Peninsula Medical School Report 2005
“Overall, Upstream seems to have been highly successful in identifying and engaging with their target socially isolated elderly population. The majority of participants at entry to Upstream were living alone, and substantial psychological and physiological morbidity was evident, including a 53% prevalence of depression and high rates of chronic illness and disability. Overall quality of life for both mental and physical well-being was well below the expected normative, age-matched population values. In terms of outcomes, putting the qualitative and quantitative data together suggests that the intervention is delivering significant and clinically meaningful benefits to this population.
“The results suggest that engaging socially isolated elderly people in social and creative activities, using an individually tailored, mentoring approach, which focuses on building efficacy /confidence and self-determination can enhance their overall health-related quality of life, with a particularly impact on depression, as well as increasing perceived social support. Additional physical health benefits may be possible, particularly in the longer term if activities are sustained. The extent of the possible health gains is clinically meaningful in terms of the average changes in outcome scores reported. Furthermore, a substantial number of individuals were reported to experience quite radical transformations, including enhanced psychological well-being and lifestyle changes, as well as physical health benefits.
“Against an expected picture of decline in both physical and mental health in this age group, overall health seems to be improving in this population, with stronger short term benefits in psychological well-being, and longer-term benefits in terms of depression, physical health and perceived social support.
“The intervention seems to coincide with improvements in other health-related behaviours, such as greater attention to diet, a reduction in some people’s alcohol consumption, and an increase in the amount and type of exercise people engaged in. One reason why Upstream may work especially well with those suffering from depression is that it appears to alleviate some symptoms by socially integrating previously isolated people and providing a reason for getting out of bed.”
Unique Aspects of Upstream
- The networking /multi-method approach identifies socially isolated people.
- Individual tailoring enhances engagement in activities and sustainability.
- Mentoring ‘holds’ participants as long as needed to affect sustainable change.
- There is an underlying philosophy of empowerment, building confidence and self-determination, consistent with the drive towards self-management and away from dependence on health and social services.
- Veterans feedback into activity groups, increasing social capital.