Recommendations

People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care.

Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

1.1 Principles of good practice

1.1.1 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 (see the sections on group-based activities, one-to-one activities and volunteering, and implementation). In particular, target older people who are identified as being most at risk of a decline in their independence and mental wellbeing (see the section on identification).

1.1.2 Involve older people in the design and delivery of activities.

1.1.3 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.

1.1.4 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).

1.2 Group-based activities

1.2.1 Provide a range of group activities, including multicomponent activities, combining 1 or more of the following:

1.2.2 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.

1.3 One-to-one activities

1.3.1 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.

1.4 Volunteering

1.4.1 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.

1.4.2 Provide opportunities for older people to volunteer.

1.4.3 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.

1.4.4 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.

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

1.5.1 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.

1.5.2 Ensure staff in contact with older people are aware of the importance of maintaining and improving their independence and mental wellbeing.

1.5.3 Ensure staff in contact with older people can identify those most at risk of a decline in their independence and mental wellbeing (see implementation section). 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.

1.5.4 Ensure staff in contact with older people give those most at risk information on activities that might help them (see the sections on group-based activities, one-to-one activities and volunteering).

Terms used in this guideline

This section defines terms that have been used in a particular way for this guideline. For other definitions, see the NICE glossary and the Think Local, Act Personal Care and Support Jargon Buster.

Age-related disability

Any physical or mental impairment associated with ageing, such as a reduction in, or loss of vision, hearing, mobility or cognitive ability.

Independence

The ability to make choices and to exercise control over your life. This includes being able to live independently with or without support.

Loneliness

Emotional loneliness is felt when people miss the companionship of one particular person – often a spouse, sibling or best friend. Social loneliness is experienced when people perceive that they lack a wider social network or group of friends.

Mental wellbeing

Emotional and psychological wellbeing. This includes self‑esteem and the ability to socialise and cope in the face of adversity. It also includes being able to develop potential, work productively and creatively, build strong and positive relationships with others and contribute to the community.

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.

  • National Institute for Health and Care Excellence (NICE)