elderly woman washing hands

What is Self Isolation?

To follow Government guidelines on Coronavirus and public health, everyone within the UK has been asked to stay indoors. But what is self isolation exactly? This article will discuss the details of self isolation along with how best to stay safe throughout the ongoing situation across the country. We will also discuss who is most at risk from Covid-19 along with the importance of social distancing even whilst self-isolating.

What are the government’s guidelines for self-isolating?

At the time of writing, the Government’s Covid-19 Action Plan, is at a stage that has widely been called a lockdown. What this means, is that leaving the house should be strictly for essentials and exercise. Fundamentally, this is limited to minimal journeys for food or medicine along with exercise in your local area. For those that are unable to work from home, lockdown also allows for journeys to and from work. Where possible, journeys for food and medicine should be avoided. Many supermarkets are offering improved delivery services to accommodate demand and pharmacies across the country are delivering prescriptions.

The lockdown is being enforced across the country to reduce all non-essential contact and curb the spread of the virus. That is why the Government has also advised social distancing, meaning that whenever you do need to leave the house or have necessary visitors you stay at least 2m away from them With the virus having an an incubation period of up to 11 days and some people only showing very mild symptoms when they do get it, it is possible that someone that does not look ill could pass it on.

While much is unknown still about the virus, there have been some consistencies amongst those most affected by Covid-19. So far, it is those over the age of 60 that have been most at risk of developing severe symptoms. Here’s some underlying health conditions that can exacerbate the illness.

  • Breathing problems – those with asthma, bronchitis, lung cancer or any other respiratory issues must be particularly careful as Covid-19 affects the lungs.
  • Diabetes – those with both type 1 and type 2 diabetes are at higher risk.
  • Hypertension – high blood pressure  is a risk for anyone developing Coronavirus, particularly those that have had organ transplants.

How to stay safe while self isolating

For those that are particularly vulnerable, self isolation can be particularly daunting. It’s hard enough when you lose lose social visits. Keeping healthy is hard wile mobility is limited and you’re staying inside. It is important that self isolating is done as safely as possible to protect your physical and mental wellbeing. Here are some of the key ways to minimise the risk that might result from self isolating for older people:

Care Visits and Prescriptions

For those that require a carer, it is still important to practice social distancing wherever possible and keep contact to a minimum. Similarly, carers should be taking all hygiene precautions, such as using sanitised gloves and face masks where possible. Should a carer show any symptoms of the illness, such as a dry cough or fever, is is worth requesting a different carer to visit in their place.

Many pharmacies across the country can arrange to have your prescription delivered. It is worth finding out if they provide non-contact delivery services to a person who is at risk. Pharmacies across the country are developing these non-contact delivery services to assist those most at risk.

Personal Safety

With many elderly people living alone in the UK, self isolation can be particularly isolating. For those with health or mobility problems it can also be dangerous. All of the ‘normal’ health threats remain as well as COVID-19. That’s why it is important to keep up regular communication. It’s vital to check in on those that are more vulnerable at this time. Keeping to a regular daily time for calls can help provide some peace of mind throughout the self isolation period.

The Assure personal alarm bracelet can also be used to monitor the safety of those that are more vulnerable. The wristband provided a combination of alert triggers to provide comprehensive protection.

If the wearer gets short of breath or experiences pain a squeeze of the band will call for help; it can also monitor for severe falls. Te I’m OK checks are the simplest way for the wearer to confirm they are OK periodically throughout the day.

Get in touch

If you have any questions about self isolation or would like know more about the Assure personal monitoring system, please get in touch. Simply call us on 0345 25 75 080 or email us and one of our helpful team will get back to you as soon as possible.

Woman gardening wearing emergency alarm wristband for elderly and disabled

Making the most of Social Distancing and Social Isolation can seem like hard work. We know we have some tough times ahead but we need to look for the silver linings in the clouds and make the best of a bad lot.

Making sure we are aware of what these words mean is important, and actually they refer to physical distancing and isolation.

50 years ago, being physically distant automatically meant someone was socially distant too. A lucky few would have access to a phone and could dial a friend and have a one to one chat, probably sitting by a telephone table in their hallway. That you are reading this online is a testament to how far things have come. Physical isolation does not mean social isolation and may even offer opportunities to reconnect with old friends electronically who we have lost touch with.

What we know about COVID-19 is that it is highly infectious and that it tends to have relatively mild effects in people below the age of 50 who have no existing medical complications, but as the age and medical history increase so does the death rate.

Though nobody can truly be said not to be at any risk, we must all take sensible precautions to try and give the more vulnerable among us the best chance of not being struck down.

This is where ‘social distancing’ and ‘social isolation’ come into play.

Senior Man Doing Crossword Puzzle In Garden

What is Social Isolation

Social Isolation is trying to stop all but the most essential contact. You might have heard of it as Quarantine. At the moment this is self-imposed by households where someone has symptoms or where they have recently returned from a notified area. Those in isolation should not venture outside unless they have to. They should try and have any shopping delivered to their doorstep. There are health benefits to going outside and health secretary, Matt Hancock, has said ‘People should go outside. Yes, walk your pets, but, if you’re in household isolation, do go outside but try to avoid other people.’

‘Lockdown’ is a more aggressive version of Social Isolation where it is enforced by the police or army. We are not there yet (19 March 2020), and hopefully this can be avoided.

What is Social Distancing

Social Distancing is the current instruction. This is a softer version of social isolation where non-essential work is still happening with people travelling to and from work, public transport is still available to all, though we are advised not to use it and it is OK to walk with friends in the open air as long as we keep a sensible distance and keep washing our hands. We are also advised to keep going to the shops but to keep our distance from other shoppers.

However, both of these scenarios involve us being in direct contact with people less and being physically isolated more.

Physical isolation could mean social isolation and before technology was so widely used probably would have done. However, there is so much we can now do to combat that sense of social isolation to minimise the problem, and could even offer a few opportunities, perfect for making the most of social distancing and social isolation.

Making the Most of Social Distancing and Social Isolation
Old technology

If you live in a small community, and are able to, why not start a telephone tree. This needs someone to coordinate it and make sure a printed sheet goes through the door of anyone who is ‘off the radar’ asking them to give you some contact information to be used during distancing/isolation so that the community can be confident everyone is OK. Be explicit about the use and keep these records with sensitivity, but frankly there are bigger fish to fry than full compliance with General Data Protection Regulations at the moment.

Older people are often reluctant to ask for help until a problem turns into a crisis. It may take some convincing to get people to offer their telephone number as they think they will not be affected. Make sure everyone gets a call at least once a day – twice would be better – even if they are feeling fine. Have a few questions to make sure people are alright and have food and other essentials but if anyone is particularly vulnerable make sure you can give them some time so they are reminded there are people in their community who care and are there for them if they need it. Make sure there is a roster of people who can help by getting essential shopping; leaving the shopping on the doorstep does not risk infection.

Using people who are normally socially isolated can be great for the caller as well as the callee. We benefit from having a sense of purpose and the caller is connecting with more people than those receiving a call. Make sure that everyone gets called, including the callers, they might need help too.

Create a community store/resource. If someone needs a food parcel or some painkillers at 8pm on a Sunday night could you muster some up from people in the community or from a store rather than having to wait for the shops to open?

Making the Most of Social Distancing and Social Isolation
New technology

People having access to the internet can be a real boon if you can’t get out. Is there a neighbour who doesn’t have access that you could lend an old iPad to and show them how to do a few basic things. Is their house covered by a neighbours WIFI that they could borrow? If so, you can help them keep up to date with the latest news and be linked more to the village community.

There are lots of ways of using the internet to keep connected. You may already be aware of these but if not see if you can get connected to them and try them out. You are better to establish your use early rather than waiting until you need it.


This is a fantastic way of keeping in touch with family & friends when making the most of social distancing and social isolation

As well as sending messages you can have phone calls and video chats with up to 16 people, but more usually just with one or two people. This medium lends itself to quite intimate conversations as well as general keeping in touch.

WhatsApp needs the user to have a mobile phone even if they use the desktop version. If you don’t yet have it is well worth getting as you can still see people face to face when you can’t see them in person.


There are three main advantages of using Facebook
This is a big Social Media platform and has the following uses:

Keeping in touch with family, friends and acquaintances.

You connect with people you want to (and who agree to connect with you) and people share what is happening for them, what is of concern or often just things that have made them smile. You can respond to what people say and start conversations. Generally, the tone of the discussions are like you would have if you bumped into someone in a café or bar. You can get started by joining, finding a few people you know and putting in a friend request. You’ll then be able to get an idea by seeing what is going on before making your own post.
You can also send direct messages to individuals through a facility called ‘messenger’

Keeping in touch with what is going on in a location or interest group.

There are also community-based bulletin boards where information for the benefit of a particular group (geographic or interest) can be shared. Be careful about what you see on Facebook as people can inadvertently pass around false news and rumour, so anything factual or medical should be checked to see if you can find a reliable source saying it.

Online games

In the Facebook ‘explore’ menu there is a link to ‘Games’ if you choose a game to play you can invite specific friends, groups or anyone you know to play an online game with you.
So even if you can’t meet in person for Bridge Night, you can electronically. There are games of all sorts (strategy, action, quizzes) and for different numbers of players. You can use messenger to have a conversation while you play.

Video Conferencing

This lets you speak face to face to anything from 1 to 100s of people. If you don’t have WhatsApp or want to connect with people who aren’t on WhatsApp you can get a free video conferencing account.
Personally, I find www.whereby.com very easy to use as I give people a web address to visit. 4 people can meet in a free account which is often enough. www.zoom.us also have a free plan but this involves downloading and running a small programme which might put some off.

Some of the opportunities for video conferencing:

Coffee mornings

If you can’t meet in the café, you can continue to see each other. There are some advantages too, as you no longer need to spend time and effort getting to the meeting place you can meet more frequently, perhaps three or more times a week where you only used to meet once. You might even think of including people who have moved away as now distance is immaterial, this could be a chance to reacquaint yourself with old friends.

Watching TV together

This sounds odd but when making the most of social distancing and social isolation, provided you watch the same TV programme live, you can share the experience a bit like being in the room together. Whether is adds spice to quiz shows or makes comedy shows funnier (have you noticed that you don’t laugh in the same way when you watch a comedy by yourself?) or just adds a bit of company this is something worth trying out.


Without intending to hark back to the blitz spirit, many of us have seen how the singing from balconies by those isolated in Milan has been uplifting. As video conferencing can have hundreds of participants there are singalongs organised in some communities. You don’t need to be good at singing but can join in for the craic.

Music/Poetry groups

See if you can keep doing those things that give you joy.

Getting help in an emergency

Some people have been waking up finding it is difficult to breathe. Think about how you would get help in such a situation. Telephone trees would be good but might take some time to for people to realise you need help.

Please consider a getting a device like the Assure to make sure that if you are isolated and have any need (non COVID related incidents will continue to happen) you can get help.

We didn’t design the Assure specifically for pandemics but for anyone when spends time alone and could need help, programming an I’m OK check every few hours is such a simple way to confirm you don’t need help and along with its SOS buttons and fall monitor it could be ideal for getting through isolation with peace of mind that if the worst does occur you can easily get help.

Learning remotely

How many people have said ‘I’d love to learn about x, y, or z, if only I had time’.
If you find you have lots of time on your hands there are loads of online courses. There are a few things you can’t learn online, swimming for example, but there are lots of things you can learn, or at least learn the theory side of before getting the practice in once freedom of movement is back.

Futurelearn is a great place to look as it aggregates courses run mainly by UK universities. Access to the course learning is free. Find out more at www.futurelearn.com

If you’d like to get to grips with a language there is a page full of advice at www.bbc.co.uk/languages/learn/

Keeping fit

Getting out is normally a key part of keeping up levels of exercise, if you are stuck indoors it is still important to maintain fitness as best you can. The NHS have some online classes for you to follow where you get to choose the type of exercise that is right for you. 

Visit www.nhs.uk/conditions/nhs-fitness-studio/ to find out more.


Most of us are grateful for those in our community who are keeping essential services going. Working in health or social care at the moment is difficult as is trying to keep shops functioning and a myriad of other services that will help us to get through this crisis. When you see someone who is working under pressure, if you are grateful, let them know it.



Understanding COVID-19

Bringing information together from various sources to understand more about COVID-19, why we should be concerned, how to avoid it and what to do if you think you have it.

Why Coronavirus COVID-19 is different from flu

Transmission methods


Transmission period

According to the US Center for Disease Control & Prevention (CDC), the prime time for transmission for flu is in the first 3 to 4 days of illness though it is possible to spread it a day before the illness becomes evident and up to 7 days after it starts.

Transmission methods

It is transmitted by respiratory droplets – from coughs, sneezes or normal speech landing in the mouths or noses of people nearby.
It can also be transmitted by contact with a surface that has such droplets on it. Contact with the skin is not enough and the recipient would then need to touch their mouth, nose or eyes.
Combined this means that Flu is reasonably difficult to catch provided the following sensible precautions are taken:

  • don’t visit someone who is displaying symptoms unless it is necessary
  • always wash your hands before touching your face and eating
  • encourage others to cough into the crook of their elbow, where any germs are less likely to be passed on.


Representation of Covid-19

Transmission period

Is transmittable for up to two weeks before the person is showing signs of the disease as well as when there are symptoms. Some people are atypical meaning they will never develop symptoms but will be carrying and transmitting COVID-19.

Transmission methods

It is acknowledged that COVID-19 can be transmitted by respiratory droplets. Evidence is also emerging, unusually for the family of viruses known coronaviruses, that it might be possible to transmit through the following methods, as well:

  • Fomites – surfaces on which the virus can survive, such as furniture, sheets, tools and clothes. The latest NHS advice is that ‘Viruses like coronavirus cannot live outside the body for very long.’ However, studies have demonstrated similar viruses surviving for up to 9 days. Thankfully they are easily killed with disinfectant. This has a low risk of infection. (click here for report)
  • Fecal-Oral: essentially touching something that has been touched by someone who has not washed their hand properly, for instance on a toilet door handle and eating. Though this is a new method of transmission for a coronavirus the Wuhan Institute of Virology has found the virus in oral swabs, anal swabs, and blood. (click here for report)
  • Airborne (aerosol), which does not need immediate or recent proximity to an infected person. Though it has a lower risk of infection, if this is true, visiting someone infected at home would carry a risk even if you did not touch anything.
    This has a low chance of contagion but has been noted in China’s clinical guidelines since late last month. (click here for report)


The variety of ways that COVID-19 can be spread along with a substantial period when someone can be inadvertently spreading it makes the virus highly contagious. Though we are still learning about the virus, Marc Lipsitch, a Harvard epidemiologist, estimates that within the coming year 40-70% of people will be infected with the virus.

Direct effects of COVID-19

After infection, some people will remain atypical and not show any sign of infection. This is known as some countries have mass screened citizens rather than just those suspected of having the virus.

Early-stage symptoms are fever, cough and shortness of breath. There are many causes of such symptoms and few of us have got through life without experiencing this combination of symptoms, so if they occur follow the latest NHS advice but don’t panic.

With COVID-19 this can persist and develop into pneumonia meaning 20% of those infected will need hospitalisation.

Approximately 25% of those will need intensive care for respiratory support.

Ultimately there are two outcomes from contracting COVID-19, recovery or death.

Mortality rates are very difficult to ascertain as treatment methods improve. It appears that overall mortality is 1-2% but this is hugely skewed towards the older population. Figures released on 29th Feb show no deaths below the age of 9 years, less than 0.5% to the age of 50 and then rising to 14.8% among over 80’s. This is unusually skewed as most viruses have higher mortality rates among both the young and the old.

Flu has 5-7 times the mortality rate in an 85-year-old compared to a 50-year-old whilst COVID-19 is more like 30 times as lethal.
As there are roughly 2.8m people over the age of 80 living in the U, if 40% of them contract COVID-19 that is approx. 1.1m people and could lead to 150,000+ deaths due to the virus, in this age group alone.

To put this in perspective, the report Surveillance of influenza and other respiratory viruses in the UK Winter 2018 to 2019 – Public Health England expects annual deaths due to flu, for all age groups, are generally between 6,000 and 15,000.

Wider effect on Society – side effects

The Government is planning for many possible effects and though they have not yet implemented any changes in behaviour and are encouraging people to carry on as normal, it is highly likely that instructions will have to be issued in the coming days and weeks which mean it will no longer be ‘business as usual’.

Schools may have to close and young children will need to be looked after and parents given time off work to do that so many other areas of life might become short-staffed. The NHS will have a huge burden placed on an already busy service, as potentially thousands of people need intensive care, and may not be able to respond as it normally would to other medical needs.

Bearing in mind the infectiousness of COVID-19 it is not just about treating patients but treating them in isolation to minimise cross-infection. This is a heavy burden and other NHS services that are normally available could suffer as a result.

If interaction with other people is kept to a minimum that will impact the ability of stores to restock and may have knock-on effects into whether interaction that is considered non-essential can continue.

There is a chance that many people will be asked to self-isolate either as they are showing symptoms of COVID-19 or as a quarantine measure as in China. All sorts of services which we expect to be available could be short-staffed and unable to operate as normal.

What can we all do about it



If you don’t come into contact with the virus you cannot contract the disease. However, as the virus is highly transmittable this is difficult to achieve. You might try to lessen opportunities for infection though.

  • You might like to consider what activities are necessary for you – including those that are needed to keep your spirits up.
  • Walking, alone or with friends, is relatively risk-free and could be a better option than meeting up for a coffee where there are more communal surfaces and items the virus could be transmitted on.
  • Try not to touch anything outside of your control, e.g. let the person hold the photo and show you rather than passing it around.
  • If you have to take things to someone in quarantine, try not to touch anything you haven’t brought. Use your mobile phone to say when you have arrived and get them to open the door rather than touching the door furniture. If you want to greet with physical contact would an ‘elbow bump’ work?
  • Keep some hand sanitiser with you so if there is contact you can wash it immediately.
  • If you are losing regular contact, consider how to make sure you don’t end up isolated in an emergency. Just because COVID-19 is active you will not be less likely to have any of the other illnesses or accidents that would need help. If you have the Assure you can get help easily, but if you don’t you might want to make sure you have methods in place to make sure you don’t end up languishing.

Full advice is available from the World Health Organisation, here.

Plan as if you were going into quarantine

If you do have to isolate yourself do you have what you need to remain comfortable for up to a fortnight? Think about what would happen if the person who normally looks out for you was also in quarantine and unable to visit.

This includes thinking about:

  • Enough canned and dry goods to get you through.
  • Consider what you might use in your bathroom in a fortnight.
  • Think about your pet’s needs.
  • Always having a fortnight’s store of essential medicine (ask your doctor).
  • Entertainment – if you are a very social person how are you going to fend off cabin fever?
  • Letting people know you are OK. If visits become difficult or impossible phone calls can help and the Assure’s I’m OK function is a great way to confirm you are OK periodically throughout the day, you choose the times for the wristband to vibrate and just press a single button to confirm you are OK.


This is general advice but you might be particularly vigilant whilst COVID-19 is active:

  • don’t visit someone who is displaying symptoms unless it is necessary.
  • always wash your hands or use hand sanitiser before touching your face and eating.
  • encourage others to cough into the crook of their elbow, where any germs are less likely to be passed on.
  • mobile phones harbour germs and avoiding contact with your face can help, though it might feel odd speaking on handsfree this could help. You could even turn a phone call into a video call and improve the experience.

If you think you might have COVID-19

Get the latest advice from the NHS.
This is available by calling 111 on your phone or by visiting https://111.nhs.uk/covid-19

DO NOT visit your GP
GP’s surgeries have many medically vulnerable people visiting them and we all have a responsibility not to behave in a way which is likely to spread COVID-19 or any other virus.

Living in isolation

If you are in quarantine it may be that you have tested for COVID-19 or that you are at risk from it. Either way, the following advice stands.

DO NOT take antibiotics for COVID-19
Many of us have spare antibiotics in our homes, perhaps from old prescriptions. Whilst antibiotics can be very effective against bacterial infection, they have no benefits in treating viruses. Use of antibiotics when you don’t need them may lessen their effectiveness when you do need them.

Eat and drink well
Make sure any food you have is sustaining. Though it is a cliché, chicken soup does seem to have curative properties (see New York Times article). Make sure you remain hydrated.

Exercise and sleep
Don’t be a couch potato. Whilst you don’t have to go as far as one person in China who ran a double marathon in laps of his living room, it is worth making sure you compensate for the lack of outdoors activity. Perhaps look for an exercise programme online (perhaps on youtube) or crack out the Jane Fonda DVDs.

Sleep is also important as this is when your body has a chance to recharge and continue its fight to recover.

Looking after each other

Please look out for others in your community who may be self-isolating. You are probably already aware of your family situation but look out for neighbours. There may be some shopping they need, and leaving shopping by their front door does not break their isolation.

Bear in mind that in ‘normal’ times there are many illnesses/mishaps that can befall a person, so just checking they are OK is valuable. You could do this by knocking on their door, phoning them or – if you have an Assure system – checking on their dashboard.

Informative links

CDC latest information: click here

Johns Hopkins University interactive map showing the latest stats: click here

Informative article with loads of references: click here


Brew Monday

This is an idea about how we can combat Blue Monday. Today is officially meant to be the most depressing day of the year (at least things can only get better). The Christmas decorations are down, the days are still short and it is a long time until the next significant break for many of us.

London Underground notice board poem about Brew Monday

Just to compound matters we have just started a cold snap. The forecaster’s advice is to check on older or vulnerable people and make sure they are OK.

There is an increased risk of stroke in the cold. Bear in mind that, even if the person is wearing extra jumpers, if the air they breathe is consistently below 18 degrees C they will become more susceptible to respiratory infections. If someone has a broken heating system this is when it might become apparent. With an Assure system you can look online to make sure that the home is warm and even set a minimum temperature so that if the person is at home and the temperature drops below this minimum you will get a message to let you know – we call it the ‘cold at home’ alert.

Many in our communities have fading eyesight as they age making them less confident about going out at night and the long dark evenings can leave them feeling isolated.

Brew Monday

So far Blue Monday doesn’t sound like a bundle of laughs, but ‘Brew Monday’ does its best to ‘turn that frown upside down’. If you were passing through some London Underground stations you might have seen this poem on a notice board.

Instead of feeling blue, connect with someone. Ask a neighbour over, put the kettle on, brew some tea and have a chat. It doesn’t need to be over anything important. If you don’t know what their favourite pasta shape is that could be a starting point. If they are uncomfortable coming out at night, take some cake around and ask if you can share it.

As the poem suggests, it doesn’t need to be at home (is there someone who might appreciate a trip to a pub for a different kind of brew?) and it doesn’t have to be today – but today is as good a day as any!

It is important in the colder weather and long nights that those of us who can look out, for those who need it.

As the Zulu idea of Ubuntu proposes, we are defined by how we relate to those around us (they say ‘I am because we are’). So let’s put in a bit of effort to connect – over a brew.

To find out more have a look at the Samaritans information page.


Age Apartheid

Age Apartheid

A new report by ‘United for all ages’ (https://www.unitedforallages.com/) highlights that the UK is one of the most age segregated countries in the world. Intergenerational living, either in the same house or local area, was not unusual. Close proximity could mean seeing elderly relatives several times a week.  In recent times this has become rarer resulting in more older people reporting feeling lonely and generally excluded from their community.

Teenage Boy Helping Senior Woman with Shopping

There are benefits being missed by the younger people too. Being able to pop home for a meal and a chat or having someone who might have the time to wait in for a delivery when you can’t. How many of us enjoyed spending times with grandparents when we were very young? and how helpful was that for our parents.

One of the reasons for this drift (the young to the cities) is that working aged people often find employment in the large urban centres, resulting in them both living and socialising there. They may also prefer the social life afforded by a city. On the other hand, retired people can find a lifestyle they prefer away from the city. They might also find that by swapping their city property for a country one they have more money in their pocket to enjoy.

These tendencies to have been around for some time but have got greater over the last decade as service industries based in offices have dominated employment compared to manufacturing based in factories which were more geographically spread.

What can be done

No doubt there are structural issues in society which could be addressed. With better transport infrastructure more people could stay where they grew up and commute. Even in areas like London, which have good transport coverage, there is difficulty coping with demand. Roads are highly congested and public transport very crowded. Other parts of the country are lacking public transport. Better public transport would enable some workers to live further from their workplace and closer to their family.

What you can do

In the meantime, we have the benefits of the internet age to help keep us in touch. Skype and WhatsApp both enable video calling on a laptop or smartphone. If someone you’d like to feel more connected with doesn’t yet have any IT then Portal from Facebook might be worth exploring.

The point of the report is not be fatalistic but to highlight the sorts of things we can do to improve intergenerational integration. Though families may be dispersed there are still ways of encouraging mixing between the generations with our localities.

Some interesting ideas include:

Our own experience at Acticheck is that there is a massive amount of neighbourliness and people are generally happy to look out for and after each other.

If you’d like to see our communities more linked across the generation do consider signing up for the United for all ages network (www.unitedforallages.com/join-us). This will keep you in touch with what is going on and offer support with local projects.


Artificial intelligence

Using Artificial intelligence in triage

Artificial Intelligence (AI) is an automated way of processing information. In this case, a computer system has been taught about medical conditions their symptoms. It asks questions to narrow down the possible causes and decide the priority the medics should give to it.

Human machine analysis

If you speak to someone on NHS 111 they will be using AI to take your answers and to ask the next question, until the system makes a recommendation. You can also do this yourself online at www.111.nhs.uk whenever you feel worried about a condition.

The at-home service will become even easier as the NHS has entered an agreement with Amazon so their Alexa platform will be able to answer your health queries. You will get advice just by talking to Alexa. (read more on this here)

There is some debate about how much Alexa should guide an individual’s health. Should it listen for indicators of suicidal thoughts (more here); and what does that do for individual privacy. Even the most ardent protector of personal privacy might soften if someone they loved was saved by an intervention because of ‘listening in’.

Some hospitals, such as Birmingham University Hospitals, are encouraging patients to undertake a two minute “artificial intelligence triage” before they consider attending hospital. This could instead direct people to their pharmacist or possibly advise people to call 999 for rapid assistance (read more here). Some hospitals have booths set up so when you first arrive you can enter your symptoms.

Spotting hidden urgent conditions

Many people have been surprised by the effectiveness of these AI systems.

A&E is often operating under pressure and humans naturally will go towards the obvious need. However, there are a number of conditions that don’t present dramatically but where speed of treatment is vital. For instance, strokes and sepsis are two conditions where early intervention can dramatically improve the outcome and where delay can cause life changing outcomes or even death. You may have heard of the ‘golden hour’ for strokes but many patients may present with cuts & bruises after a fall and not realise they have had a stroke. Likewise Sepsis (www.sepsistrust.org ), which kills 52,000 people a year, often presents as a general lethargy and occasionally people can be sent home to rest when they desperately need medical assistance.

With the pressures on A&E departments, many are missing their targets to see patients within 4 hours, when for some patients being seen immediately is paramount. Having pods where patients go upon arrival to fill in an electronic questionnaire may seem impersonal but it is a very efficient way of getting the information, perhaps because the machine will not get side-tracked by chatting about the weather, last night’s football scores or ‘Strictly’.

Other than the speed of collecting the right information, the major advantage of AI is it has machine learning and can scour through millions of individual’s records for combinations of symptoms that match. By tracking the eventual, confirmed diagnoses of patients with matching symptoms there is a stronger idea of your diagnosis. This is particularly impressive when separating out symptoms that may be due to overlapping issues.

Evin if your pattern of responses to the questions has only been seen 5 times throughout Europe, AI will find them all in seconds and include their end diagnoses and prioritise you accordingly.

Once you are in the NHS system you will then be cared for by professionals (humans) but AI can help get you to the right starting place faster and more reliably.

Staying warm at home

Knowing how warm a house is saves lives

Even if you feel ‘warm enough’, if the air you breathe is less than 18C respiratory infections become likely. A major problem at this time of year is people not realising their home is too cold. The NHS give some useful advice (below) and Acticheck have a ‘Cold at home’ warning which can help.

A forest in winter.

NHS England ‘How to stay warm and well in winter gives the following advice:

  • if you’re not very mobile, are 65 or over, or have a health condition, such as heart or lung disease, heat your home to at least 18C [optimal temperature is 21C]
  • keep your bedroom at 18C all night if you can – and keep the bedroom window closed
  • use a hot water bottle or electric blanket to keep warm in bed – but do not use both at the same time
  • have at least 1 hot meal a day – eating regularly helps keep you warm
  • have hot drinks regularly
  • draw curtains at dusk and keep doors closed to block out draughts
  • get your heating system checked regularly by a qualified professional

Why monitor?

People don’t always realise when they are getting too cold and so the Acticheck ‘cold at home’ warning indicates when there might be a problem. It could be the thermostat needs adjusting or there is a problem with the boiler. If the wearer is at home and the temperature is too low their responders will get an email. In addition, by enabling the ‘frost monitor’, the wearer and all responders will receive a warning email if the temperature falls below 5C when the wearer is not at home.

How to make use of the Acticheck ‘Cold at home alert’

  1. Go to MY BASE and then look at the bottom right of the screen (see below),
  2. Turn the ‘Enable room temperature monitor’ on,
  3. Set your minimum temperature*,
  4. Set the time window to be monitored,
  5. Then press Save (top right).

Settings for Cold at home

*Bear in mind the base station reports on its ambient temperature and you may need to make adjustments if it is not representative of the general household level. You can see the general temperature trend on the chart in MY BASE.



Creativity and spirituality

The previous parts of this guide is aimed at ensuring you can age healthily by being best placed to meet your ‘physiological needs’ over the longer term, however the guide would not be complete without exploring creativity and spirituality.

Three standing stones of the Ring of Brodgar

“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you not to be? You are a child of God. …”

~ Marrianne Williamson (full quote below)


Creativity is exploring how to do things differently, like an artist adding more techniques. Probably they will never revolutionise their established way of doing things but from time to time they might find that their exploration re-engages them with how they were doing things before and changes things in a nuanced way. Some may find things they enjoy and bring it into a portfolio of work or like Picasso you might find what you do transformed from time to time. It is never too late to join a choir or write a memoir.

The Arts are great ways of getting creative and there are so many things to see and to do yourself. The Arts can demand that you stretch yourself emotionally and can give you new ways of seeing the world. If you can, commit to seeing or visiting two things a month for the next six months and set aside two hours a week to learn a new creative skill which demands your invention and engages your emotional side. Painting, pottery or writing are suitable but crochet, where you are following a pattern does not engage your creativity in the same way.

Travel can also be a fine way of expanding your horizons (literally) and seeing how others live their lives gives us permission to see our own lives differently.


For millions of people, their religion or spirituality is a core part of their being. Many would not use those words, yet they too face the big questions of life – Do I have a purpose? How do I live well? What do I owe other people?

We can have different ideas about many things, but most of us accept that our life on this earth will end. Some people may simply dismiss all this and concentrate on enjoying life, helping others, and sorting things out so as not to leave a muddle when they do go. There are far worse approaches to life. However, as we get older, this may spur you to think more deeply.

Here are some thoughts for those who want to go further.

Your religion and its community may become more important to you and it might be a time to become more involved. Questions may be thrown up which take you exploring in other directions. People who ‘gave all that up at school’ may revisit that decision.

The majority of us don’t belong to an organisation with a formalised system for exploring how to live. Even those who do may differ very much from each other in terms of how they live. It is worth remembering that for many people familiar practices, festivals, and the community of the faith matter more than the fine detail of beliefs.

Wherever we start, we are on our own journey, and even if we find answers, they may not be those other people find.


“Rivers, ponds, lakes and streams – they all have different names, but they all contain water. Just as religions do – they all contain truths.”

~ Muhammed Ali


Many religious organisations have formal worship, social activities, or courses to find out more. Some might enjoy Evensong or Taize singing without being committed church goers.

Some offer a safe space or community for you to explore your thoughts and do not have expectations of beliefs.

You can consider a practice which takes you out of yourself through physical exercise and has spiritual aspects which makes no demands on what you believe. Yoga and Tai Chi are good examples. Some people like solitary reflective practice outside such as walking in a park, the countryside or by the sea.

Meditation and mindfulness etc are often taught as techniques without much emphasis on the underlying philosophies.

If entering a new group, is it friendly and open? Are allowances made for new people? If the emphasis of the group seems to be money, laying on guilt, or exerting pressure, then be wary. Ask trusted family and friends for recommendations.

You could also consider:

    • Philosophy groups
    • Lectures or discussion groups, or good courses on science or history.
    • Walks and simple activities where you attempt to be more ‘present’ than usual and notice what is around you.
    • Book Groups
    • Yoga groups: try gentle ones if you are starting out, and ideal for keeping fit too.
    • Tai Chi
    • Art groups
    • Communal singing
    • Local places of worship and set yourself time limits when you will review your experience and see if this is nourishing.
    • A pilgrimage or retreat: this does not need to be of a group that you particularly agree with but being in a group of people with a shared intention is powerful and may move you on your journey.

The point of this discussion is simply to say that thinking about life as the end gets a bit closer is natural. We have choices how we live, which affect us, our immediate surroundings, and the community. Every stage of life has opportunities, and you may have time to explore. Fortunately, we are not all required to think or be the same.


The full quote from Marrianne Williamson:

“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us.
We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you.
We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone.
And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.”

Healthy Active Ageing

This post is the final section from Healthy Active Ageing, a series of mini-guides that together cover most of what we can do as human beings to make the later stages of our lives as positive as they can be. If you complete the details below we’ll email you one of the guides every until you have the full set. You will know a lot of the information but there is nothing wrong with a reminder every now and then; and there may even be some information which is new to you.



Reducing Stress


Identifying and reducing stress

“In times of stress, the best thing we can do for each other is to listen with our ears and our hearts and to be assured that our questions are just as important as our answers.”   ~ Fred Rogers

Important: health warning If you think you are currently in an emotional crisis you could contact the Samaritans. You can call them free at any time from any phone on 116 123, email jo@samaritans.org or you may have a branch near you that you can visit (see samaritans.org/branches).

Stressed man

Identifying the cause of your stress

Whatever event or situation is stressing you, there are ways of coping with the problem and regaining your balance. Sometimes a therapist can help you to identify what is bothering you and help you to regain your life balance. Sometimes simply considering matters yourself in a moment when you are more relaxed will reveal your issues and potential solutions. These are some of the most common sources of stress for you to consider:

Stress at work

While some workplace stress is normal, excessive stress can interfere with your productivity and performance, impact your physical and emotional health, and affect your relationships and home life. It can even mean the difference between success and failure on the job. Think about what you can do to protect yourself from the damaging effects of stress. There might be simple things like wearing headphones to cut out noise, or getting a headset to make phone calls easier, or it could be that you are at a stage where you are ready for a different challenge. If you find yourself stressing about work the day before you are returning then speak with your Human Resources department.

Retirement & unemployment stress

Losing a job is one of life’s most stressful experiences. It’s normal to feel angry, hurt, or depressed, grieve at all that you’ve lost or feel anxious about what the future holds. Losing a job is far more than just losing income. It can be a change of identity and a loss of purpose which can rock your sense of purpose and self-esteem.

While the stress can seem overwhelming, there are many things you can do to come out of this difficult period stronger, more resilient and with a renewed sense of purpose. If your change is due to retirement then try activities that give you a sense of purpose. These could be projects in your home & garden, helping your family, volunteering with a local charity or project or if you have business or other relevant skills offering to be a trustee. Many people who retire can find a renewed sense of purpose and drive and also that they have less free time than when they were working.

Caregiver stress

The demands of caregiving can be overwhelming, especially if you feel you’re in over your head or have little control over the situation. If the stress of caregiving is left unchecked, it can take a toll on your health, relationships, and state of mind — eventually leading to burnout. There are charities that can offer support and also put you in touch with respite opportunities. Using a suitable device such as the Assure can give you more day to day freedom. knowing the person you care for can alert you if they need to, gives you more time out, perhaps catching up with friends, than if you are constantly worried when you are out on a task.

Grief and loss

Coping with the loss of someone or something you love is one of life’s biggest stressors. The pain and stress can feel overwhelming. Many people experience all kinds of difficult and unexpected emotions, from shock or anger to disbelief, guilt, and profound sadness. There are ways to cope with the pain and emotion of loss. Cruse Bereavement Care has excellent advice and resources for those who are having emotional difficulties due to loss.

Financial stress

This can be caused by having too much as well as too little money and typically results from a lack of financial planning that can lead to debt. It is easy to lose control of your finances and this can lead to stress. Managing your money can be a complicated task so either take the time to learn how to do it or seek expert advice. Most importantly, do not be taken in by any ‘get rich quick’ schemes.

Addiction/dependency stress

This is a specialised area but many people have suffered from addictions and help is available. The ‘Anonymous’ networks (such as Alcoholics Anonymous) have a tried and tested system or your doctors should be able to point you in the right direction. Mind.org.uk maintain a list of addiction and dependency services which you can visit by clicking www.acticheck.com/dependency

Event/situation based stress

Often people find themselves under stress because of illnesses or conditions they find themselves or loved ones with. Usually there are specialist charities where people understand the stresses related to particular medical conditions or life events. Seek them out and speak with them. They will be able to point you towards resources that others in a similar situation have found helpful both emotionally and for extra costs associated with a condition; and it is good to know there are others in the same boat who are willing to support each other and who understand.

Trauma stress

At the moment of a crisis such as a fall or sudden incapacitating pain there will be an adrenaline rush and though the event will have been highly stressful your body has a way of getting you through the immediate aftermath.

More damaging for many is the aftermath of such a situation if they are not found and don’t know how long they will have to wait to be found. Even diligent neighbours have been known to take 4-5 days before looking through windows, such is the British reserve and respect for personal space. The waiting and not knowing whether help will come before your demise can be far more traumatic than the initial shock and many people don’t make it home after this type of experience. 13 people aged over 65 die every day through a fall and there are 600 emergency hospital admissions every day. You can eliminate the trauma of a long wait by making sure you have an alert system to get help in case you need it.

Loneliness stress

Some people are happy in their own company whilst others with a similar level of contact describe themselves as lonely. It is all very well to say you should ‘get out more’ and this guide offers lots of possibilities but there are other ways. There is a far more complete list of stresses at www.helpguide.org

Reducing unhealthy stress

Identifying the causes of stress may have already set you on a path to reducing unhealthy stress and you may have committed to a course of action. Often that can be supported by making small changes to have an evolution to becoming less stressed. The following actions could help:

Connect with your existing support network

A strong network of supportive friends and family members is an enormous buffer against stress. When you have people you can count on, life’s pressures don’t seem as overwhelming. Families are more dispersed than ever however technology can help bring them closer. Here are some commonly available free technologies that are great at keeping people in touch

  • WhatsApp WhatsApp is a brilliant app for keeping families in touch. It is entirely private and you can share messages and photos with chosen individuals or groups and also have phone calls free of charge to people on your network or even video calls. It is not difficult to set up, and you can start with just two people and then build different networks from there. There is no advertising on WhatsApp either but you will need a smartphone.
  • Facebook Facebook allows you to build a social network and most things that are said are shared with everyone on your network. It is not as good at communicating one to one or with smaller groups but comes into its own when you want a wider forum, so think of it more as being in a market square.
  • Skype, Again this has free calls and video calls but is not as good at generally sharing photos as the others as it is focussed on realtime communications. You both have to be looking at Skype at the same time but it still offers you free calls worldwide.
  • Appear.in A really simple system where if up to 6 people visit the same webpage at the same time and turn their video cameras on (on phone, tablets or laptops) they will be in a conference call/chatroom. You make your chatrooms by adding a random set of words after the link appear.in, for instance www.appear.in/acticheckisgreat !

Connect to others

The simple act of talking face-to-face with another human can trigger hormones that relieve stress when you’re feeling agitated or insecure. Even just a brief exchange of kind words or a friendly look from another human being can help calm and soothe your nervous system. So, spend time with people who make you feel good and don’t let your responsibilities keep you from having a social life.


Ubuntu is a Zulu word that translates as ‘I am because we are’. This highlights the idea that we are formed by our relations with others, that a child born in isolation would not grow into a rounded adult even if it were fed the same information and given the same knowledge as someone who has grown up in community.

Have you been clear about your needs? Don’t assume people know you are feeling lonely so make it clear. Some people will withdraw through loneliness and, to outsiders, it can be seen as a being aloof. Help them to help you by telling them how you’d like to relate to them and if someone comes to visit who you’d like to see more often be grateful for the time they have taken and don’t complain about how long it has been since you last saw them.

If your natural network still leaves you feeling lonely then you should speak to charities, your local council or your local GP who will be able to point you in the right direction. Do not suffer in silence! As well as ensuring you have people you are connected to, the radio can be a useful tonic at home. If you look online or on a smartphone or iPad app you can find internet radio stations like Radio 4 Extra which broadcasts archived repeats of comedies, drama and documentaries 24 hours a day.

Get moving

Upping your activity level is something you can do right now to help relieve stress and start to feel better. Exercise clatters your body chemistry which lifts your mood and can be a distraction from worries, breaking cycles of negative thoughts that feed stress. Rhythmic exercises such as walking, running, swimming, and dancing are particularly effective, especially if you exercise mindfully (focusing your attention on the physical sensations you experience as you move).

Engage your senses

Another fast way to relax can be to engage a single sense— sight, sound, taste, smell, touch, or movement. The key is to find the sensory input that works for you. Does listening to an uplifting song make you feel calm? Or smelling ground coffee? Or maybe petting an animal works quickly to make you feel centred? Everyone responds to sensory input a little differently, so experiment to find what works best for you.

Learn to relax

Relaxation techniques such as yoga, meditation, and deep breathing induce a state of restfulness that is the polar opposite of the stress response. When practiced regularly, these activities can reduce your everyday stress levels and boost feelings of joy and serenity. They also increase your ability to stay calm and collected under pressure. There are lots of resources online, for example relaxlikeaboss.com has interesting ideas on using positive affirmations to control stress

Eat a healthy diet

Eating a diet full of processed and convenience food, refined carbohydrates, and sugary snacks can worsen symptoms of stress while eating adiet rich in fresh fruit and vegetables, high-quality protein, and omega-3 fatty acids, can help you better cope with life’s ups and downs. Get your rest. Feeling tired can increase stress by causing you to think irrationally. At the same time, chronic stress can disrupt your sleep which can in turn make you more stressed. Find ways to get adequate rest.   

The next (and final) mini-guide explores Spiritual Health.  

 Healthy Active Ageing

This blog post is an excerpt from Healthy Active Ageing, a series of mini-guides that together cover most of what we can do as human beings to make the later stages of our lives as positive as they can be. If you complete the details below we’ll email you one of the guides every until you have the full set. You will know a lot of the information but there is nothing wrong with a reminder every now and then; and there may even be some information which is new to you.




Mental health matters

“When I look back on all these worries, I remember the story of the old man who said on his deathbed that he had had a lot of trouble in his life, most of which had never happened.”
~Winston Churchill

Important: health warning
If you think you are currently in an emotional crisis you could contact the Samaritans. You can call them free at any time from any phone on 116 123, email jo@samaritans.org or you may have a branch near you that you can visit (see samaritans.org/branches).

Mental health always needs care and sometimes needs fixing

Very few people will get through life without having a mental health issue, but so few seem willing to talk about it that we can all think that something is unique to us. An important thing is to assess whether you are reasonably well prepared to cope with everyday life.

Mentalhealth.co.uk have ideas for Positive Mental Health and how you can improve yours. at: www.mentalhealth.org.uk/your-mental-health/looking-after-your-mental-health

Keeping a healthy level of stress

Stress is healthy as long as it is managed. It is your body’s way of responding to any kind of demand or threat. When you sense danger—whether it’s real or imagined—the body’s defences kick into high gear in a rapid, automatic process known as the “fight-or-flight” reaction or the “stress response.”

In emergency situations, it helps you stay focused, energetic, and can save your life— giving you extra strength to defend yourself, for example, or spurring you to slam on the brakes to avoid an accident.

Stress can also help you rise to meet challenges. It’s what keeps you on your toes during a presentation at work, sharpens your concentration when you’re attempting the gamewinning free throw, or drives you to study for an exam when you’d rather be watching TV.

Unhealthy stress

But beyond a certain point, stress stops being helpful and starts causing major damage to your health, your mood, your productivity, your relationships, and your quality of life.

If you tend to get stressed frequently your body may be chronically stressed which can lead to serious health problems. Chronic stress disrupts nearly every system in your body. As well as suppressing your immune system, upsetting your digestive and reproductive systems, increasing the risk of heart attack and stroke, and speeding up the aging process, it can leave you more vulnerable to anxiety, depression, and other mental health problems.

The symptoms of unhealthy stress

The most dangerous thing about stress is how easily it can creep up on you. You get used to it. It starts to feel familiar — even normal. You don’t notice how much it’s affecting you, even as it takes a heavy toll. That’s why it’s important to be aware of the common warning signs and symptoms of stress overload.

Look at the following list of symptoms and underline any that you are aware of:

  • Cognitive symptoms: Memory problems, Inability to concentrate, Poor judgment, Seeing only the negative, Anxious or racing thoughts, Constant worrying.
  • Emotional symptoms: Depression or general unhappiness, Anxiety and agitation, Moodiness & irritability or anger, Feeling overwhelmed, Loneliness and isolation.
  • Physical symptoms: Aches and pains, Diarrhoea or constipation, Nausea & dizziness, Chest pain/rapid heart rate, Loss of sex drive, Frequent colds or flu.
  • Behavioural symptoms: Eating more or less, Sleeping too much or too little, Withdrawing from others, Procrastinating or neglecting responsibilities, Using alcohol cigarettes or drugs to relax, Nervous habits (e.g. nail biting, pacing).

How much stress is too much?

Because of the widespread damage stress can cause, it’s important to know your own limit. But just how much stress is “too much” differs from person to person. Some people seem to be able to roll with life’s punches, while others tend to crumble in the face of small obstacles or frustrations. Some people even thrive on stressful excitement, otherwise no-one would ever do a bungee jump.

Looking at the list above, does the number of things you underlined in the list above worry (stress) you? If so you should probably do something about it.


The next section helps you identify the causes of your stress and has some ideas about what you can do about it.

Healthy Active Ageing

This blog post is an excerpt from Healthy Active Ageing, a series of mini-guides that together cover most of what we can do as human beings to make the later stages of our lives as positive as they can be. If you complete the details below we’ll email you one of the guides every until you have the full set. You will know a lot of the information but there is nothing wrong with a reminder every now and then; and there may even be some information which is new to you.


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