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RESEARCH

TO PRACTICE
BRIEFING 2
Research to Practce Briefngs bring together lessons learned
from the literature on a topical issue in community aged care as a
resource for those working in this sector. As in most areas of social
policy and practce, the research evidence in the literature on
community aged care is contnually evolving. The Briefngs aim to
distl key themes and messages from the research and to point to
promising and innovatve practces.
An advisory group of academics and expert practtoners working in
the area of aged care provide advice and peer review.An advisory
group of academics and expert practtoners working in the area of
aged care provide advice and peer review.
This Briefing has been prepared by the Social Policy Research
Centre in partnership with The Benevolent Society.
Research to Practice Briefngs
www.benevolent.org.au
Older peoples participation in social networks is a
signifcant component of wellbeing. This Briefng focuses
on the nature and impact of older peoples social
networks, and on how community aged care workers can
promote participation in social networks by older clients
living in their own homes.
The aim of this Briefng is to draw from the research
evidence of promising and innovative practices that can
be readily adapted and incorporated by care workers and
managers into their day-to-day work.
Promoting social networks
for older people in
community aged care
2 SOCIAL NETWORKS FOR OLDER PEOPLE
Research to Practice Briefng 2
Older peoples social networks and
participation
The majority of older Australians are actvely
involved with the people around them. The 2006
General Social Survey found that 96% of older
people (aged 65 and over) had some form of contact
at least once a week with family and friends from
outside their household, and 76% had face-to-face
contact with them.
However, while many older people are socially
actve and partcipate in cultural, recreatonal and
other actvites, partcipaton and atendance rates
generally decline with age, leaving a signifcant
proporton of older people who do not partcipate in
or atend these actvites.
Around 93% of older people living in the community
partcipated in informal social actvites (e.g. visitng
or socialising with friends) in the previous three
months. The most common type of social actvity
was visitng (or being visited by) friends (87%),
followed by meetng friends for indoor (61%) or
outdoor (58%) actvites (AIHW, 2007b).
Similar proportons of older men and women
partcipate in these social actvites untl aged 85
years and over. By these ages, 15% of males and 9%
of females had not undertaken any of these informal
social actvites in the previous three months (AIHW,
2007).
Sixty-six percent of people aged 6574 years were
actvely involved in a social or support group
compared with 43% of people aged 85 and over
(AIHW, 2007).
Social contact with friends outside the home
declined signifcantly with age. For example, 41% of
people aged 85 and over went out with or visited a
group of friends (outdoor actvites) in the previous
three months, as compared to 72% of people aged
55-64 (AIHW, 2007).
Consequences of social isolation
While many older people have access to social
networks, social isolaton is a real concern for some.
Evidence shows that social isolaton is associated
with depression and low morale.
Some of the risk factors for isolaton are: loss of
a partner or other family member; being a carer;
difcultes with communicaton (e.g. hearing loss);
coming from a non-Englishspeaking background;
living in a rural or remote area; living in an aged-
care facility; access to transport; and being male
and single (Findlay & Cartwright, 2002). Disability
and illness and associated loss of functonal
actvites can clearly impose restrictons on social
partcipaton. Older people have also reported
feelings of discriminaton and self-consciousness
about their disability as hindering their partcipaton
in community actvites (Hillier, 2007).
Inadequate social support is associated not only with
lower overall general health and wellbeing, but also
with higher levels of emotonal distress, more illness
and higher mortality rates (WHO, 2002). There are
a higher number of deaths among isolated people
than among those with networks of relatonships
and emotonal support (Giummarra et al., 2004; Bath
& Deeg, 2005; Maier & Klumb, 2005), while being
part of a social network is a signifcant determinant
of longevity. This is especially the case for men
(Rowe & Kahn, 1997; Zunzunegui et al., 2005).
Community care providers have found that 41 to
62% of new clients are depressed and 41% are lonely
(Lewin & Paterson, 2008).
The impact of social networks
Social networks can be defned by their structure
(number of tes, proximity of relatonship), by
their functon (frequency of contact, reciprocity,
duraton), and according to the nature of the
relatonship (friends, relatves, children, spouse).
All of these characteristcs may have signifcant
and distnct efects on the experiences and
circumstances of ageing (Zunzunegui et al., 2005).
Impact on wellbeing
There is a wide consensus that partcipaton in social
networks is highly benefcial and connected with
ageing that is comfortable, secure and productve (in
the widest sense). Such partcipaton, to the extent
SOCIAL NETWORKS FOR OLDER PEOPLE 3
Research to Practice Briefng 2
that it means feeling valued and appreciated, is
regarded as a signifcant component of wellbeing. It
can help maintain morale even in the face of serious
illness and disability, and contribute to motvatng
physical actvity and making it enjoyable (PMSEIC,
2003). Engagement in social actvites is associated
with optmal cognitve and physical functoning and
a rewarding emotonal life. One important beneft
is that people can be socially engaged even though
they might have physical limitatons that restrict
their partcipaton in other kinds of actvites, and
this engagement can contribute to a sense of
competence in ways that other actvites cannot.
Social networks can, under some circumstances,
have negatve efects on wellbeing because they
may involve confict, unreasonable demands and
disappointments, and they may also be the source
of reinforcement for risky or unhealthy behaviour
(Giummarra et al., 2004). Families in partcular can
be a source of frustraton and resentment, as well
as love and support (Maier & Klumb, 2005; Giles,
Metcalfe et al., 2004).
It should also not be forgoten that there are some
people who prefer their own company (Mavandadi,
Rook & Newsom, 2007).
These research observatons indicate that the
queston of maintaining or improving social contacts
and partcipaton to enhance older peoples
wellbeing requires careful understanding and
consideraton of the individual older persons needs
and wishes.
Impact on health and disability
Researchers have found that positve social
interactons protect against developing difcultes
with physical functons in later life (Mavandadi, Rook
& Newsom, 2007). Numerous studies have shown
that being part of an extensive social network has
a protectve efect on health (Giummarra et al,
2004; Bath & Deeg, 2005; Bath & Gardiner, 2005;
Mavandadi, Rook & Newsom, 2007; Miller-Martnez
& Wallace, 2007). A UK study of older peoples social
engagement and health, and their use of community
care and medicaton, found that those who were
more socially engaged were less likely to have seen
their family doctor or district nurse in the month
prior to the study (Bath & Gardiner, 2005). Another
study (Zunzunegui et al., 2005) of the associaton
between the ability to undertake actvites of daily
living (ADLs), disability and social tes among people
over 65 in three European countries, found that
social tes can help to maintain ADL abilites in old
age and even to restore them afer injury or trauma.
Social networks with relatives
A study using the Australian Longitudinal Study
of Ageing data investgated the impact of social
networks with children, relatves (other than spouse
and children), friends and confdants, on less severe
forms of disability among older people (Giles,
Metcalfe et al., 2004). It found that while social
networks overall had a protectve efect, networks
with relatves had a partcularly signifcant protectve
efect, both in delaying the onset of disability and in
recovery.
Social networks with friends
Time spent with friends has been found to have
a positve impact on the survival of older people,
whether or not they actually engage in leisure
actvites together. It would seem that it is the mere
presence of other people that is advantageous,
rather than the actvites undertaken (Maier &
Klumb, 2005).
However, it is not clear whether sociability leads to
the survival advantage, or whether people who are
less frail are more likely to be sociable. It could be
that community engagement gives people resources
a sense of meaning, increased confdence and
feelings of competence that enable them to
overcome or to fend of physical frailty. On the other
hand, it could be that increasing frailty results in
people having fewer contacts outside the home, and
hence a reducton in their involvement with friends
(Zunzunegui et al., 2005).
4 SOCIAL NETWORKS FOR OLDER PEOPLE
Research to Practice Briefng 2
Supporting older peoples social
networks
Support can be of two kinds, instrumental and
socio-emotonal, and range from providing material
assistance, transport, informaton and physical help,
to expressions of respect and love. However, not
all forms of support are benefcial. The literature
indicates that it is important that support is enabling,
encouraging and autonomy-enhancing (Rowe &
Kahn, 1987 1997).
People need support that, as far as possible, allows
them to develop their own coping mechanisms to
deal with lifes stresses (Seedsman, 2007a, 2007b)
and does not undermine their autonomy. People
should be encouraged to identfy and achieve their
own goals and assisted to build on past life strengths
and achievements such as past employment, hobbies
and interests (Hillier, 2007; Lewin & Paterson, 2008).
Service planning and delivery
It can be difcult for older people to maintain social
contacts and strategies aimed at reducing social
isolaton may be necessary. These strategies should
be planned in consultaton with older people and be
appropriately evaluated (Howat, Iredell et al., 2004;
Howat, Boldy, & Horner, 2004).
Interventons are more likely to be efectve if they
use existng community resources and contribute
to community capacity (Findlay, 2003). One UK
study found that efectve interventons to combat
loneliness among older people had a number of
characteristcs. They tended to be group actvites
(rather than one-to-one interactons such as home
visitng), long-term, directed towards a partcular
secton of the older populaton, had some element
of partcipant control and ofered a wide range of
actvites (Catan & White, 1998).
SOCIAL NETWORKS FOR OLDER PEOPLE 5
Research to Practice Briefng 2
Role of service providers
Social mobilisaton (i.e. ways of enabling older
people to make connectons with their communites)
involves building social networks, supportng
peoples partcipaton in social actvites, and
fostering social support and mutual aid among older
people.
Some research suggests that the role of community
care professionals is best fulflled by creatng an
environment that enhances communicaton, builds
trust and mutual respect, and empowers clients
through sensitve communicaton and support, help
to develop selfawareness, and through access to
resources and informaton (Giummarra et al., 2004).
Socialisaton and social enablement programs that
provide individualised support to socially isolated
older recipients of community care services can
increase peoples feelings of self worth, their
confdence in social situatons and thus their ability
to re-engage with the community (Hillier 2007;
Lewin & Paterson 2008). Such programs have used
volunteers as peer mentors.
A review of services to address social isolaton
among older people reported that befriending
programs have had some success, when they have
a good referral system and trained staf, as well
as telephone support that targets specifc high-
risk groups. Reaching specifc types of isolated
individuals may be possible through radio programs
and the internet, but their efectveness is as yet
unclear (Bartlet, 2007).
Approaches to supporting older people
It has been suggested that there are four types of
interventons in an older persons social networks
therapy, reinforcement, constructon and mediaton.
A therapy interventon may be required when the
person has some form of personal difculty and
involves the training of the family and friendship
network members by a professional worker. A
reinforcement interventon may be appropriate
where the persons informal care and support
network has become stressed. It requires the
provision of practcal support services by formal
service providers in order to ease the burden on the
informal carers. A constructon interventon may
be required by people who have been cut of from
social networks (e.g. recent migrants) and need help
making new contacts. Finally, mediaton may be
required where there is confict (Litwin, 2007).
Older peoples social networks are not infnitely
resourceful and this is especially the case when the
needs of older people are greatest (Litwin, 2007).
Not all interventons will suit everyone. The type and
amount of support needed will vary for each person
and should be tailored to the partcular individual
(Mavandadi, Rook & Newsom, 2007).
Aboriginal and Torres Strait Islander older
people
Working with the individual needs and strengths of
each older client in the context of their family and
community is partcularly pertnent for practtoners
working with Aboriginal and Torres Strait Islander
older people. Culturally empowering services for
Indigenous older people have a number of features
including using appropriate language, establishing
trust by using acceptable mentors or intermediaries,
developing culturally specifc protocols for
community networking, and giving families control
over service provision and ensuring partcipaton of
the whole community, not just the family (Morse &
Lau, 2007).
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www.benevolent.org.au or fnd us on
We are The Benevolent Society
www.benevolent.org.au
We welcome feedback on this Briefng.
A full list of references can be accessed on The Benevolent Societys website.
The Social Policy Research Centre is a research centre of the Faculty of Arts
and Social Sciences at the University of New South Wales. The SPRC conducts
research and fosters discussion on all aspects of social policy in Australia.
t 02 9385 7800 e SPRC@unsw.edu.au
2013 Originally printed February 2009. Republished April 2013.
Community aged care providers and workers
can enhance the health and wellbeing of
their clients by paying atenton to their
social networks and partcipaton and by
complementng practcal care services with
social support strategies.
Effective strategies with individual
community care clients include:
careful understanding and consideraton of
individual older peoples needs and wishes
provision of support in ways that enhance
autonomy
taking into account the needs and wishes of
carers/ family members
building on strengths and life achievements,
such as past employment, hobbies and
interests
assistng people to identfy their own goals
building of self worth and confdence
engaging clients in health promoton
actvites such as those that increase
physical actvity, improve nutriton and
improve mental health
using volunteer peers as mentors
to facilitate social engagement and
partcipaton in actvites
addressing practcal barriers such as
communicaton difcultes, cost and
transport
facilitatng clients engagement with friends
and with relatves (other than spouse and
children) and
ofering a wide range of actvites, which
are long term, group based and tailored to
specifc sectons of the older populaton.
In the design of social support
strategies, best practice includes:
introducing interventons as part of a wider
strategic approach
targetng specifc groups of older people
involving older people themselves in
program planning, delivery and evaluaton
building community capacity by using
existng community resources as far as
possible and
establishing partnerships with stakeholders
and organisatons.
Practice implications
1 REFERENCE LIST
Research to Practice Briefng 2
Promoting social networks for older people in
community aged care
Reference List
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