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Social isolation and loneliness have the potential to contribute to increasing the risk of cognitive decline and can increase an older person's chances of premature death by 14%.
Social isolation is the lack of 'structural' and 'functional' social support. Structural social support is normally assessed through the size of networks and frequency of contacts. Functional social support is a subjective judgment of the quality or perceived value of emotional, instrumental and informational support provided by others.
Recent rapid search revealed current UK studies of telephone befriending but found that several new studies, ranging from a feasibility study to trials on the effects of video calls on isolation, were not in the UK. Reviews highlighted the need for further research on IT based interventions to reduce loneliness or social isolation among older people, especially those isolated in nursing homes with a high risk for cognitive decline.
Improving the quality and quantity of social contacts may help in maintaining quality of life, both of people with dementia and their families but it is not clear if the capability for video calls improves overall quantity and quality of contact.
From initial research we can conclude that video calls are likely to be feasible (given appropriate technology to assist) with older people with no noticeable or mild cognitive impairment, perhaps moderate levels of dementia but not with more advanced dementia (typified by not being able to engage with television and not able to follow and understand simple instructions).
A study in care homes with a ‘mixed’ population with varying degrees, from at-risk to early stages, of cognitive impairment/dementia would allow clarification of for whom video calls might be useful and lead to a definitive RCT of its impact on loneliness and mental wellbeing. In the longer term, others are starting to explore impact of video calls on cognitive functioning  and this will form part of our research trajectory.
By collaborating with older people, both with and without cognitive decline, living in care homes across Devon, along with their families and staff members the research team can assess feasibility and acceptability through a pilot trial. Outcome measures of lonliness, social networks and well-being will be assessed through qualitative and quantitative measures. This pilot trial will enforce a future definitive trial that can be implemented across all care homes in the UK.
The study will explore and assess the acceptability of video calls between family and residents in care homes, will develop and test feasibility of data collection methods and reduce uncertainty about required sample size needed for a full trial. In addition, it will explore the perceptions of barriers and benefits of video calls for the main family contact, and care home staff attitudes towards implementation of such interventions. This exploration will be undertaken through a collaborative action research design allowing residents, families and staff to be directly involved in how best to implement video-calls within this setting.
A definitive trial will assess impact on quality of contacts, loneliness, and mental wellbeing for care home residents with; at most, mild levels of cognitive impairment.
Sonam's project has featured in news articles on the PenCLAHRC website:
The project was also featured in the Autumn 2016 edition of Innov-age magazine; skip to page 20 to read the article.
02 August 2018
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