BEFRIENDAS study: The impact of befriending on depression, anxiety, social support and loneliness in older adults living in residential aged care facilities

INTERVENTION: Up to half of people living in residential aged care facilities (RACFs) have significant depression symptoms. Many residents are socially isolated in RACFs even though they are in communal living, and social isolation is a contributor to depression. The literature provides some evidence for ‘befriending’ in alleviating depression, anxiety, social isolation and loneliness as well as improving quality of life and wellbeing, but few studies have been conducted for older adults living in RACFs. Befriending is non‐directive emotional and social support generally provided on a regular basis by volunteers. Volunteers will be recruited and trained using beyondblue resources and a manual for befriending. Befriending will be delivered by volunteers to residents at least weekly for four months. Befriending will be one‐on‐one and preferably face to face at RACFs, but can include telephone calls or skype calls if a face to face visit is not possible that week, to accumulate 30‐60 minutes of befriending per week. Befriending conversations will consist of neutral topics of interest to both parties, including discussions around hobbies, family, neutral news topics, and other topics to be negotiated between the two parties and tailored to individual interests. Each befriending visit will be audio recorded to enable the project team to monitor a 10% random sample to test fidelity to treatment. CONDITION: Depression;Anxiety;Loneliness;Lack of social support; ; Depression ; Anxiety ; Loneliness ; Lack of social support Mental Health ‐ Anxiety Mental Health ‐ Depression PRIMARY OUTCOME: Depression as measured by the 15 item Geriatric Depression Scale[Baseline (T1), 2 months (T2) and 4 months (T3 ‐ primary endpoint) after the commencement of the intervention] SECONDARY OUTCOME: Anxiety as measured by the Geriatric Anxiety Inventory (20 item version)[Baseline (T1), 2 months (T2), and 4 months (T3) after the commencement of the intervention] Cost of delivering befriending based on quality of life measured by the EQ‐5D‐5L as the main measure of effectiveness[Baseline (T1), 2 months (T2), and 4 months (T3) after the commencement of the intervention] Feasibility and acceptability of the befriending intervention as measured by comments in interviews[Interviews will be conducted with up to 15 residents depending on data saturation. These interviews will be conducted at the conclusion of the befriending intervention.] Health service usage in 4 months prior to timepoint ‐ Total number of ED presentations, total number of inpatient hospital stays, GP consults, specialist consults (psychogeriatrician, psychologist, psychiatrist, other). This information will be obtained from resident files [Baseline (T1) and 4 months (T3) after the commencement of the intervention] Loneliness as measured by the UCLA Loneliness Scale[Baseline (T1), 2 months (T2), and 4 months (T3) after the commencement of the intervention] Social support as measured by the Lubben Social Network Scale‐6[Baseline (T1), 2 months (T2), and 4 months (T3) after the commencement of the intervention] INCLUSION CRITERIA: ‐Cornell Scale for Depression in Dementia (CSDD) score of 8 or greater as assessed by RACF at most recent ACFI review (no older than six months prior). The CSDD is routinely used in RACFs as part of funding reliability assessments and has been found to be a valid and reliable tool (Korner et al, 2006); and ‐Geriatric Depression Scale (GDS;15 item version; Li et al, 2015) score of 4 or more as assessed by research team. ‐GP Cog screen score more than 4 as assessed by research team (Brodaty et al, 2002) ‐either no, minimal or mild impairment on Psychogeriatric Assessment Scale – Cognitive Impairment Scale (PAS‐CIS; Jorm & Mackinnon, 1995) as assessed by RACF at most recent ACFI review (no older than six months prior) – score equal to or less than 10.