What do you expect at your age? Loneliness and old age Christina Victor, School of Health Sciences & Social Care, Brunel University

2 Presentation overview What is loneliness? Why is loneliness important? Loneliness & old age

Living alone Being alone IsolationSolitude 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 …. 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

Are older people the loneliest? Source: Victor & Yang, 2012

Has loneliness in old age increased? SHELDON 1948 TOWNSEND 1954 VICTOR 2005 Always/often899 Sometimes Never Source: Victor et al, 2009

Loneliness & ethnic minorities 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 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