REFLECTING ON ISOLATION AND SOCIAL CARE
A RESOURCE FOR SMALL GROUP STUDY
LENT 2015
Prepared by Rev. Canon Dr. Nigel Rooms,
Diocese of Southwell & Nottingham
Introduction
WHY THIS LENT RESOURCE?
These small group studies accompany the “I care about caremproved Social Care” campaign of Citizens UK ( in advance of the 2015 General Election and are prepared for Lent 2015 (though they could be used with minor adjustments at any other time as well). They are intended to be used in the Diocese of Southwell & Nottingham alongside the other resources available on the website; (and again with minor adjustments they could be used in any place to deal with the issues raised by isolation and social care in UK).
WHO IS INVOLVED?
The course was prepared by Nigel Rooms who works in adult learning and development in the Diocese of Southwell & Nottingham with support from Lydia Rye, a Community Organizer at Nottingham Citizens. The course is designed to be broadly ecumenical in nature and is in no way restricted to Anglican churches – it could be studied by any Christian denomination.
Locally of course Lent Courses are delivered in all sorts of ways by all sorts of people. Perhaps the best way is in small groups. Conventional wisdom about group size says that they shouldn’t be less than 6/7 people, or more than 15, but between 8 and 12 is best.
Each group needs a facilitator or two. In fact it is good practice to have two people because this can introduce balance in the leadership both in style and gender and leave a back up if one can’t make a session.
There is no reason why this course might not include children and young people – in fact their insights and creativity might be invaluable. Do think seriously about how they may be involved – see especially SESSION 4.
WHAT WILL YOU NEED?
First of all this material! It forms the basis of each session and offers ideas for designing the course in your local context. It is good if everyone participating can have a copy.
You’ll also need a flipchart and some pens – and it would be great if some members had access to the internet at home or even during the sessions themselves. In one session there is the possibility of watching an internet video so you’ll need access to the internet and a digital projector if you are going to offer that.
When making action plans I have added a pro-forma in Appendix 1 for writing these up. Experience shows if this is not done and accountabilities made then nothing will actually happen
The sessions are as follows:
1. THE CAUSES OF ISOLATION
2.SOCIAL CARE
3. FULLY HUMAN? - VALUE, RESPECT AND DIGNITY
4. INTERGENERATIONAL PRACTICE
5. GOD AND COMMUNITY
6. THE STATURE OF WAITING and REVIEW (optional
WHEN?
As you can see the course has enough material for five or six sessions (with the final session being an optional one mainly reviewing the learning and planning for more action). This should fit with the five/six weeks of Lent depending on when the first session begins. The course is designed to be flexible, but facilitators will need to plan what will happen and when in good time.
HOW? Our Method
Most sessions will follow a similar pattern. We will use a method based on a simple way of doing theology (remember a theologian has been defined as one whose prayer is true!) called ‘See, Judge, Act.’ So we will begin with some relevant experience, reflect (or judge) on it using a bible passage and then make plans for action.
We haven’t suggested timings for the various parts of the session but given a meeting time total of ninety minutes or up to two hours (excluding refreshments/meeting up time and opening closing prayer & worship) – the three sections could be given roughly equal time. We generally, also have not included starting and ending suggestions for prayer and worship. Most groups can work out what is appropriate for them and how long they wish to spend on this.
There is some preparation to be done in between Sessions One and Five and the more people can do the more material there will be to reflect on in the sessions.
SESSION 1: THE CAUSES OF ISOLATION
Read the following material;
Here are some facts taken from the websites of organisations who work in this area like Age UK (
- More than half of over 75s live alone with 6 - 13% of older people saying they feel very or always lonely.
- 1 in 6 adults aged over 50 are socially isolated with 6% of older people not leaving their house more than once a week and 11% in contact with their families less than once a month
- An estimated 5 million older people consider their TV to be their main form of companionship, while almost 600,000 only leave their house once a week or less.
A million older people in the UK haven't spoken to anyone for a month.
- Older people are particularly vulnerable to social isolation and loneliness owing to loss of friends and family, mobility or income.
- Social isolation and loneliness have a detrimental effect on health and wellbeing.
- Studies show that being lonely or isolated can impact on blood pressure, and is closely linked to depression.
Definitions
The Loneliness and Isolation Evidence Review[1]published by Age UK reports;
While the terms ‘loneliness’ and ‘isolation’ are sometimes used as if they were synonymous, they refer to two different concepts. Isolation refers to separation from social or familial contact, community involvement, or access to services. Loneliness, by contrast, can be understood as an individual’s personal, subjective sense of lacking these things to the extent that they are wanted or needed.
It is therefore possible to be isolated without being lonely, and to be lonely without being isolated. For instance, an older person can be physically isolated (living on one’s own, not seeing many other people etc.) without feeling lonely. For some, physical separation is even a result of choice. Similarly, one can feel lonely in the midst of other people. Older family members and care-home residents may not appear to be physically isolated, but their relationship with the people they live with may not be enough to ward off loneliness, particularly when the death of friends
and loved ones takes away the companionship they need.
Despite a great deal of research into the meaning of loneliness and isolation asking people the simple question ‘Do you feel lonely?’ seems to give a reasonable result across a broad spectrum of people.
Discussion
Does the group agree with these definitions? Discuss them for a few minutes so they can become clearer especially around the difference between the more ‘objective’ idea of social isolation and the more subjective feeling of loneliness in an individual.
Another question that might be worth asking is at this stage; “Is loneliness and isolation restricted to older people?” If not what kinds of people might be susceptible? Make a list on a flip-chart.
The Causes of Loneliness and Isolation
Allow everyone to have a think about why they think loneliness and isolation are so prevalent in our society. On the flip-chart list everything that people say as they call out their reasons in a free-for-all time.
Once everyone’s ideas are noted have a look at the full list and see if two or three larger themes or ideas emerge that could cover a number of the original contributions. Make a note of these.
While not exactly answering the ‘why’ question the Age UK report cited above lists several factors affecting loneliness in UK;
- loneliness increases with age, the loss of friends and poor health
- there is a strong connection between low contact with family members and loneliness
- loneliness is strongly allied to perceived poor quality of life.
- contact with children is an especially effective antidote to loneliness. This appears to apply to cross-generational contacts in general, i.e. contact with children and young people as well as contact with one’s own (grown-up) offspring
- having children but not feeling close to any of them is associated with higher rates of loneliness than being childless
- having friends is a more important factor in warding off loneliness than frequent contact with these friends
- there is a clear and significant correlation between low socio-economic status and loneliness
- although wealth is an important determinant of people’s life satisfaction, its effect declines over the age of 75
Compare and contrast this list to the one generated in the group
Bible reflection
Read together in the group Luke 8: 40-48.
Think together about the causes of the woman’s isolation and what that would have felt like.
Reflect together on the importance of touch in this story in relation to isolation and loneliness.
The woman it seems was healed on touching Jesus, why then does he call her out of the crowd specifically and speak to her personally in v48?
What does this story tell us about healing and wholeness in relation to isolation?
Action
In a time of quiet reflection everyone writes two sentences – one beginning with the words
I think that......
and the second
I will ......
These are written up on a flipchart and the group discusses themes emerging from this week’s study.
Prayer
As a group pray for people known to the participants who are lonely and isolated
Preparation for Session 2
Research the care homes and sheltered residential units in your parish/area.
See if you can find out
a)how many there are
b)how many people live and work in them
c)who runs them
Read the story from Michelle Simmons before the next session.
SESSION 2: SOCIAL CARE
The issue of social care is one that effects many of us be it through our own experience or that of family and friends. Currently £19bn is spent on care for the elderly every year in the UK (not including informal family care) and yet it seems every week that news outlets cover stories of failing care homes, carers receiving often less than the minimum wage, real concerns about unpaid travel time and the increasing use of 15 minute visits – emphasising task over relationship. Too often these are stories of blame pitting all of those involved in social care against each other.
A Story - of one person’s experience (taken from the icareaboutcare website)
Michele Simmons is a Citizens UK member. Michele's account of her experiences of social care moved a group of North London Citizens to act. The result of their actions is the Citizens UK Improving Social Care campaign, and we hope the start of significant changes to the social care system across the UK.
After my dad died, mum became increasingly confused. To begin with the doctor put it down to grief – eventually she was diagnosed with dementia.
We then entered a dark and frightening world which took us through social services, a range of carers, hospitals, homes – and dementia units.
Seeing someone you love suffer with any illness is desperately hard but the most difficult thing was not watching the mother I knew disappear but seeing her become invisible to anyone we dealt with.
There are so many examples of thoughtlessness and insensitivity it’s hard to narrow it down.
In the early stages she had cataracts and I remember taking mum for an outpatients appointment and the doctor telling me, in front of her, that as she had dementia there was no point in bothering to even examine her.
Some months later, on the advice of social services, I took my mum for a day visit to a local home. She was frightened and wouldn’t sit still – not an uncommon symptom of dementia. Not one of the staff talked to her – other than to tell where to sit, or wait, or to tell her off. The manager of the home then called me in and told me they wouldn’t be able to take her as she was too demanding.
Then there was the time, after an infection, she ended up in hospital. By now she could no longer talk – or feed herself. Food was left by her bed until someone remembered that she needed feeding, often some time later. Sometimes they forgot altogether. One day the woman opposite mum fell out of bed but was ignored. I went over and asked the nurses if they could help. I was told that she didn’t need help as she was perfectly capable of getting back into bed and she was just attention seeking. I helped her myself.
Eventually mum needed full time care and I found a place for her in a dementia unit. The brochure and senior management made all the right noises but, sadly, the reality was very different.
There was the patient who was hoisted onto a commode, in the lounge area, in front of residents and visitors, because it was ‘much quicker’, than taking the woman to the toilet.
The case where two residents had the same name and the staff kept mixing them up and taking the wrong one to appointments.
Or the woman that begged for a drink but was ignored. When I offered to get her one I was told no, by one of the carers, she’d had one not long ago and she’d have to wait until dinner. No other explanation. Those, it seems, were the rules.
Many of the carers I saw rarely bothered to talk to the residents – or even look at them. One sat reading the paper for a whole hour while residents roamed around aimlessly, walking into doors, asking, repeatedly, to be taken to the toilet...Often music was blaring on a sound system – generally Radio 1 – and at the same time the telly was on but, turned down, so the carers could listen to the radio.
The Home did organise activities for residents but often excluded those with dementia ‘because they couldn’t really join in’. So, the residents would be left, all day, in the same chair. They’d only be moved when they were taken to be ‘toileted’.
When I went to visit mum she’d often have someone else’s clothes on – and they weren’t even the right size. Prior to mum going into the home, I’d had sat for hours writing her name, and room number, on everything – as requested - yet no-one bothered to check. One day she even had a pair of plastic shoes on. They were about 2 sizes too small but someone had somehow managed to squash her feet into them. When I managed to pull them off I saw, quite clearly, that they had someone else’s name on them.
Unable to sit up, mum would flop around in a wheelchair, knocking herself on its steel arms. Her ‘crepe paper’ thin arms would bleed, leaving trickles of blood running down her arms. I suggested that something soft could be wound around the chair’s arm, to protect mum’s skin. It didn’t happen and a few days later when I visited my mother’s arms had been bandaged up as the wounds were so bad.
With no strength in her arms, Mum was also unable to wipe her nose so had to put up with a constant dribble, as not all staff would check to see how see was doing. Attempting to wipe her face she would often involuntarily rub her eyes too, resulting in endless outbreaks of conjunctivitis.
Two further memories, which are hard to forget. One freezing December day I went for my usual visit and mum was slumped on the chair, her face contorted, her eyes completely blank and her skin sweaty and sticky. I asked to see a doctor – I was told no, ‘it was just the dementia’. I’d seen her at least once a week since she’d been diagnosed and I had never seen her like this. I asked again and my request dismissed.
The next morning, before 7, I had a call to say that they had sent her to the hospital in an ambulance. No-one from the home had gone with her and due to the hospitals being full, she’d had to stay in the ambulance for hours – virtually alone, frightened – and cold as the Home has sent her in a thin nightie, with no slippers – and no notes – so when I finally tracked her down, shaking, looking pitiful as well as terrified, the duty doctor had no information on her whatsoever.
After weeks in hospital the final indignity was, as she was lying there agitated and in pain, I had to beg for her to be given pain relief. The nurse insisted she wasn’t in pain. Looking at her expression, the noises she was making and the way she was trying desperately to move, l begged to differ. I asked again. The nursedisappeared. Fifteen minutes later, as mum seemed worse, I went to remind the nurse who was busy chatting and was clearly irritated by the interruption. I went back to mum and waited...and waited. I held her hand and talked to her, telling her it would be alright and the pain what stop soon. Then mum took her last breath.
Soon after the nurse arrived. I told her I thought it was too late. She had a cursory look, in between loading up the syringe. She agreed as she pulled across my mother’s arm. I asked her what she was doing and I was informed that she had to use up the morphine as it had been signed for....