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

Christina Victor, School of Health Sciences & Social Care, Brunel University E-mail: [email protected]


Presentation overview

• • What is loneliness?

Why is loneliness important?

• Loneliness & old age

KJV Psalms 25 verse 16 ’ Turn

to me and be gracious to me, for I am lonely and afflicted’.

Terminological in exactitude!

Living alone Being alone

Loneliness-emotional, social, existential

Isolation Solitude

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)

Understanding loneliness

Interpersonal Engagement (e.g. quality of relationships with family, friends, neighbours) Life Stage Events (e.g. retirement, widowhood, sensory impairments, physical health) Intrapersonal Factors (e.g. personality and cognitive variables, identity) 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) Source: Sullivan & Victor, 2012

Are older people the loneliest?

35 30 25 20 15 10 5 0 <25 25-34 35-44 45-54 55-64 65-74 Source: Victor & Yang, 2012 ≥75 Male Always lonely Male Sometimes lonely Female Always lonely Female Sometimes lonely

Has loneliness in old age increased?


Always/often 8 9


9 Sometimes 13 Never 79 25 66 32 61 Source: Victor et al, 2009

30 25 20 15 10 5 0

Loneliness & ethnic minorities

45-64 65+ 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 Worse loneliness loneliness Consistently Never lonely (%) lonely (%) (%)

Victor Bowling & 12 (2012)


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