficulty on which we are currently working. We sign multilateral agreements and establish joint action protocols. The next step will be to develop a training program with all the agents that implies in some way the reorganization of some services to citizens.

  • What lessons did you learn from implementing this initiative?

    1) Lessons about older people: -In most cases, social reconnection is facilitated by simple interests and preferences: "I want to go back to the market to buy, to the stop I always went to, I haven't been there for a long time because my legs are very bad and I don't have anyone to take me." -The vast majority are going through some type of grief and that is a barrier to social participation (loss of family and friends, changes of place of residence, changes in your physique-loss of mobility or disabilities). -We have verified that co-production empowers the person. 2) Lessons about systemic and community-based work: -It is difficult to create a stable structure, since it requires the commitment of each and every one of the participating entities. -The services and organizations are capable of adapting our procedures to accommodate individual action plans. For example, a civic center adapts a cooking class for an elderly blind person.

  • Do you have any other reflections you would like to share?

    With the LightHouse project we have also verified that there is a lot of loneliness in residences for the elderly. The main reasons are: - People do not live in their habitual residence and perceive it as a loss and therefore there is mourning, which is not good for social connection. - They do not make decisions about almost any aspect of domestic life (schedules, the menu, the way to dress - sometimes - when to take a walk down the street, etc.). This leads to depersonalization and a certain degree of apathy and sadness; the person every time wants to do less things. - They are surrounded by people but they are not friends of their choice and therefore, true and meaningful relationships are difficult. For all of the above, we believe that residential services must be redesigned so that they are more significant environments and do not depersonalize users or isolate them from the rest of the community.

Submitter

Lluís Marroyo Molina

Manager

Source Organization

Campus Arnau d'Escala Foundation

Decade Action Areas

Age-friendly Environments

Level of Implementation

Spain

Sector

Private Sector

Other Information

This is part of a collection of online case studies published for the UN Decade of Healthy Ageing Progress Report, 2023.

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