Ageing alone: Loneliness and the ‘Oldest Old’

Society is reluctant to talk about loneliness in old age but we have to stop brushing it under the carpet. Loneliness causes misery and poor quality of life for too many people, but it is the oldest old – the over 85s – who are most badly affected. Nearly half of this age group experience loneliness some or most of the time. Understanding loneliness in this cohort is becoming increasingly important as what was once a small group of exceptional individuals rapidly grows into a whole new generation.

Loneliness also has both financial and social costs to wider society with research suggesting that loneliness is strongly associated with greater risk of various illnesses and that socially isolated and lonely adults are more likely to undergo early admission into residential or nursing care.

Growing older does not have to mean growing lonelier. There is clear evidence that people respond to interventions and as a result they can become less lonely or stop being lonely at all. However while local projects are having a demonstrable impact on alleviating loneliness, access to services across the country is piecemeal. Loneliness should be properly and systematically addressed as an important public health priority but that is not the case at present. Only just over half of the Health and Wellbeing Boards who have published a Joint Health and Wellbeing Strategy have acknowledged loneliness and/or isolation in their strategies.

Even where services are available, there are issues in relation to accessing them. This is particularly the case of the over 85s. As a result organisations providing interventions to tackle loneliness need to be proactive in identifying people who will benefit from those services. Working closely with a range of agencies and organisations, particularly health and social care services, is one way to ensure they are reaching those in need of their services. Care workers often represent the most frequent human contact that many of the oldest old have but because of the way social care contracts are specified they are generally an underutilised resource. Developing the primary and secondary evidence base on loneliness in the over 85s should be a priority for research funders. Supporting additional services will not be easy in the current financial climate so government should commission research into the financial costs of loneliness in the over 85s and the potential savings in health, care and other costs that can be achieved by action to reduce and prevent loneliness.

Through case study analysis of projects that are tackling loneliness effectively, this report explores practical steps that can be taken to reduce levels of loneliness among the oldest old. The case studies also illustrate the continued willingness of individuals of all ages to get involved in their local community. But whereas people might once have volunteered informally to help people they knew, ‘permission’ to initiate contact, through formalised and structured opportunities, is important. This is an important pointer as to how our modern society can organise itself to help address loneliness.