Robotic dogs, laughter therapy and mindfulness are some of the ways that might help people - particularly the elderly - cope with loneliness and social isolation while social distancing, say researchers at the University of Cambridge.
A team at Cambridge's School of Medicine carried out a systematic review looking at the existing evidence on different approaches to tackling loneliness and social isolation. While all the individual studies were carried out pre-pandemic, the team considered which approaches might be feasible when people are still required to socially distance. Their results are published today in PLOS ONE .
At the start of the pandemic in the UK, over 1.5 million people were told they must self-isolate or shield themselves for a period of at least 12 weeks. Strict social distancing guidance advised the public to stop all non-essential travel and stay at home. While these measures were initially eased, social distancing measures remain in place, cases and contacts are required to self-isolate, and further lockdown measures have been re-introduced.
One possible consequence of both the shielding of vulnerable people, and the social distancing restrictions for all, is for physical separation to lead to social isolation and loneliness. There is strong evidence that both social isolation and loneliness are linked to cardiovascular disease, depression and anxiety. This means there is an urgent need to identify effective interventions to combat this problem.
A team led by Dr Christopher Williams, at the time University of Cambridge medical student, identified 58 relevant studies of interventions to reduce social isolation, social support and loneliness that could potentially be adapted for people living in pandemic-related isolation. Most of the studies (51 out of 58) related to older people - a group that often face the strictest limitations imposed on their social contacts during the pandemic.
"Lockdown and social distancing measures have meant that many people have little or no contact with others, which can lead to loneliness and isolation," said Dr Williams, now a doctor in his first year of practice.
"We carried out our review to try and identify approaches that might help people cope with these challenging times. Although the individual studies themselves took place before the pandemic, we've identified several that would still be feasible even with social distancing measures in place."
Among some of the approaches identified in the studies are:
The robotic animals gave better results than an 'avian companionship' scheme involving interacting with a live budgie, which did not report significant results.
The majority of the studies improved loneliness. The little evidence found by the team on tackling social isolation suggests that enabling or encouraging people to interact with their existing social circles was more effective than trying to enable them to make new friends.
"Many of these activities, such as mindfulness, meditation and talking therapies, could be delivered at a large scale in online groups, potentially at low cost," said Dr Adam Townson from School of Clinical Medicine at Cambridge.
"A significant problem, however, is that those who are most likely to be lonely or isolated - and most in need of support - may not own, or know how to use, electronic devices and might not have access to a high-speed internet connection. Any approach to help people suffering from loneliness or social isolation must take digital exclusion into consideration."
Several studies involved initiatives to combat loneliness and social isolation in nursing and care homes, which may have been hit particularly hard by lockdown measures. Effective interventions in these settings included weekly visits from an interactive robotic dog or seal, Wii gaming, gardening, videoconferencing, and cognitive/psychological interventions.
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The UK Government has announced a £5 million Loneliness COVID-19 Grant Fund to support charities currently offering services such as telephone befriending and community volunteering schemes. In addition, the NHS.uk website provides both support for people feeling lonely and onward referral for psychological therapies if appropriate. The researchers hope that their findings could help inform these national efforts.
The research was supported by the National Institute for Health Research.
Reference
Williams, C, et al. Interventions to reduce social isolation and loneliness during COVID-19 physical distancing measures: A rapid systematic review. PLOS ONE ; 17 Feb 2021; DOI: 10.1371/journal.pone.0247139
PLOS ONE