Loneliness and later life: prevalence and consequences

Christina Victor, School of Health Sciences & Social Care, Brunel University, UK

Presentation overview

• What is loneliness-definition & measurements • Prevalence of loneliness • Consequences of loneliness

What gives quality to life?

• Personal social capital (social activities, contacts and support, loneliness) a key dimension of quality of life • Social relationships one of the ‘good things’ that give ‘quality’ to life.

Bowling and Gabriel (2004) (Bowling et al. 2002).

“Language... has created the word "loneliness" to express the pain of being alone. And it has created the word "solitude" to express the glory of being alone.” Paul Tillich

What is loneliness?

Living alone Being alone

Loneliness-emotional, social, existential

Isolation Solitude

What is loneliness?

Theoretical or conceptual understandings of loneliness are both complex and contested (Peplau and Perlman, 1982). Three main approaches: Self rating question Single dimension scale-UCLA Multi-dimensional scale-de Jong Gierveld measure which distinguishes social and emotional 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 and old age

In 2010 a survey reported community breakdown as the major contemporary ‘social ills- it was felt that neighbours no longer know or look out for one another, which left people feeling isolated, lonely and fearful – particularly the elderly

‘’Loneliness is an inner, gnawing pain born of circumstance and inertia, verging on despair. There is a higher risk the older

you get, and no one talks about it’’ Joan Bakewell-The Times 31/12/09

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)

Prevalence of loneliness

• • • • Peer group (comparison with other older people) Generation contrasted (comparison with younger people) Age-related (comparison with younger selves) Preceding cohort (comparison with previous cohorts of older people)

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?

SHELDON 1948 TOWNSEND 1954

Always/often 8 9

VICTOR 2005

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

Age related loneliness

More Less No change

Loneliness compared with 10 years ago

13 10 77

Loneliness in 10 years time

16 13 71

Loneliness varies over time

• 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

How does loneliness vary over time?

• • If we follow people aged 65+ over 5 years we find that: – 25% become more lonely – 12% become less lonely – 22% were always lonely – 44% never lonely So we can see different types of loneliness which might have different causes and require different types of interventions Source: Victor & Bowling, 2012

Understanding loneliness

‘’Loneliness and

social isolation are subjective lived experiences that exist in the form of multiple realities constructed and reconstructed by individual older people within the context of their different lives and life histories’’

al., 2009).

(Victor et Interpersonal Engagement (e.g. quality of relationships with family, friends, neighbours) Source: Sullivan & Victor, 2012 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)

Loneliness & ethnic minorities

Source: Victor & Burholt, 2012

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