loneliness in older people with an intellectual disability€¦ · loneliness in older people with...

Loneliness in Older People with an Intellectual Disability

Presented by Andrew Wormald

Date 09/06/17

Defining Loneliness

– Loneliness is the distressing feeling that accompanies discrepancies between one’s desired and actual social relationships (Hawkley et al., 2010), and contributes to serious disease and premature death (Lynch, 1977)

– Loneliness is not isolation

– Loneliness is not depression

Why Should we be concerned about Loneliness? Consistent Loneliness

– Reduces quality of life

– Premature mortality

– Loneliness raises Systolic Blood Pressure

– Increases levels of the stress hormone epinephrine

– Causes DNA changes dampening cortisol response

– Causes DNA changes that affect the response to bacteria and viruses

– Creates Sleeping Difficulties

– Increases use of medications

– Increases alcohol consumption

Why should we be concerned about Loneliness?

Consistent Loneliness is Nearly Double in the ID population

0

5

10

15

20

25

30

IDS-TILDA Victor et al. (2015) Victor et al.(2008) Wenger & Burholt (2004)

Jylha (2004)

Consistent Loneliness

Population Wave 2,N=315. Longitudinal, N=297

23.9

46.5

24.3

5.3

IDS-TILDA Level of ID

35

50

Level of ID

Mild

Moderate

Severe

Profound

31.2

47.2

21.6

Type of Residence

Indep/Family

Community group home

Residential Care

17.1

35.6

47.3

IDS-TILDA Residence

Loneliness Model Perlman & Peplau (1988) Cognitive Discrepancy Approach to Loneliness

Cognitive Attribution Model.

Trajectories of Loneliness

Loneliness Scale

Antecedents of Loneliness Hawkley et al. 2008

Trinity College Dublin, The University of Dublin

Antecedents of Loneliness Predisposers and precipitators

Protective Against Loneliness

Fewer Functional Limitations

Cognition and Attributions Burholt & Scharf (2013)

Trinity College Dublin, The University of Dublin

Cognition and Attribution

Cognitive Loop

Negative Framework

Expect more negative

outcomes

Remember more negative

events

Elicit Negative Behaviour

Trinity College Dublin, The University of Dublin

The role of depressive thinking

Experience of Loneliness Victor et al. (2008)

Trajectories of Loneliness: Consistently Lonely Regenerative Degenerative Never Lonely

Trinity College Dublin, The University of Dublin

Trajectories of Loneliness

0

10

20

30

40

50

60

Never Regenerative Degenerative Consistently

IDS-TILDA

Victor et al.(2008)

Wenger & Burholt (2004)

Jylha (2004)

Trinity College Dublin, The University of Dublin

Trajectories of Loneliness

Consistent Loneliness (26%)

– Being Older

– Being Female

– Experiencing Pain

– Having more Chronic Conditions (Protective)

– Falling

– Experiencing Difficulty Doing Activities

– Voting in Last Election

– Holidaying Abroad (Protective)

Trinity College Dublin, The University of Dublin

Trajectories of Loneliness

Never Lonely (42%)

– Low on Functional Limitations

– Individualised Personal Plans

– Social Lives Matched Desires

Trajectories of Loneliness

Regenerative (19%)

– Changed the amount they met family and friends

Degenerative (12%)

– Movement within the service organisation

Outcomes of Loneliness Hawkley & Cacioppo (2007)

Trinity College Dublin, The University of Dublin

Proportions

Trinity College Dublin, The University of Dublin

Analysis of Covariance

Trinity College Dublin, The University of Dublin

Binary Logistic Regression

Trinity College Dublin, The University of Dublin

Physical Outcomes

Loneliness Predicts Sleeping Problems

Loneliness Predicts Raised Blood Pressure

Trinity College Dublin, The University of Dublin

Coping with Loneliness

Lonely People do more moderate exercise

Report Diet as Good or Very Good

Attend Church Services

Vote in Elections

Active Engagement

Final Model

Trinity College Dublin, The University of Dublin

Avoiding & Overcoming Loneliness

1) Focus personal planning on the needs of the person.

2) Tackle high levels of depression.

3) Train staff to facilitate individual social lives.

4) Encourage the development of community-based social roles.

5) Consider the effect on individuals when making organisational changes.

Trinity College Dublin, The University of Dublin

Acknowledgement

Grateful appreciation to the participants and families

Funders

Thank You