Loneliness in the elderly

Loneliness and Relationship Well-Being: Investigating the Mediating Roles of Relationship Awareness and Distraction among Romantic Partners

Loneliness arises when there is a discrepancy between one's desired and actual social connection with others. Studies examining the effects of loneliness in romantic relationships show that people who are lonely are less satisfied and committed to their romantic relationships. The present study explored the association between loneliness and romantic relationship well-being. Using a cross-sectional design, loneliness was correlated with relationship commitment, trust, and conflict. Relationship awareness, but not relationship distraction, statistically mediated the association between loneliness, relationship conflict, and relationship trust. The indirect effect of loneliness on relationship well-being was only present in people reporting low and medium levels of psychological inflexibility. Implications are discussed for acceptance- and mindfulness-based interventions for persons in romantic relationships.

Impact of continuity of care on older adults diagnosed with mental and behavioural disorders at risk of death due to intentional self-harm: a retrospective Korean cohort study

OBJECTIVES

The aim of this study was to evaluate the impact of continuity of care on older adults diagnosed with mental and behavioural disorders who are at risk of death due to intentional self-harm.

STUDY DESIGN

This was a retrospective cohort study.

METHODS

Data from the Korean National Health Insurance Service-Elderly Cohort Database (2002-2013) were used. A total of 53,980 patients who had visited the outpatient clinic three or more times within the year following the initial diagnosis of mental and behavioural disorders were included. A generalised estimating equation model was generated to examine the impact of continuity of care (CoC) on the risk of death due to intentional self-harm among older adults with mental illnesses.

RESULTS

The risk of death due to intentional self-harm was significantly higher in those with poor CoC for mental and behavioural disorders than in those with good CoC. The risk ratio, adjusting for all covariates, was larger for the Usual Provider of Care index (adjusted risk ratio [aRR]: 1.63, 95% confidence interval [CI]: 1.25-2.12) than for the CoC index (aRR: 1.50, 95% CI: 1.18-1.90), indicating a stronger association with the concentration of contact with the most frequently visited provider.

CONCLUSIONS

Poor CoC among Korean older adults diagnosed with mental and behavioural disorders was identified as a significant risk factor for death due to intentional self-harm. The results of this study highlight the need for interventions that can prevent suicidal behaviour in older adults, such as institutionalising the usual providers of mental health care for older adults.

Desolated milieu: exploring the trajectory of workplace loneliness (2006-2019)

Purpose

The purpose of this paper is to trace the trajectory of research done exclusively on the topic of Workplace Loneliness from 2006 to 2019. Based on the content analysis of 29 articles, this paper critically assesses, summarizes and consolidates the existing body of knowledge in the field of workplace loneliness.

Design/methodology/approach

This review is organized around five major themes – origin and the conceptual grounding of the construct; emergence of the concept of workplace loneliness, conceptualizations and overlap with the related constructs; measurement tools and techniques; analysis of its predictors, outcomes, mediators and moderators; and development of an integrated model specifying the nomological network of workplace loneliness for clarifying the current state of thinking and guiding future research in the area.

Findings

The concept of workplace loneliness started receiving attention from the year 2006 and gained momentum in 2016. The studies from wide range of countries show that workplace loneliness is not restricted to one geographical location but is a phenomenon that affects people and economies around the world. The review highlights the conceptualization and measurement challenges along with the need for theoretical development of the field. Further, the existing literature fails to provide a comprehensive picture of the predictors, underlying processes, contingencies and outcomes of workplace loneliness.

Originality/value

This study being one of the rare attempts to consolidate the existing body of knowledge on loneliness at work will provide academicians and practitioners with a comprehensive account of the state of research and development on an important and yet neglected issue of workplace loneliness.

Loneliness among older people living in care homes in Sri Lanka

AIM AND OBJECTIVES

The aim of this study was to explore loneliness in older people (aged 65+) living in care homes in Colombo, Sri Lanka.

BACKGROUND

Loneliness, defined as the subjective, unwelcome feeling of the lack or loss of companionship, is known to be associated with old age, especially among older people living in care homes. Although several studies have shown that loneliness is highly prevalent, we lack knowledge about older people's personal experience of loneliness when residing in a care home and the strategies that older people use by themselves on a day-to-day basis to alleviate loneliness.

METHODS

The participants (n = 75) were randomly selected from three different types of care homes: governmental, non-governmental and private, and loneliness was screened using the Revised University of California-Los Angeles (R-UCLA) Loneliness Scale. The 15 participants with the highest score on the loneliness scale were purposively selected for individual interviews.

RESULTS

The median loneliness score was 45 (range 20-80); no significant differences concerning loneliness were found between the care homes. No differences concerning loneliness were found for any demographic variable except marital status. Loneliness was experienced as coping with inner pain, which older people described as emotional suffering caused by feeling abandoned from the family network and fettered to the care home, anxious about their future and depressed. Participants managed their loneliness by accepting their loneliness, practising religion, staying in touch with family, engaging in daily activities and participating in social activities.

CONCLUSION

Reliable and socio-culturally validated tools for screening loneliness and culturally applicable interventions targeting factors associated with loneliness are necessary in the care of older people residing in care homes. A person-centred approach involving family or significant others is recommended in clinical practice, and an increase in the number of nurses with specialist education in geriatric nursing seems urgent.

Social Skills and Psychosocial Problems among the Elderly

The disruption of communication behaviors as a result of aging led to the hypothesis that elderly subjects would exhibit more problematic social skills than younger subjects. These social skills deficits were further hypothesized to be associated with rejection from others and a number of psychosocial problems. Elderly and young subjects engaged in two different interactions, with an age-matched partner, and an age-unmatched partner, from which social skills and interpersonal rejection were assessed. Subjects also completed self-report measures of social skills and psychosocial problems. Elderly subjects did not differ from young subjects on most measures of social skill, nor on the measure of interpersonal rejection. However, the elderly reported more symptoms of dysphoria and lower self-esteem than did young subjects. The lack of young-elderly differences in social skills may be due to the high level of functioning evident in the elderly sample.

The prevalence of loneliness among U.S. Chinese older adults

OBJECTIVE

Loneliness is an important indicator of well-being. However, we have limited understanding of loneliness in minority aging populations. This study aims to identify the prevalence of loneliness among U.S. Chinese older adults.

METHOD

Data were drawn from the PINE study, a population-based study of 3,159 U.S. Chinese older adults in the Greater Chicago area.

RESULTS

Our findings indicated that the prevalence of loneliness was 26.2%. Older adults with older age, female gender, and living alone reported higher prevalence of loneliness. Older adults with worsened health status, poorer quality of life, and negative health changes over the past year were also more likely to experience loneliness.

DISCUSSION

Loneliness is common among U.S. Chinese older adults in the Greater Chicago area. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with loneliness in Chinese older adults.

Perception and negative effect of loneliness in a Chicago Chinese population of older adults

This qualitative study aims to investigate the cultural understandings of loneliness, identify the contexts of loneliness, and to examine its effect on the health and well-being of U.S. Chinese older adults. Despite loneliness is one of the main indicators of well-being, little attention has been paid to understanding loneliness among immigrant older adults. This study utilizes both survey questionnaires and semi-structured focus group methods to investigate the feelings of loneliness among U.S. Chinese older adults. Based on interviews with 78 community-dwelling Chinese older adults in Chicago Chinatown, this community-based participatory research study (CBPR) shows loneliness is common among U.S. Chinese older adults. It was frequently identified through emotional isolation and social isolation. Social, psychological and physical health factors could contribute to the experience of loneliness. In addition, the health of older adults with loneliness may be associated with worsening overall health, elder mistreatment, health behavior changes and increased healthcare utilizations. This study has implications for healthcare professionals, social services agencies and policy makers. Our findings point to the needs for healthcare professionals to be more alert of the association of loneliness and adverse health outcomes. Communities and social services agencies should collectively take a lead in reducing social isolation, improving intergenerational relationships, and increasing social networks and companionship for this group of vulnerable older adults.

Assessing the loneliness of older people with cerebral palsy

PURPOSE

To use the University of California Los Angeles Loneliness Scale Version 3 to (a) explore and compare the levels of loneliness experienced between two groups of older adults (aged 40 years and over) with cerebral palsy, a group who use natural speech to communicate and a group who use augmentative and alternative communication (AAC) and (b) to test the reliability of the UCLA Loneliness Scale (Version 3) when used with the older adults with cerebral palsy who use a variety of communication modes.

METHOD

The UCLA Loneliness Scale (Version 3) was administered twice to two groups of older participants with cerebral palsy. Group 1 consisted of 11 participants who used natural speech and Group 2 consisted of nine participants who used augmentative and alternative communication systems. The scores from the second assessment were used to calculate test retest reliability.

RESULTS

The mean loneliness scores for the two groups indicated that older people with cerebral palsy experience more loneliness than older adults without disability. There was no significant difference between the scores of Groups 1 and 2. The UCLA Loneliness Scale (Version 3) is a reliable tool for use with people who communicate using a variety of communication modes.

CONCLUSIONS

The UCLA Loneliness Scale (Version 3) items are pertinent to participants' perceived satisfaction with the quantity and quality of their relationships with others. Policy makers, service providers and the general community have a responsibility to ensure that older people with cerebral palsy are given the support they need to achieve satisfactory relationships and thus facilitate a good quality of life as they age.

Loneliness: a concept analysis

TOPIC

Loneliness is a universal human experience recognized since the dawn of time, yet it is unique for every individual. Loneliness can lead to both depression and low self-esteem.

PURPOSE

This article explicates the concept of loneliness through the examination of its conceptual definition and uses, defining attributes, related concepts, and empirical referents.

SOURCES OF INFORMATION

Literature review using hand search and database were used as sources of information.

CONCLUSION

Because loneliness is commonly encountered in nursing situations, the information provided will serve as a framework for assessment, planning, intervention, and evaluation of clients.

The experience of social and emotional loneliness among older people in Ireland

This paper reports a study of the risk factors for social and emotional loneliness among older people in Ireland. Using the ‘Social and Emotional Scale for Adults’, the social and emotional dimensions of loneliness were measured. Emotional loneliness was conceptualised as having elements of both family loneliness and romantic loneliness. The data were collected through a national telephone survey of loneliness in older people conducted in 2004 that completed interviews with 683 people aged 65 or more years. It was found that levels of social and family loneliness were low, but that romantic loneliness was relatively high. Predictors for social loneliness were identified as greater age, poorer health, living in a rural area, and lack of contact with friends. Living in a rural setting, gender (male), having a lower income, being widowed, no access to transport, infrequent contact with children and relatives and caring for a spouse or relative at home were significant predictors of family loneliness. Romantic loneliness was predicted by marital status, in particular being widowed. Never having married or being divorced or separated were also significant predictors for romantic loneliness. The findings indicate that loneliness for older people is variable, multi-dimensional and experienced differently according to life events, with, for example, the death of a partner being followed by the experience of emotional loneliness, or the loss of friends or declining health leading to social loneliness.

Loneliness in older women: a review of the literature

Older women report more loneliness than male peers. Loneliness is an area of concern related to the well being of older women because it is a cause of emotional distress and is linked to a variety of health problems in older individuals. Life changes, including widowhood and relocation, are associated with increased vulnerability to loneliness. Gender, social, and cultural factors influence the experience of loneliness in older women. Cognitive and interactionist theoretical approaches to loneliness have utility for nursing practice and research with older women who experience loneliness.

Predictors of loneliness in centenarians: a parallel study

The purpose of this study was to evaluate predictors of loneliness in centenarians for two countries: The USA and Sweden. It was hypothesized that cognition, personality, social support and physical health would predict loneliness. Results indicated that personality, social support and physical health were good predictors of loneliness in the US sample, while cognition and social support were the strongest predictors in the Swedish sample. Social support predicted loneliness negatively in the US sample, but was positively associated with loneliness in Sweden.

Analysis of the concept of aloneness. As applied to older women being treated for depression

The concept of aloneness is examined in very few published materials. This article analyzes the concept of aloneness through the experiences of eight older women being treated for depression. When the women were depressed, they viewed aloneness as being vulnerable, fearful, helpless, and as having a loss of control of self and identity confusion. As the women progressed in their recovery from depression, they viewed aloneness as being self-reliant, hopeful, and resourceful and as having self-determination and self-reflection. Establishing and clarifying the meaning of aloneness for older women during their depression and during their recovery from depression is basic to using the concept of aloneness in nursing theory development and in gerontological nursing practice, education, and research.

Predictors of loneliness in elderly Korean immigrant women living in the United States of America

The purpose of this study was to examine the predictors of loneliness in elderly Korean immigrant women. The sample was derived from a larger study designed to examine loneliness in elderly Korean immigrants. Subjects were 110 elderly Korean immigrant women who were at least 60 years of age and lived in a large metropolitan city area in the United States of America. Data were collected by telephone interview using the Revised University of California Los Angeles (UCLA) Loneliness Scale (RULS), Social Support Questionnaire, Ethnic Attachment Questionnaire and Instrumental Activities of Daily Living (ADL) Scale. Measures were prepared using translation and back-translation procedures. Results indicate that elderly Korean immigrant women were more lonely than those found in other studies. Satisfaction with social support, social network size, ethnic attachment and functional status were predictive variables of loneliness. Satisfaction with social support was the largest predictor of loneliness in elderly Korean women. Marital status was not a predictor of loneliness.

Loneliness: an epidemic in modern society

Loneliness is a little discussed concept in today's self-obsessed climate, where it is seen as a negative embarrassing condition. It is unique for every individual, and as such, it is difficult to define. There are other closely related concepts, for example, aloneness and solitude, that further complicate an already complex issue. Loneliness also has various causes and effects that can be one and the same, and so it can be confused with similar but different conditions, for example, depression and self-esteem. But, at the end of the day, if the word loneliness is mentioned in conversation, everybody will understand what it means to them, and how distressing an ordeal it can be. Everyone is lonely to some degree, no matter how much they pretend they are not: it is part of being human. Nursing literature looks at loneliness from a rather basic, superficial perspective, when discussing whether such a traumatic state of being can be solved, but this is not a solution as such. It is such an innate part of the human psyche, that it cannot be solved like a puzzle; it can only be alleviated and made less painful. This can only be achieved by increasing humankind's awareness of this distressing condition that everyone has to endure in some way, shape or form, some time during their lives, about which there is nothing to be embarrassed. If non-lonely individuals could spare a smile or a word for people who might be perceived as being lonely, even if in doing so they selfishly think 'there but for the grace of God go I', such a small gesture might just make their day a little less of an ordeal.

The oldest old, ADL, social network, and loneliness

This study examined the influence of activities of daily living (ADL) and frequency of social contacts on the loneliness and social relationships in a sample of very elderly individuals. Associations between functional ability, social contacts, and emotional loneliness and social loneliness were also assessed. The sample was composed of 221 participants, age 80 to 105 years, residing in the greater Bergen area in Norway. Results demonstrated that dependence on the environment in ADL is related to low levels of emotional loneliness, whereas only dependence in activities of toileting and transferring corresponded with low levels of social loneliness. High frequency of social contacts with family, friends, or neighbors was negatively related to both emotional and social loneliness. Results show that frequency of such contacts appeared to buffer the effect of continence on emotional loneliness and the effect of toileting and transferring on social loneliness.

The lived experience of aloneness for older women currently being treated for depression

A phenomenological study was conducted to answer the following question: What is the lived experience of aloneness for older women currently being treated for depression? Eight women from Northern Ohio composed the purposively selected sample. Transcriptions of each 1-hr interview were reviewed by use of Colaizzi's (1978) method of data analysis. The analysis identified two major experiences of self for all participants: aloneness in depression and aloneness in recovery. Five paired, and somewhat dichotomous, themes defined the essence of aloneness: (a) vulnerability versus self-reliance, (b) fear versus hope, (c) helplessness versus resourcefulness, (d) loss of self-control versus self-determination, and (e) identity confusion versus self-reflection. All the participants expressed profound feelings of moving between the five paired themes as they gained clarity of insight into their experiences of depression and recovery. Results of this study make a valuable contribution by providing important insights into the lived experience of aloneness among older women currently being treated for depression, offer direction in the assessment and treatment of these women, and serve as an impetus for further research.

Loneliness in elderly people: an important area for nursing research

The phenomenon of loneliness occurs in people of all ages but may be a particular problem in the elderly. It is acknowledged that loneliness is not a necessary accompaniment to ageing and that ageing is not solely responsible for the development of loneliness in elderly people. However, there is a relationship between ageing and loneliness. Four major theories of loneliness are reviewed and their utility for application to research in the elderly is examined along with a consideration of the ways in which loneliness can be measured. While causal relationships are difficult to determine, there is evidence that loneliness is associated with a number of physical and psychological pathologies and the relevance of these to nursing is discussed. There is a growing awareness of the phenomenon of loneliness in elderly people in the nursing literature and some evidence that nursing intervention can be beneficial in this regard both at alleviating loneliness and reducing some of the adverse effects of loneliness. Finally some directions for nursing research are presented which are aimed at improving the assessment and nursing intervention for loneliness in elderly people.

A new perspective on loneliness in later life

Loneliness in later life remains a serious problem despite extensive research across the life span. Unfortunately, most studies of loneliness that include older adults focus on individuals who are already lonely; findings suggest interventions dependent upon external factors such as socialization and functional status. Such interventions are not always feasible for older adults, who may have experienced social and functional losses. Nurses must adopt a new perspective in examining loneliness in later life. This new perspective should include a more positive approach that focuses on older adults who are not lonely even though they may have experienced decreased socialization or physical function. Identification of strategies employed by these older individuals may be used to help many elders avoid loneliness and help others cope with the related losses so frequent in later life.

Validation of social isolation related to maturational age: elderly

The purpose of this study was to obtain expert validation of the defining characteristics used when diagnosing social isolation in the elderly and to compare these characteristics with those identified in the NANDA Taxonomy I Revised (1990) and the characteristics identified by the investigator through a literature review. A descriptive survey design using Fehring's Diagnostic Content Validity Model and a Q-Sort methodology was used. The sample consisted of 300 registered nurses (68% response rate) selected randomly from the ANA's Council of Gerontology and Community Health. Findings suggest the need for clinical validation of this diagnosis and the possible need for the addition of developmental age categories to the defining characteristics of social isolation.

Loneliness in low-vision older women

The purpose of this analysis was to identify predictors of loneliness in women 75 years of age and older with low vision. The sample of 56 women was derived from a larger study of low-vision adults. Women's loneliness, optimism, social support, living arrangement, vision, and perceived health were examined using the revised University of California, Los Angeles, Loneliness Scale, the Life Orientation Test, the Social Support Questionnaire, and a demographic questionnaire. Data were analyzed using descriptive statistics, Pearson correlations, multiple regressions, and t-tests. Optimism and social support satisfaction were found to predict degree of loneliness in the sample. Women who were less optimistic and less satisfied with their social support system experienced higher levels of loneliness. Duration of visual impairment was associated with duration of loneliness. The findings provide nurses with information for identifying low-vision older women who are at risk for loneliness.

Human-pet interaction and loneliness: a test of concepts from Roy's adaptation model

This research used two key concepts from Roy's adaptation model of nursing to examine the relationship between human-pet interaction and loneliness in nursing home residents. These concepts included (a) environmental stimuli as factors influencing adaptation and (b) interdependence as a mode of response to the environment. The hypothesis of this study asserted that the residents of a nursing home who had greater levels of interaction with a pet program would experience less loneliness than those who had lower levels of interaction with a pet. The study used an ex post facto nonexperimental design with 65 subjects. The simplified version of the revised UCLA loneliness scale was used to measure loneliness. Reported level of human-pet interaction was measured according to a four-point scale (1 = no interaction, 4 = quite a lot of interaction). The hypothesis was supported at the p less than 0.03 level of significance. Implications for practice through organizing pet programs in situations where loneliness exists are discussed. Recommendations for future research include replicating the study using a larger sample and developing a comprehensive human-pet interaction tool.

Sounds of silence--coping with hearing loss and loneliness

The vast majority of people will suffer presbycusis during the aging process. This hearing loss has potential social consequences, which place these individuals at risk for loneliness. Nurses need to encourage thorough audiological examination and follow through on recommendations to improve hearing. The use of hearing aids needs to be encouraged. A suggested model of interaction among variables influencing loneliness identifies areas amenable to nursing intervention. Frequency of significant interaction and motivation to engage in interactions represent two important variables that influence loneliness.

Loneliness. Easing the pain of the hospitalized elderly

For the older adult, loneliness may contribute to deterioration in physical and mental health. Some factors that may contribute to loneliness in the older adult include the death of a spouse, loss of a pet, lack of visitors, physical incapacity, role changes, and relocation. In general, loneliness may be the result of events that typically occur as a part of the aging process. Nurses can decrease the incidence of loneliness in the older adult by ensuring access to visitors and facilitating involvement in usual activities. Assessment information that is needed to plan nursing care to decrease the incidence of loneliness includes data regarding the patient's cultural background; significant persons, objects, and activities; and previous hospitalization experiences.