Loneliness In Older People Research Articles

The effectiveness of e-Interventions on reducing social isolation in older persons: A systematic review of systematic reviews.

As the older adult population group has been increasing in size, there has been evidence of growing social isolation and loneliness in their lives. The increased use of information communication technology and Internet-supported interventions has stimulated an interest in the benefits of e-Interventions for older people and specifically in having a role in increasing social networks and decreasing loneliness. A systematic review of e-Interventions to reduce loneliness in older people was conducted with the aim to synthesize high quality evidence on the effectiveness of e-Interventions to decrease social isolation/loneliness for older people living in community/residential care. A systematic search of 12 databases for reviews published between 2000-2017 was conducted using search term synonyms for older people, social isolation and interventions. Three independent researchers screened articles and two reviewers extracted data. The Revised-Assessment of Multiple Systematic Reviews was used to assess the quality of reviews. The final search identified 12 reviews, which included 22 unique primary research studies evaluating e-Interventions for social isolation or loneliness. The reviews were of moderate quality and the primary studies showed a lack of rigor. Loneliness was most frequently measured using the University California Los Angeles Loneliness Scale. Despite the limitations of the reviewed studies, there is inconsistent and weak evidence on using e-Interventions for loneliness in older people.

MAKING AN ECONOMIC CASE FOR TACKLING LONELINESS IN LATER LIFE

Little research has been conducted on the economic case for tackling loneliness. We have developed an economic model documenting the long term costs and benefits of a program to tackle loneliness in older people in rural England. The program provides tailored, one to one volunteer-delivered time-limited support over six months to reconnect participants with interests and activities in their local community. The economic model synthesises published literature on potential avoidable health related costs of loneliness, with insights from interviews with participants and volunteers on rates of uptake and continued engagement with the program, as well as changes in levels of loneliness measured using the UCLA Loneliness Scale. Baseline findings indicate that there is likely to be a positive return on investment, but that this is highly dependent on the quality of volunteer – participant relationship and on the sustainability of new social connections beyond the duration of the program.

The role of socio-economic status and neighborhood social capital on loneliness among older adults: evidence from the Sant Boi Aging Study.

The aim of the present study is to analyze the role of age in the association between socio-economic status (SES) and loneliness as well as the role of neighborhood social capital (NSC) in the association between individual social capital and loneliness. Data include a representative population-based sample from Sant Boi de Llobregat (a suburb of Barcelona) of 1124 adults aged 50 and over. Logistic regression models were used to analyze the survey data. Interactions between SES and age, and NSC and individual social capital were explored. Among the poorest older adults, older individuals showed a lower likelihood of loneliness (OR 0.09, 95% CI 0.02, 0.30, p<0.05) compared with the youngest cohort after adjusting for covariates, while among the richest individuals there were no significant differences among age cohorts. Individuals living in an area with high NSC and high individual social capital showed a lower likelihood of loneliness (OR 0.36, 95% CI 0.17, 0.73, p<0.05) compared with those with low individual social capital after adjusting for covariates. The effect of individual social capital was not significant among individuals living in an area with low NSC. Interventions focusing on low SES middle-aged (50-59years old) individuals and those aiming to increase NSC could be effective strategies to reduce the prevalence of loneliness in older people.

Reducing social isolation and loneliness in older people: a systematic review protocol

IntroductionSocial isolation and loneliness affect approximately one-third to one-half of the elderly population and have a negative impact on their physical and mental health. Group-based interventions where facilitators are well...

Age UK enlists nurses to tackle loneliness in older people.

A pilot programme by charity Age UK has helped to combat loneliness in older people, early findings show. The scheme, involving eight local Age UK services in England, raises awareness of the common characteristics of loneliness among ward nurses, hospital discharge teams and practice nurses.

Charity enlists nurses to tackle loneliness in older people.

An Age UK pilot programme involving nurses is helping to combat loneliness in older people, early findings show.

Loneliness, Sociodemographic and Mental Health Variables in Spanish Adults over 65 Years Old.

Loneliness is a risk factor for morbidity as well as mortality. Older people are more vulnerable to feeling alone due to age-associated changes and losses they might experience. This study aimed to analyze sociodemographic, psychosocial, and mental health variables related to loneliness in the elderly. A random sample of 419 people over 65 years old from the Community of Madrid was used. The UCLA Loneliness Scale, the CIDI65+ Diagnostic Interview, and the WHOQOL-BREF Quality of Life Measure were administered. A regression p model was estimated to identify the variables that best predict loneliness associated with old age. Loneliness-associated variables included living alone t(161.41) = 2.07; p < .040, marital status F(5, 404) = 4.52; p < .001, frequency of economic problems F(1, 408 ) = 4.86; p < .028, quality of life F(4, 405) = 7.36; p < .001, satisfaction with life F(4, 405) = 3.80; p < .005, satisfaction with social relationships F(4, 405) = 19.50; p < .001, presence of a mental disorder (t(98.70) = 2.92; p < .004), and having an anxiety disorder (t(51.11) = 2.19; p < .033). The results presented in this paper highlight some predictors of loneliness in older people that could be useful in intervention, to minimize harmful conditions that can lead to loneliness in people over 65.

Education within the Dutch National Care for the Elderly Programme

The Netherlands Organisation of Health Research and Development started in 2008 the Dutch National Care for the Elderly Programme (in Dutch abbreviated as NPO) with the aim to improve the quality of life for the frail older people through better quality of care (health, social, community) which is tailored to the needs and wants of older people. The delivery of good care is related with competent professional behaviour which is inextricably linked to the education of professionals. This article presents an overview of 32 educational programmes developed within the NPO. Within the NPO different educational programmes were developed on relevant themes to improve elderly care. However, the programmes focused mainly on professionals in health care, especially those working in primary care. For nurses and nursing assistants and more or less for physicians also different educational programmes were developed. Educational programmes for paramedics or professionals working in social care, housing or in the municipalities were scarce. This is also the case for specific themes in elderly care like loneliness or (domestic) violence. Moreover, none of the experiments focused on older people or informal care givers. Although 22 of the 32projects developed educational programmes for different groups, multi - or interdisciplinary education is rare in these programmes. Based on the overview we advise the development of more educational programmes on: target groups which were less or not addressed in the NPO, like professionals in social care and paramedics; multi- or interdisciplinary collaboration; and themes, like loneliness in older people and elder abuse.

Home Alone or Not? A Mixed Methods Study of Different Perceptions of Social Isolation between Care Managers and Older Housebound Adults

Purpose: This paper aims to discuss whether the level of social isolation and loneliness as assessed by care managers corresponds to the level of social isolation and loneliness as perceived by the older persons whose care needs are being assessed. Design/methodology/approach: This mixed methods study followed up the assessment of 40 older people by 20 care managers with a focus on the accuracy of the care manager’s assessment on the level of social isolation experienced by the service user. In order for this to be achieved structured interviews were conducted with both the older person and the care manager assessing their needs, with a specific focus on the assessment of loneliness and social isolation. Following these initial interviews two focus groups were then undertaken with the care manager to discuss the findings and unpack the assessment process. Findings: The key issues were that the true level of social isolation and loneliness was under assessed by the care manager completing the assessment. That the care manager’s assessment was predominantly focused on the physical well-being of the older person and heavily influenced by the assessment paperwork. Originality/value: This provides lessons for professionals about the lack of effectiveness of their assessment of social isolation and loneliness in older people, and the potential impact this has on the older person’s quality of life.

Establishing routines to cope with the loneliness associated with widowhood: a narrative analysis.

Background Loneliness in older people is a public health concern in many Western countries. While not necessarily a symptom of mental disorder, it is often associated with depression and anxiety. Widowhood is a transition period during which many older people experience acute loneliness but over time develops strategies to manage it. Little is known about effective strategies that older people have used to manage the experience. The strategies older people used to manage this was the focus of this paper. Aim The aim was to examine older widows' experiences of loneliness. Design The design of this study was a qualitative narrative analysis with thematic analysis and the participants were 40 older widow/widowers aged between 70 and 97years. Findings The study found that the participants negotiated the experience of loneliness following widowhood from an acute phase of experiencing an absence and the associated loss of routine connection to the establishment of new routines that provided new connections and a new sense of identity as an individual rather than a couple. Conclusions It is important for mental health nurses to screen for loneliness and be able to facilitate interventions that may alleviate the experience of loneliness.

Understanding and alleviating loneliness in later life: perspectives of older people

Purpose There is extensive empirical literature that has sought to establish the prevalence of, and risk factors for, loneliness and social isolation in later life. Traditional empirical gerontological approaches have characterised loneliness as a linear experience that is both pathological and easily relieved with external intervention. The purpose of this paper is to explore the potential of qualitative interview data to reveal the possible complexities in understanding loneliness, including conceptual considerations for the dynamic and multi-dimensional aspects of loneliness. Design/methodology/approach The authors draw on two different studies where the purpose was to qualitatively examine the meaning of loneliness in the lives of older people and how they understood loneliness in the context of their daily life (n=37). Findings Interviews with “lonely” older people revealed that loneliness is a complex and dynamic experience. The authors also identified a range of internal and external factors that contribute to vulnerability for loneliness as well as resources to alleviate it. Originality/value The dynamic and multi-dimensional characteristics of loneliness in older people may help explain why community-based interventions to diminish it may be so challenging.

Improving transitions from hospital to home.

❛The success of out-of-hospital care will partly be judged by its ability to offer older people a quality dimension to their life experience.❜ The imperative of making integrated care a reality is widely accepted. However, yet again, there is evidence that some patients do not transition between hospitals and community settings in an effective manner (Ungoed-Thomas, 2015), with some NHS Trusts experiencing delayed discharges in excess of 100 days. During the year ending March 2015, the University Hospital Southampton NHS Foundation Trust had 207 patients who waited 4 weeks or longer after having been declared fit for discharge (Ungoed-Thomas, 2015). While only a minority of patients experience long delays when medically fit for discharge, the need to improve transition arrangements was the basis of the recent National Institute for Health and Care Excellence (NICE) (2015) guidance. The NICE guideline rightly recommends that those with social care needs should have a care plan that addresses all aspects of their life. The care plan should include agreed preferences relating to their care needs and information exchange, so that care decisions are always person-centred and respectful, with the involvement of the individual and his/her family and/or carer as appropriate. Importantly, the care plan should incorporate agreed decisions relating to advance care plans and end-of-life care. Indeed, it is possible that the very old or very frail do not want to be admitted to hospital at all, having expressed their desire to have a dignified death in their current home. However, if a hospital admission is appropriate, the NICE guideline emphasises coordination between the hospital-based and community-based multidisciplinary teams so that there is a seamless approach across the services. Good record-keeping of assessments, treatments (prescribed and non-prescribed medications), and progress toward discharge are essential to ensure the timely transfer back to the patient’s current home or an alternative. NICE recommends the use of discharge protocols that include good information-sharing arrangements between health and social care providers, as well as between patients and their families. Knowing the preferred place of death of those at the end of life provides community nursing services the opportunity to enable a dignified death in the preferred setting, utilising generic and specialist palliative care services. The NICE guideline recommends that such patients should be followed up within 24 hours of hospital discharge so that ongoing care plans can be agreed and carers given practical support. Other hospital discharges will relate to ongoing care and re-enablement, and again, the importance of a follow up within 24–72 hours of discharge is emphasised so that the care delivery meets expectations and unnecessary readmissions are avoided. The increasing social isolation and loneliness of older people may exacerbate their vulnerability. Identifying local resources such as ‘Contact the Elderly’ (www.contact-the-elderly. org.uk/) for those aged over 75 years and living alone may be one strategy to reduce the experience of loneliness. It offers connectivity with a social group with whom to share conversations and develop new friendships. The success of out-of-hospital care will partly be judged by its ability to offer older people a quality dimension to their life experience, because no advanced society should condone life extension without a reasonable quality of life. Community nurses, as advocates of their clients, should be at the forefront of promoting a high quality of life for all those receiving nursing at home. BJCN

HOME ALONE? A MIXED METHODS STUDY OF DIFFERENT PERCEPTIONS OF SOCIAL ISOLATION BETWEEN CARE MANAGERS AND OLDER HOUSEBOUND ADULTS

Purpose; This paper aims to discuss whether the level of social isolation and loneliness as assessed by care managers corresponds to the level of social isolation and loneliness as perceived by the older persons whose care needs are being assessed. Design/methodology/approach This mixed methods study followed up the assessment of 40 older people by 20 care managers with a focus on the accuracy of the care manager’s assessment on the level of social isolation experienced by the service user. In order for this to be achieved structured interviews were conducted with both the older person and the care manager assessing their needs, with a specific focus on the assessment of loneliness and social isolation. Following these initial interviews two focus groups were then undertaken with the care manager to discuss the findings and unpack the assessment process. Findings The key issues were that the true level of social isolation and loneliness was under assessed by the care manager completing the assessment. That the care manager’s assessment was predominantly focused on the physical well-being of the older person and heavily influenced by the assessment paperwork. Originality/value This provides lessons for professionals about the lack of effectiveness of their assessment of social isolation and loneliness in older people, and the potential impact this has on the older person’s quality of life.

Correlates of social and emotional loneliness in older people: evidence from an English community study

Various factors have been found to be associated with loneliness in old age, but few studies have distinguished between those correlated with social loneliness (SL) (the absence of social networks, which provide a sense of belonging, companionship and community) and emotional loneliness (EL) (the absence of an attachment figure).

Older People and Their Loneliness: A Case in a Transitional Society

The article reports on investigation about older people's loneliness, the reasons for it, and its consequences. The detected theoretical findings triggered the authors' empirical study in Slovenia as a society in transition from the preindustrial village solidarity into the modern market individualism. In the empirical part, some aspects of the life of older people regarding their residences were compared: among older people living with their relatives, alone, with a partner, or in a retirement home, with special regard to the reasons/causes for residence, and the feeling of loneliness and contacts with relatives. The obtained empirical results showed that older people living alone or in a retirement home are feeling lonelier than those living with relatives or with a partner. They grew up in a period in which the village solidarity society was changing to the industrialized society and, in the recent 25 years, to a capitalistic individualistic market society. Their feelings may have been adapted to these crucial changes, or less so.

Community approaches to loneliness in older people

Community approaches to loneliness in older people

Association between depressive symptoms and age, sex, loneliness and treatment among older people in Sweden

Objectives: The objective of this study was to examine the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex among older people (65–80 years) and to investigate to what extent those who report depressive symptoms had visited a health care professional and/or used antidepressant medication.Method: A cross-sectional study was conducted in a Swedish sample randomized from the total population in the age group 65–80 years (n = 6659). Chi square tests and logistic regression analyses were conducted.Results: The data showed that 9.8% (n = 653) reported depressive symptoms and 27.5% reported feelings of loneliness. More men than women reported depressive symptoms, and the largest proportion was found among men in the age group 75–80 years. An association between the odds to have a depressive disorder and loneliness was found which, however, decreased with increasing age. Of those with depressive symptoms a low proportion had visited a psychologist (2.9%) or a welfare officer (4.2%), and one in four reported that they use antidepressant medication. Of those who reported depressive symptoms, 29% considered that they had needed medical care during the last three months but had refrained from seeking, and the most common reason for that was negative experience from previous visits.Conclusion: Contrary to findings in most of the studies, depressive symptoms were not more prevalent among women. The result highlights the importance of detecting depressive symptoms and loneliness in older people and to offer adequate treatment in order to increase their well-being.

The impact of an unfavorable depression course on network size and loneliness in older people: a longitudinal study in the community

This work aims to gain insight into the long-term impact of depression course on social network size and perceived loneliness in older people living in the community. Within a large representative sample of older people in the community (Longitudinal Aging Study Amsterdam (LASA)), participants with clinically relevant levels of depressive symptoms (scores >16 on the Center for Epidemiological Studies Depression Scale) were followed up over a period of 13 years of the LASA study (five waves). General estimating equations were used to estimate the impact of depression course on network size and loneliness and the interaction with gender and age. An unfavorable course of depression was found to be associated with smaller network sizes and higher levels of loneliness over time, especially in men and older participants. The findings of this study stress the importance of clinical attention to the negative consequences of chronicity in depressed older people. Clinicians should assess possible erosion of the social network over time and be aware of increased feelings of loneliness in this patient group.

Reducing loneliness amongst older people: a systematic search and narrative review

Objective: To investigate the effectiveness of recent social therapeutic interventions to reduce loneliness in older people. Method: To examine this matter, a literature review, using seven databases, was undertaken using search terms relating to the themes of ageing, loneliness and social support. A total of 17 relevant studies relating to loneliness interventions were analysed. Results: Three studies reporting on new technologies and one on a group work intervention identified significant reductions in loneliness.Conclusion: Further research into interventions using new technologies to reduce loneliness in older people is recommended.

Correlates of social and emotional loneliness in older people: evidence from an English community study

Objectives: Loneliness is an important influence on quality of life in old age and has been conceptualised as consisting of two dimensions, social and emotional. This article describes analyses that sought to produce models of social and emotional loneliness in older people, using demographic, psychological and health, and social variables.Method: Older people (aged 65+, n = 1255) from the Barnsley metropolitan area of the United Kingdom were recruited randomly from within a stratified sampling frame and received a questionnaire-based interview (response rate: 68.1%). The questionnaire contained items and scales on demographic, psychological and health, and social characteristics, and a validated measure of loneliness that assesses both social and emotional loneliness.Results: Of the respondents, 7.7% were found to be severely or very severely lonely, while another 38.3% were moderately lonely. Social and emotional loneliness shared 19.36% variance. Being male, being widowed, low well-being, low self-esteem, low-income comfort, low contact with family, low contact with friends, low activity, low perceived community integration, and receipt of community care were significant predictors of social loneliness (R = 0.50, R2 = 0.25, F(18, 979) = 18.17, p < 0.001). Being widowed, low well-being, low self-esteem, high activity restriction, low-income comfort, and non-receipt of informal care were significant predictors of emotional loneliness (R = 0.55, R2 = 0.30, F (18, 973) = 23.00, p < 0.001).Conclusion: This study provides further empirical support for the conceptual separation of emotional and social loneliness. Consequently, policy on loneliness in older people should be directed to developing a range of divergent intervention strategies if both emotional and social loneliness are to be reduced.