Background
Loneliness, defined as a subjective feeling of isolation, lack of belonging or lack of friendship, is on the rise in recent decades. The older adult population is particularly susceptible to loneliness, since aging involves the loss of friends and relatives and the reduction of social networks. Studies show that loneliness has a deleterious effect on both physical and mental health, including an increase in depression, cognitive damage, and even mortality. In March 2020, the World Health Organization declared COVID-19 as a pandemic. Many countries, including Israel, declared a state of emergency and announced a variety of restrictions and guidelines designed to implement the principle of social distancing to slow down the spread of the virus. Due to these restrictions and guidelines, everyone’s daily routine, as well as the frequency and nature of social and family contacts, changed significantly. It is reasonable to assume that these changes intensified the loneliness experienced by older adults and weakened their mental resilience.
The growing awareness of the extensive effects of loneliness on older adults (65+), together with its intensification during COVID-19, led to the development of interventions designed to alleviate the loneliness felt by older adults and to improve their abilities to cope with it. Realizing the long-term social impact of the pandemic, and to cope with future social challenges, the Ministry of Welfare and Social Affairs (hereinafter, Ministry of Welfare) formulated guidelines for the development of such programs. Based on these guidelines, during the Covid-19 pandemic municipal authorities developed programs for senior citizens aged 65 and above, with each authority implementing programs tailored to the needs of its own senior citizen population. In 2021, based on the Myers-JDC-Brookdale (MJB) Institute’s extensive experience in evaluating similar programs for older adults, and in developing the instruments for examining their needs and preferences, the Ministry of Welfare commissioned an MJB evaluation study to examine the effectiveness of these programs.
Objective
The main objective of this study was to examine the effectiveness of the programs provided by municipal authorities and help policymakers formulate recommendations for the future of the project. Four research goals were derived from this objective:
- Describe the mental and social status of older adults during COVID-19 and during the period of return to their regular routine
- Describe and provide a typology of programs for the alleviation of loneliness provided by municipal authorities
- Identify the programs that were highly effective in relieving loneliness and other negative feelings
- Identify administrative issues related to the programs’ implementation
Method
The study relied on four information sources:
- Semi-structured interviews and focus groups with older adults – giving voice to a variety of reactions to the loneliness felt among senior citizens during COVID-19 and its effects on the return to their routine
- A typology of programs for the relief of loneliness – describing, sorting, and classifying the programs based on their content and characteristics
- A survey among participants in programs to alleviate loneliness, conducted at the start of each program and a year later, to identify the perceived contribution of participation in the programs as well as actual changes in the senior citizen’s lives, with an emphasis on depression, loneliness, belonging, and meaningfulness
- A survey among the program administrators or instructors to examine issues related to program implementation and success from their point of view
Findings
The pandemic distorted the social order and disrupted global, social, family, and personal circles of belonging. The interviews indicated that, at the time of study, the participants found it difficult to resume their pre-pandemic routine. The programs for the alleviation of loneliness provided by the municipal authorities served as an anchor for senior citizens in this difficult period. The programs were classified by content (meaningful group leisure activities; exercise and healthy lifestyle; use of digital tools; individual activities; candid conversations; other programs), as well as by the level of continuity (ongoing programs, completed programs, programs the respondents did not recall participating in). It was found that older senior citizens with particular characteristics tended to participate in particular types of programs.
The perceived contribution of all programs was significant. The participants reported being highly satisfied with participation in the programs, and that they had improved their lives in a variety of areas. It was also found that the continuity of the programs increased their impact: ongoing programs were found to contribute more in all areas examined, compared to programs that had already ended or those whose level of continuity was unknown because the respondents did not recall participating in them. Moreover, ongoing programs of the “meaningful group leisure activities” type significantly contributed to an improvement in feelings of depression, loneliness, and a sense of belonging.
Recommendations
Recommendations were provided in two areas: the administrative area that related to the programs’ management and logistic issues, and the content area that focused on the nature of the content transmitted in the meetings. The recommendations were as follows:
- The programs must be tailored to the senior citizens’ To do so, a mechanism for identifying such characteristics must be developed in the various municipal authorities. Implementing more than one type of programming will enable reaching out to a broader audience
- Programs must be systematically documented using a standardized system
- A process of lesson learning should be developed by gathering information on dropping out of programs and feedback from both instructors and participants
- Ongoing programs, found to be most effective, should be encouraged
- Group programs revolving around a certain area of interest should be encouraged, subject to follow-up studies that will examine other types of programs