Social isolation Resources

People living within rural areas of Scotland, as in other remote parts of the UK, face certain challenges in relation to economy, transport, education and health. The definition of rural Scotland is defined as settlements with a population of less than 3,000, with these settlements further defined by postcodes and drive times to larger settlements. Also within such rural communities, there is a higher percentage of ‘older smaller’ households, where one or both adults are of pensionable age. In addition, remote rural areas have a higher proportion of single pensioner households (‘single older’) compared to accessible rural areas and the rest of Scotland (Scottish Government, 2021). Scotland’s population compared to urban areas as a whole is ageing, with a larger proportion of the population in remote rural areas now aged 65 and over, with a lower percentage of people aged 16–44 years old (Rural and Environmental Science and Analytical Services [RESAS], 2023). This paper highlights these issues and showcases the collaborative work being undertaken by Urram, a local charity to address issues residents face in a rural community on the west coast of Scotland.

A leg ulcer can be defined as a break in a person’s skin which becomes chronic in nature and takes longer than two weeks to heal (NHS UK, 2019). Evidence outlined by The National Institute for Health and Care Excellence (NICE) states that the prevalence of leg ulcers in the United Kingdom is around one percent over a lifetime, which still describes a large number of people (NICE 2022; Lim et al, 2018). The prevalence of leg ulcers continues to rise and a shift in lifestyle factors, including smoking and obesity, have contributed to this (Agale, 2013). Further risk factors for developing leg ulcers include immobility, advancing age, a history of varicose veins or deep vein thrombosis (DVT) and having a sedentary lifestyle (Scottish Intercollegiate Guidelines Network [SIGN], 2010; Lim et al, 2018). The challenge of caring for these chronic wounds often falls to staff in primary care. Therefore, they should have a good understanding of leg ulcers and how best to treat them. In the author’s opinion, Leg Clubs® provide an ideal opportunity to manage lower limb wounds, while also tackling the wider holistic issues of leg ulcers, such as social isolation and loneliness.

The recent pandemic has highlighted the impact of social isolation on health. District and community nurses are in daily contact with vulnerable, elderly clients for whom the norm is a world with little social contact. This compounds the health inequalities affecting this population. District and community nurses require support to meet the psychological and social needs of these clients. In order to improve the health of older people with long-term conditions, joint action between agencies, voluntary groups and charities is imperative. Inclusive and creative evidence-based interventions could be the public health solution to the emerging crisis in the psychological health of elderly clients with chronic conditions.

Dr Iain Foulds explains the incidence and nature of this form of eczema
Dr Iain Foulds is a Consultant Dermatologist.
Article accepted for publication: January 2005