What do you expect at your age? Loneliness and old age

Christina Victor,School of Health Sciences &

Social Care,Brunel University

E-mail: Christina.Victor@brunel.ac.uk

2

Presentation overview

• What is loneliness?• Why is loneliness

important?• Loneliness & old age

Living alone

Being alone

Isolation Solitude

Loneliness-emotional, social, existential

Terminological in exactitude!

KJV Psalms 25 verse 16 ’ Turn to me and be gracious to me, for I am lonely and afflicted’.

What is loneliness?

Cognitive discrepancy theory

Loneliness results from the difference between desired and actual social relations (Perlman & Pelau, 1981)-either in quantity or quality of relationships (or both)

Loneliness map-Britain 1971-2001….

Based on 4 measures:-

% single,

% living alone,

% in private rented housing,

% lived in area for less than a year

Why does loneliness matter?

• Reduced or low quality of life• Negative health behaviours (e.g.

smoking, alcohol)• Negative health outcomes - Early

studies by Durkheim link loneliness to mortality-50% higher for those lonely/isolated (independent of health status!)

• Excessive use of health services-hospital admission, A&E contact,GP consultations

‘The Loneliness’ (Ewa Gawlik)

Loneliness and old age ‘’A distressing feature of old age is

loneliness. All who have done welfare work among the old have found it the most common, if at the same time the most imponderable, of the ills from which the aged suffer, and its frequency was amply confirmed by our study’’

(Rowntree, 1947,52)

Interpersonal Engagement(e.g. quality of relationships with

family, friends, neighbours)

Life Stage Events(e.g. retirement, widowhood, sensory impairments, physical

health)

Wider Social Structures(e.g. poverty, quality of health and

social care, ageism)

Social Environment(e.g. living arrangements, community

connectedness, hobbies/interests, pets, housing, car, holidays/seasons)

Intrapersonal Factors

(e.g. personality and cognitive variables,

identity)

Understanding loneliness

Source: Sullivan & Victor, 2012

<25 25-34 35-44 45-54 55-64 65-74 ≥750

5

10

15

20

25

30

35

Male Always lonelyMale Sometimes lonelyFemale Always lonelyFemale Sometimes lonely

Are older people the loneliest?

Source: Victor & Yang, 2012

Has loneliness in old age increased?SHELDON 1948

TOWNSEND1954

VICTOR 2005

Always/often 8 9 9

Sometimes 13 25 32

Never 79 66 61

Source: Victor et al, 2009

Loneliness & ethnic minorities

White AC

Black A

frican

Indian

Pakist

ani

Bangla

deshi

Chinese0

5

10

15

20

25

30

45-6465+

Source: Victor & Burholt, 2012

Care homes & loneliness

M (care worker) say “Why you cry? Why you cry?” so I say ‘’I feeling lonely’’

‘’ don’t, I don’t feel ill love……I just feel lonely.’’

Temporal aspects of loneliness• 50% reported loneliness worse at night &

two thirds at weekend (Victor et al, 2005)

• ‘’I'm lonely of a night. ‘’(Man 16)

• ‘’Of a night you're lonely’’. (Woman 12)

• ‘’Such a lonely life … Saturdays and Sundays are a bit dead for me…’’

• ‘’So long [Sunday] and so lonely.’’

Source: Bennett & Victor, 2012

Longitudinal aspects of loneliness

Improved

loneliness

(%)

Worse

loneliness

(%)

Consistently

lonely (%)

Never

lonely (%)

Victor &

Bowling

(2012)

12 25 22 44

Source: Victor & Bowling, 2012

What is the point of loneliness interventions?

To reduce the risk of loneliness evolving into serious long-term health problems

To reduce prevalence of loneliness

To improve quality of life

To prevent loneliness from occurring

What loneliness interventions work?

• Balance of evidence is that.. • Effective interventions:• Social activity and / or support in a group/skills

development ; Older people as active participants & are theoretically grounded

• No or poor evidence of effectiveness:• Internet training (group or one to one); One to one

providing (volunteer) activities, support, home visiting