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Older people: independence and mental wellbeing

Terms used in this guideline

  • Mid-life People aged 40 to 64
  • Multicomponent activities Programmes for older people involving a range of topics, settings, media, and activities. A programme could include, for example, lunch with the opportunity to socialise and learn a new craft or skill in a community venue. Or it could involve a physical activity, such as a dance class, gardening or walking group, plus printed information on the benefits of physical activity
  • Older People People aged 65 or older
  • Vulnerable older people People at greater risk of a decline in their independence or mental wellbeing than others of the same chronological age. Vulnerable people may not be able to cope with stressful events or may have limited physical mobility or restricted life choices, possibly due to lack of finances or support

Principles of good practice

  • Support, publicise and, if there is not enough provision, consider providing a range of group, one-to-one, and volunteering activities that meet the needs and interests of local older people. In particular, target older people who are identified as being most at risk of a decline in their independence and mental wellbeing
  • Involve older people in the design and delivery of activities
  • Ensure each activity:
    • includes a clear description of what is on offer
    • takes place at regular times and in a regular location
    • provides the opportunity to socialise
    • complements other activities that may support different aspects of older people's independence and mental wellbeing, such as their physical health, their sense of belonging to a community ('social connectedness'), and their sense of purpose
  • Ensure activities are inclusive and take account of a range of different needs (for example, think about the needs of older people with an age-related disability)

Group-based activities

  • Provide a range of group activities, including multicomponent activities, combining 1 or more of the following:
    • singing programmes, in particular, those involving a professionally-led community choir
    • arts and crafts, and other creative activities
    • tailored, community-based physical activity programmes including walking schemes (see recommendations 2 and 3 in NICE's guideline on occupational therapy and physical activity interventions to promote the mental wellbeing of older people )
    • intergenerational activities involving, for example, older people helping with reading in schools or young people providing older people with support to use new technologies
  • Consider offering:
    • activities, training and ongoing technical support that encourages older people to use information and communication technologies such as mobile telephones, internet-enabled TVs, and computers
    • activities related to hobbies and interests, education, and other learning opportunities

One-to-one activities

  • Offer one-to-one activities, such as:
    • programmes to help people develop and maintain friendships. For example, peer volunteer home visiting programmes, programmes to learn about how to make and sustain friendships, or befriending programmes based in places of worship
    • befriending opportunities that involve brief visits, telephone calls, or the use of other media
    • information on national or local services offering support and advice by telephone and other media

Volunteering

  • Make older people aware of the value and benefits of volunteering. For example, it provides the opportunity to socialise, have an enjoyable experience, and help others to benefit from their experience, knowledge, and skills
  • Provide opportunities for older people to volunteer
  • Encourage older people to volunteer by:
    • varying the length and times of volunteering sessions to suit individual ability or preference
    • helping them to gain new skills (including good quality training)
    • providing supervision and ongoing support
  • Use a variety of approaches to recruit older volunteers. This includes: articles and advertisements in local print and broadcast media, posters in community and care settings, direct mail, digital (including social media), and word of mouth

Identifying those most at risk of a decline in their independence and mental wellbeing

  • Make service providers and others aware of the effect that poor mental wellbeing and lack of independence can have on an older person's mental and physical health, and their social interactions
  • Ensure staff in contact with older people are aware of the importance of maintaining and improving their independence and mental wellbeing
  • Ensure staff in contact with older people can identify those most at risk of a decline in their independence and mental wellbeing. This includes being aware that certain life events or circumstances are more likely to increase the risk of decline. For example, older people whose partner has died in the past 2 years are at risk. Others at risk includes those who:
    • are carers
    • live alone and have little opportunity to socialise
    • have recently separated or divorced
    • have recently retired (particularly if involuntary)
    • were unemployed in later life
    • have a low income
    • have recently experienced or developed a health problem (whether or not it led to admission to hospital)
    • have had to give up driving
    • have an age-related disability
    • are aged 80 or older
  • Ensure staff in contact with older people give those most at risk information on activities that might help them

full guideline available from...
National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BT
nice.org.uk/guidance/ng32

National Institute for Health and Care Excellence. Older people: independence and mental wellbeing
First included: January 2016.