Self-help groups

Promoting participation

Experts in self-help and gerontology have identified barriers to greater participation by seniors in self-help:

• mobility restrictions
• sedentary lifestyle
• reluctance to disclose personal problems to strangers
• lack of information on availability of groups
• availability of support from family and friends
• lack of information on how to form a group
• geographic distance.¹⁰

Efforts to remove these barriers will contribute to an increased participation of seniors in self-help groups.

The diversity of seniors' interests, needs and capacities emphasize the importance of matching individual seniors with an appropriate group. For some seniors and caregivers, for example, a telephone support network could be effective in reducing isolation and loneliness and providing social and emotional support, while for others the need to meet face to face would be paramount. In rural areas, factors such as distance to health facilities and the length of time between visits create a natural situation for self-care through self-help. Indeed, self-help is often thought to be an urban phenomenon, but in rural areas, it is often just an extension of existing mutual support networks among community members.¹¹

Randi Fine points to the need for sensitivity to issues and concerns that may emerge as individuals age and for attention to the special needs (if any) of older participants, such as proper lighting to accommodate low vision, sound enhancement for the hard of hearing, transportation, and accessibility of the meeting space.

Fine also notes the importance of outreach and marketing. Just 20% of the information and referral calls to Toronto's Self-Help Resource Centre come from seniors, so the Centre reaches out to seniors – in shopping malls, beauty salons, drug and grocery stores, and by promoting self-help to health and social services professionals.¹² Although seniors as a group are under-users of self-help, particular groups within the senior population are especially unlikely to turn to self-help. They include men, members of ethnocultural communities, and seniors with lower incomes.¹³

One obvious barrier to self-help for seniors may be the absence of a group on a particular issue. One survey, for example, reported a lack of groups on elder abuse, ethnoculturally specific groups, groups on macular degeneration and related visual impairments, depression and the older adult, and senior couples.¹⁴

The CMHA forum on self-help identified several structural supports that are missing: strategies for building awareness, public education, models that can be replicated, a national infrastructure, a research agenda, and increased funding. It emphasized that failing to capitalize on what self-help can offer seniors brings costs. Without recourse to self-help resources, the demand for professional services increases and the senior's support infrastructure is weakened. As a result, issues escalate, resulting in increased stress for the individual. When information and emotional support dwindle, the ultimate result is that conditions worsen to the point where care must become medicalized and more costly.⁷

Arguments based on cost containment do, however, raise concerns in the minds of many about whether authorities are looking to the self-help and volunteer sectors to shoulder responsibilities that more properly belong to governments.

What a self-help group can do for family caregivers • reduce isolation, give caregivers support and hope     • improve their problem-solving skills through meetings and telephone support     • give members an opportunity to ventilate their feelings and frustrations     • education and mutual support for members     • public education and advocacy for public support and services

The ripple effect

Many seniors are reluctant to share intimate feelings in a group setting, believing that you should "keep your own counsel" when it comes to personal problems. And how many more seniors miss out on what self-help has to offer through lack of information and awareness? Fortunately, it is in the nature of self-help to grow by the ripple effect.

With increased promotion of self-help, more and more seniors will experience its benefits and word of mouth will help to close the gap between what self-help for seniors is today and the wonders it will accomplish in the twenty-first century.