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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