Talking about social engagement pays off
Measuring factors like loneliness, connection to friends and family, sense of purpose and community engagement can easily be incorporated into home care assessments and can result in happier clients and better services, a study has found
Measuring factors like loneliness, connection to friends and family, sense of purpose and community engagement can easily be incorporated into home care assessments and can result in happier clients and better services, a study has found.
Researchers from Macquarie University investigated the use of questionnaires to measure social engagement and wellbeing in community care clients, in response to concerns that existing assessments tend to focus too heavily on physical elements.
The study aimed to explore the experience of community care staff in using these tools and as well as the practicality of implementing them in routine client assessment visits.
“We identified that there was a lack of measurements out there in the aged context that really captured social needs,” Dr Joyce Siette from Macquarie University told Community Care Review.
“Existing assessments focus a lot on the physical elements, which is important, but whether the person feels isolated or requires some more activities, that’s not really been systematically captured.
“We found these tools are useful for identifying a client’s psycho-social needs, are feasible to be used by aged care organisations and provide critical and valuable information to help guide decision-making about services.”
Looking at the bigger picture
The study, reported in the journal Health and Social Care in the Community this month, was conducted in Sydney by aged care provider Uniting, which used two social engagement measures during 289 assessments over nine months.
One of them, the Australian Community Participation Questionnaire (ACPQ) looks at contact with extended household family, friends and neighbours well as religion, community activities and engagement with current affairs.
The second, ICEpop CAPability Measure for Older Adults (ICECAP-O) focuses on love, friendship, attitudes to the future, things that make a person feel happy and valued, and independence.
Researchers surveyed 12 Uniting staff who had used the instruments for assessing an average of 20 new and existing clients between July and September 2016, including some with memory loss, cognitive impairment and dementia.
Staff found the tools were convenient to use and useful in getting information to develop care plans, Dr Siette said.
Researchers concluded the tools were:
- Convenient to use
- Helpful in developing care plans
- Complemented standard assessment procedures
- Didn’t disrupt workload
- Identified social needs
- Enhanced client involvement
Boosting client involvement
However the study also found that some staff encountered “challenging” emotional responses to some questions and recommended that more training may be required in this area.
Dr Siette said that in a community care setting, older adults often aren’t given an opportunity to articulate their social situation and quality of life concerns such as loneliness and independence.
The questionnaires helped stimulate discussion and increase client involvement in decision making, she said.
“It brought out conversation and helped involve the client in decisions about services that they wanted to use,” she said.
“For example clients would say, ‘this question identified that I am quite unengaged with the community and I’d like to be, so how about I go to a day centre?”
Uniting is rolling the questionnaires out across the organisation, Dr Siette said.
She said a variety of pysho-social measurement tools already existed but were yet to be widely adopted in aged care community assessments.
Non-engagement cannot always be attributed to loneliness as it’s a complex beast. The study does not clearly state whether community care clients are participants of CHSP or HCP or other programs. The level of engagement and alleviation of loneliness is distinctly different between programs as a typical HCP person has much more complex care needs and less likely to engage outside the home.
The study seems to suggest that ‘staff’ (unsure if this refers to assessors, direct workers, other staff) may need more training to ask appropriate questions or facilitate older adults to articulate their social needs. My experience is that the skill in asking questions is to be curious so as to draw out responses, but also to know when not to push. It is in fact the relationship between client and worker/case manager/assessor that’s developed over time that allows this exploration of activities to alleviate isolation and loneliness. Within a HCP environment, there is that interesting element called the budget that somehow becomes the barrier rather than the potential beyond the physical elements of care and support. For too long, older adults have perceived care in terms of personal care and in-home help. I find it really exciting when someone articulate a social need so I can bring it to fruition.
Social engagement measures are a tool that have a place. I like the idea of organic engagements to reduce isolation/loneliness that are a result of conversations (qualitative) and focus on the person for their benefit. Unfortunately, not all organisations can engage in social research which is a big miss in the care space.
I am enjoying the shift in AA articles that focus on possibilities and less tackled issues in community care.