While Prof Chris Whitty warns of age crisis, new study finds people are more likely to die earlier when never visited by loved ones
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A new study, on data from the UK Biobank, shows that people who never saw friends or family are 77% more likely to die of any cause. Academics at the University of Glasgow calculated that even a monthly visit can make a difference. The Chief’s Medical Officer’s annual report came out as well. In this report the chief, Prof Sir Chris Whitty, warns for an ageing crisis and the need for healthcare to maximise the use of the tools we have.
The long-term study tracked the health of 458,146 people with an average age of 57, who were then followed for almost thirteen years. The study used different components to define social connection, and showed that when they were combined, they interacted. This means that, for example, having no one to confide in while also living alone appeared to increase the risk of dying of heart disease.
Never having friends and family visits, was associated with the highest all-cause mortality of any of the measures examined. But even a visit every three months marked a lower rate. Academics therefore conclude that if the relation is causal, even small changes in social connection for people suffering from a complete lack of social interaction, could suggest large health benefits.
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Ashfield House Residential Home is located in suburban Coventry, their staff discussed the topic and could only agree when asked whether they had experienced this: “Yes, definitely. People can become really withdrawn and don’t want to get out of bed, which can affect their mobility.” But at Ashfield House they don’t restrict visit times, which is for them a key factor as to how they can restrict loneliness for their residents to a minimum. “Some care homes only allow visits between two and four, which doesn’t allow family members to visit whenever they can.” They also want to emphasise that “All of our residents are different; they all have different needs. So, it is important that residents who are not so well in the morning, can have a visit in the afternoon or vice versa. So, for us the no-restrict means that family members can actually visit very regularly,” they say.
“People can become really withdrawn when they don’t get family visits. They often don’t want to get out of bed, which can affect their mobility.”
The covid pandemic made it extremely clear to them that many people’s health was deteriorating because of the extreme lack of visits: “They even stopped eating and drinking and got really depressed.” So, Ashfield Home finds it immensely important to live in a residential home but keep that contact with loved ones, which is why they encourage phone calls in any way possible: “We have special phones, special iPads, so that they can FaceTime family members who live far away.”
They end with: “Luckily, we have good providers. But still, the activities, keeping our residents busy during the day, keeping them entertained, there is no real fund for that. But it is the biggest thing for us, to keep them entertained, busy, active and mobile. So, we have to fund it by doing raffles and have to rely on families donating.” Ashfield House feels like that is the main thing they are missing out on and therefore should be funded more.
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Although the study did not examine why these social factors increased mortality risk, according to the Guardian the study’s lead author Dr Hamish Foster said: “It could be that people who are more socially isolated may have some more unhealthy behaviours like smoking or high alcohol intake, for example.” He also points out that not having someone to take you to the doctor’s or to encourage you to go and seek help are possible factors contributing to the higher mortality risk, as well as it has direct biological effect on the immune system.
On the same topic, the UK’s chief medical officer points out in his new report that it’s “a triumph of modern medicine” that people are living longer. But he emphasises the need to focus more on the quality of life rather than on quantity. Which fits in smoothly with the study mentioned above, as the report states: “Almost everyone reading this report will know older adults and will grow old themselves. Maximising the health, and therefore the life chances, of older adults should be seen as a major national priority, and one where we can make very significant progress often with relatively straightforward interventions.”
Sir Chris states that older people have essential roles in society “including significant caring responsibilities for younger generations and their peers, and skills and knowledge accumulated over a lifetime.” He emphasises that improving and maintaining the health of the oldest members of our society is a strong social responsibility.
The new report was warmly welcomed by the Centre for Ageing Better, who were happy to read about the diversity of experiences in older age. “Older generations are repeatedly grouped together as a homogonous group, when in fact many people are facing enormous challenges and hardship in their later years, as this report makes clear,” says Professor Dame Carol Black, Chair of the Centre for Ageing Better. She wants to emphasis the fact that not all of us have an equal opportunity to age well, while good health has an enormous influence on people’s enjoyment of later life. “Wealth, work, housing, discrimination; all play a significant role in the huge gap in healthy life expectancy between the richest and poorest areas of the country,” according to Dame Carol Black.
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Sir Chris’ biggest concern for policymakers is that they have not recognised the degree to which the older population is concentrating geographically in the UK. The report shows that areas such as Scarborough, North Norfolk or the south coast are going to age more rapidly compared to cities like Manchester, Birmingham and London for example. They will age very slowly because the great majority of older people move out of cities and large towns. Sir Chris writes: “Providing services and environments suitable for older adults in these areas is an absolute priority if we wish to maximise the period all older citizens have in independence. The provision of health and social care also needs to be concentrated in these areas.” He wants the NHS, social care, central and local government to start planning more systematically based on these geographical findings, more precisely where the population will age in the future. “This includes building or adapting housing and transport to be appropriate for an older population,” Sir Chris states.
“We need to aspire to improve the quality of life for people as they age, including through creating homes and communities that help people to age well.”
Improving the living environment for people of older age, is something the Centre for Ageing Better really echoes. Dame Carol Black stresses: “We need to aspire to improve the quality of life for people as they age, including through creating homes and communities that help people to age well. This will not only benefit millions of individuals but also deliver massive societal benefits if more people are given the opportunity to make the most of their later life.”
When it comes to medicine, the chief medical officer highlights the rise of multimorbidity, and the fact that medical profession needs to act on this: “The single most important way to achieve this is to recommit to maintaining generalist skills as doctors specialise.” He also finds that we are often poor at maximising the use of the continuously developing tools in medicine. So, Sir Chris wants to optimise this use.
He finds it’s NHS organisations’ responsibility to minimise the probability that someone has to visit multiple clinics for “a predictable cluster of diseases.” As well as secondary prevention: “It is predominantly the responsibility of the NHS but is currently under-prioritised.” He wants this secondary prevention as well as screening services to be prioritised so it could help “delay or stop the onset of serious disease and therefore prevent ill health in later life.”