The role of an Occupational Therapist in helping to combat loneliness
Loneliness is defined as a complex and unpleasant response to social isolation.
The effects of loneliness can be significant and are often associated with sadness, anxiety and depression. Often, a lack of connection with people can lead to significant mental health problems.
People from all walks of life can experience loneliness, due to geography, disability or from being a carer for a loved one. Older people, are particularly high risk, with an estimated 1.2 million elderly people being affected by loneliness in the UK (Guardian, 2017).
The role of Occupational Therapy is vital in combating loneliness in our communities. This is reflected in the Royal College of Occupational Therapists (RCOT) recent ‘#LiveNotExist’ campaign to empower older people.
Occupational Therapists work with people of all ages to reduce the impact of disability.
This starts with a robust and holistic assessment in order to determine how the impact of a perceived disability is creating social isolation.
An Occupational Therapist will use a holistic framework such as the Person, Occupation and Environment (PEO) Model to direct or support their assessment. This enables the therapist to better understand the person’s motivations, thoughts, wishes and feelings as well as their physical or environmental barriers.
It does this by linking the three domains of the PEO model together. The model aims to highlight the link between the three domains leading to specific person-centred intervention, and thus reducing how the individual is being disabled by social or physical barriers.
A simple application of the model sees an elderly person who lives alone and has an interest in reading and discussion groups:
The person is aware of a local group however cannot attend due to poor mobility.
The environment being his home does not currently have wheelchair access, keeping the person isolated in the house and unable to attend the group.
The occupation is being able to attend the group and express his or herself and interact socially making new social connections.
Here you can see the environment is not fitting with the domains of the person or the occupation which creates the disability and subsequent social isolation and impedes the ability to forge new social links.
By providing wheelchair access and signposting the person to transport companies to aid in getting to and from the group, the fit between the domains is improved and the disability reduced, enabling the person to access the group.
Grading the activity and goal setting
One of the core skills of an Occupational Therapist is 'activity analysis', which is the breaking down of an activity in to its component parts.
After a person’s goals have been set following an initial assessment, grading of an activity may be required.
For example; an elderly person who lives alone has become socially isolated, mainly due to reducing mobility and cognitive decline. The person feels alone, isolated and very self-conscious as they are aware of certain issues around memory. In this instance, the person feels too self-conscious about their memory to attend a local support group for dementia sufferers, however does agree to engage with a befriending service.
After a few weeks of engaging with this service, the person’s self-confidence has increased. Following an Occupational Therapy review the activity is graded to further increase exposure, with the ultimate aim of empowering the individual to attend what they want, when they want.
As discussed, an Occupational Therapist has a clear role in assessing and supporting a person compiling meaningful goals through the use of a holistic clinical approach, with the aim of empowering individuals to make unhindered informed decisions that impact on their life and daily routine.
The Guardian (2017). The battle against loneliness among older people. https://www.theguardian.com/healthcare-network/2017/may/10/loneliness-older-people