Loneliness and social support of older persons during a pandemic: Implications for gerontological social work services in resource-constrained settings

Stephan Geyer & Barbra Teater

Research on the biopsychosocial effects of COVID-19 on older persons (60+ years) has predominately originated from the global north with a dearth of studies focusing on the loneliness and social support of older persons in the developing world.

Applying a socio-ecological resilience perspective, this study aimed to determine and compare the loneliness and social support among South African older persons during COVID-19.

A cross-sectional survey was operationalised to collect data from community-dwelling older persons (n=139) and those residing in residential care (n=99) during COVID-19 through availability sampling. The 11-item loneliness scale (De Jong Gierveld & Van Tilburg, 1999) measured overall loneliness and two sub-scales. The 19-item MOS Social Support survey (Sherbourne & Stewart, 1991) was used to measure the availability of social support across four domains. Furthermore, the survey focused on social contact, number of close friends/relatives, socio-demographics, as well as subjective physical and mental health, respectively. Bivariate analyses (t-tests) were run to explore any statistically significant differences between the two groups.

Community-dwelling older persons measured with marginally higher levels of loneliness. However, interestingly no statistically significant differences were identified between the two groups. Community-dwelling older persons measured higher on social support than their peers in residential care. Nonetheless, only affectionate social support was found to be significantly different (p<0.01).

Based on the results, a bouquet of gerontological social services for resource-constrained settings are recommended to enable older persons to navigate towards reduced levels of loneliness and their desired social supports during future pandemics.

“‘I’m not old, just aging’: Perceptions of subjective age and aging amongst community dwelling older adults” - Jill Chonody & Barbra Teater

Abstract:

“Old age” is a relatively new phenomenon in the span of human existence, and these socially constructed markers are associated with age-related norms and expectations (Settersten & Hagestad, 2015), which in turn influence how individuals feel about age and aging. In fact, age-related stereotypes are internalized early in life and shape our beliefs about aging (Levy, 2009). The concept of “aging” often carries a negative connotation in many Western societies; however, research suggests collective perceptions may be shifting as people are living longer lives. This cross-sectional study using survey methodology sought to understand how older people (N = 477) perceive their age by analyzing the responses of closed- and open-ended questions through summative content analysis. The mean age of participants was 63 years, and the average age that they felt was approximately 10 years younger. The seven themes for why individuals did not feel old ranged from: maintaining an active and engaged lifestyle to “I don’t act or look old,” and the seven themes for why individuals felt old ranged from: stopped or changed activities to nearing death. Findings illuminate how subjective age is shaped by perceptions of what it means to be old, and the ways in which these micronarratives are reflective of larger macronarratives surrounding age and aging. Activities and interventions based in positive psychology may promote shifts in age perceptions. For example, findings from one program found that participants were less stressed, reported less tiredness, and were calmer compared to the control group (Greenawalt et al., 2019).

“Social Workers’ Use of Theories and Methods: What Informs Social Work Practice?” - Barbra Teater & Katrina Hannan

Abstract: Although there are established theories and methods in social work, the practice of social work is often deemed an art and a science where social workers apply knowledge from empirical research and formal theory alongside their practice knowledge, clients’ values and wishes, and experiential and informal theory (Bell, 2012). Yet, the use of formal theory and application of established methods has been found to be a challenge for social work students and practitioners (Sieminiski & Seden, 2011), which subsequently shapes the effectiveness of practice on clients. Strengthening the theory-practice relationship within social work education is a critical step in preparing students for practice and enhancing the practice of future social workers.

This mixed-methods study, based in New York City, explored social workers’ (N=105) perceived use of theories and methods in practice through an online questionnaire followed by individual interviews (N=20). The questionnaire consisted of 29 closed and opened-ended questions to elicit social workers’ perceived use of theories and methods in their social work practice, the theory and method content they received in their social work education, and what theories, methods, and/or other sources of information they use to make practice decisions. A semi-structured interview schedule was used to guide the individual interviews (e.g., Tell me about a recent case in your practice; Is there any perspective or theory that you feel was guiding you, generally, when you worked with this case?; To what extent do you feel your social work education prepared you to use theories and methods in practice?) The quantitative data were analyzed using descriptive statistics and the qualitative data from the individual interviews were analyzed using summative content analysis (Hsieh & Shannon, 2005)Social workers reported receiving approximately 1 – 6 courses on social work theory in their education which moderately influenced their current practice. The majority of the social workers reported staying “up-to-date” on practice theories and methods through continuing education/staff development followed by conversations with colleagues. Over 50% of the social workers indicated twelve theories or methods were covered in their social work education with Child Development Theories, Family Systems Theory, and Attachment Theory constituting the three theories and methods covered the most. The most commonly used theories in practice included Cognitive Behavioral Therapy, Strengths Perspective, and Trauma-Informed Care. Qualitative data indicated social workers either applied theory to practice in an “intentional and systematic way” or indicated their “practice was not that intentional.” Social work education was reported to provide a “breadth but not depth” of knowledge on theory, yet social workers highlighted the significance of field education in bridging the gap between theory and practice and the need for continuing education and professional development to hone one’s skills.

This study highlighted the complexity in applying theories and methods to practice settings and the role that social work education can play in initiating this process through introduction to theories and methods and opportunities to bridge the gap between the theoretical frameworks and foundations and the selection of methods when in practice settings.

“Stress During COVID-19: The Role of Fear and Health Across Age Groups” - Jill Chonody, Barbra Teater, Katrina Hannan, Katie Hall

Abstract:

The severity and magnitude of COVID-19 has led people to experience immense stress and uncertainty have profoundly impacted the people in a multitude of ways, including lost loved ones and ongoing social isolation. The stress that COVID-19 has caused is immeasurable (Pearman et al., 2020) and is likely to have an impact for years to come.

Data were collected from an online questionnaire distributed through social media (e.g, Facebook) and Mechanical Turk (MTurk), an Amazon service that recruits participants for monetary reward ($0.75). MTurk “master workers” were utilized, which are those with a low survey rejection rate, indicating response bias was not suspected. Participants were aged 18+ and US residents. About half of the sample (N = 458) was gained from each of the two data collection strategies, MTurk (n = 245) and social media (n = 213).

Due to incomplete data, a total of 412 participants remained for analysis. The sample was on average 42 years old and were women (61%) and White (71%). Stress was moderately high (6.9 on 10-point scale); alcohol use was indicated as the “same” by a slight majority (52%); and nearly half were working the same amount (45%). Participants had moderate pre-COVID stress levels with around a two-point increase during-COVID, and older participants had the lowest stress levels. The one-step OLS regression for the whole sample explained 47% of the variance in stress. Seven variables were significant: more conversations about COVID, using more alcohol, knowing someone with COVID, increased fear, greater avoidance of reading/watching information about COVID, decreased health status, and increased income. All of the effect sizes were small (Cohen, 1988). To determine how these factors helped explain stress by age group, three regressions were completed by age—older, middle, and younger adults.

Results of the regression for older participants explained the most variance (66%), and three variables were significant: more use of alcohol, increased fear, and decreased health status. Fear had a medium effect size (β = .67), and the other two variables had small effect sizes. The model for middle-aged participants explained 52% variance, and four variables were significant: more conversations about COVID, increased fear, decreased health status, and increased income. Lastly, the model for younger participants explained 37% of the variance, and the regression results indicated three variables were significant: more conversations about COVID, increased fear, and decreased health status.

Results of this study add to the growing substantive literature regarding COVID-19 and provide insight into specific variables by age group, which speaks to how different interventions and coping strategies may need to be modified by age group. While fear was the largest factor for everyone, understanding the source of that fear and how individuals are addressing it (or avoiding it) is important for social workers. Participants in this study had moderately low to moderate levels of stress prior to COVID, but this increased by nearly two points across every age group, which is indicative of how hard this illness has been on the psyche of Americans.

“Risk and Protective Factors of Loneliness among Older Adults: Significance of Social Isolation and Quality and Type of Contact” - Barbra Teater & Jill Chonody

Abstract: Loneliness has a significant impact on the health and well-being of older people, including an increased risk of mortality. This cross-sectional study explores possible risk and protective factors that can help explain loneliness and emotional and social loneliness in a sample of community-dwelling older adults (N = 477) in the United States. The survey incorporated a standardized scale of loneliness and items to assess type and quality of contact with others, community support, social isolation, physical health, cognitive health, and functional ability. Bivariate and multivariate analyses explored the factors that contributed to loneliness, emotional loneliness, and social loneliness. Results indicated overall quality of contact with others, use of phone contact, and social isolation was significant in all three regressions; other significant variables were different for each analysis. The findings support social work and public health recommendations for addressing loneliness, particularly within the current climate of “social distancing” under the COVID-19 pandemic.