Loneliness among older adults living in residential care: Identifying the associated risk factors
Introduction
Older adults residing in residential care has been reported to feel lonely and almost 55% of them suffer from some forms of mental impairment. Ageing is one of the reasons behind being vulnerable to loneliness (Aung et al., 2017). This mental stated makes them feel unwanted and it has a severe negative effect on their quality of life. Impact is felt both on physical health as well as mental health. Moreover, loneliness is also a sign that there is a lack of meaningful connections in life. Due to advancing age, relationships decline and it is common for older adults to feel lonely. The results are increased rate of anti-social behaviour and decreased happiness.
According to the Australian loneliness Report, at least 1 in 4 Australians are likely to feel lonely at least 5 days a week (Health Times, 2020). Although previous research has been done to identify the factors behind this issue, there is a need to understand the role of other risk factors so that the problem can be fully understood. There is a need to find clear evidence, particularly in residential settings. Therefore, the present study aims to identify the risk factors that lead to loneliness among older adults.
Literature Review
According to Grenade & Boldy (2008), there is a link between social isolation and loneliness in older adults. However, there is a lack of understanding of the risk factors that are prevalent in this case. It has been suggested that a lot of factors should be understood in order to know the extent to which these factors play a role. The study is based on community-dwelling older adults and the risk factors identified are lack of children, widowhood, sudden bereavement and loss, health deterioration or other sad life events. Particularly, in a residential setting, the lack of any protective factor can lead to increasing rate of loneliness. The study could have been enriched if the researchers could have used a residential care-focussed research.
The author in this study opined that among Canadian older adults, the key determinant or factor behind loneliness is mainly an unbalanced person-environment fit (de Jong Gierveld, Keating & Fast, 2015). Moreover, personal characteristics of an individual also determine the degree to which he or she will feel lonely. Due to the lack of social engagement, older adults are dissatisfied with their life. The study is credible because 3,799 respondents have been included in the study and they are more than 65 years old. By conducting a social survey, it has been found that the size of social network is a determining factor behind loneliness. Moreover, the lonelier individuals might have been living in an economically challenged environment.
Another study conducted among older adults in Great Britain shows that loneliness is not fixed and there are various types of loneliness prevalent among older adults. The study again reveals that changes occurring in the marital status, social networks or living arrangements are likely to cause loneliness (Victor & Bowling, 2012). Therefore, one way to deal with the issue is by improving the social relationships and physical health. It is one of the effective ways of combating the disease. Nevertheless, it is not effective to stay confined in one area. The goal of care providers should be treatment of chronic health conditions.
The author argues that residential satisfaction plays a key role in removing loneliness from the lives of older adults. Two surveys have been conducted among older adults. One survey is on 234 institutionalised older people and the other on 1106 non-institutionalised older adults. The study finally concludes that older adults are likely to feel a sense of belonging after attaining residential satisfaction.
Aims
The present study will explore the degree to which the common risk factors have an impact on loneliness of older adults. It aims to understand the direct relationship between risk factors and loneliness as well. The existing literature has shown that common risk factors influencing loneliness are lack of a child (or surviving children), changes in marital status or bereavement and sudden loss of a dear family member. It has been hypothesised that interplay of all the risk factors can have severe implications on older adults. It might be death or functional decline such as mobility and ADLs (eating or bathing).
Significance of Research
Theoretical contributions of the study
The research study will enhance the basic understanding of mental health and physical health consequences of loneliness among older adults. It would strengthen the understanding of the areas of mental health such as cognitive or physiological consequences. The difference between being alone and being lonely can be identified as well. The need of human beings to rely on their social surrounding in order to derive happiness and satisfaction shall be explored as well. It is natural for older adults to feel vulnerable and therefore, the desire to make connections with others is quite normal. Therefore, the study aims to understand these areas exclusively.
Practical outcomes
In previous studies, effective instruments were not used for measuring the extent of loneliness. Grenade & Boldy (2008) in their study relied on secondary data. Only community-based studies were considered to identify the risk factors. Similarly, de Jong Gierveld, Keating & Fast (2015) used Statistics Canada’s General Social Survey, Cycle 22 in order to determine the factors behind loneliness and presented a generalised idea that person-environment fit is necessary for improving the condition of older adults. Hence, gap exists and there is a need to employ primary research. The present study aims to use a better and valid tool to measure the impact of risk factors of loneliness on older adults.
Proposed Research Methodology
Design framework
In this study, non-experimental and quantitative method will be used and a small focus group has been chosen. Experimental research can be limited and therefore by using a non-experimental design, it would be possible to study the variables (Kumar, 2019).
Sample
50 participants have been chosen for the focus group so that they can express their opinions freely. The participants might have different reasons behind feeling lonely and some might be sensitive issues as well. Moreover, purposive sampling technique will be used so that the sample for the study can be selected in a strategic manner (Flick, 2015). Older adults above 65+ years shall be chosen from Australia-based residential care home.
Data collection method
The study will be conducted by using the semi-structured interview method. During the interview, the older adults will be asked about their life experiences so that the risk factors can be appropriately identified. The interview session will last for about 60 minutes and the information shall be recorded.
Ethical considerations
The research participants are older adults and therefore excessive care shall be taken while interviewing them. During the interview, sensitive questions might be asked; however, no one will be forced to answer the questions. After taking full consent from the families of those older adults, the interview session will be conducted.
Methodology
Participants
The target population would be Australian older adults above 65 years because research shows that almost 55% of older adults feel lonely at least five times a week (Stanley et al., 2010). Particularly, the ones lacking companionship has been chosen for the study.
Sampling method
It would be challenging to gather relevant data from older adults because some participants might be unwilling to give honest responses due to lack of judgement from others in the focus group. Hence, it would be feasible to use convenience sampling. Data will be gathered from targeted residential home.
Methodology
In this study, the non-experimental and quantitative framework shall be used. The participants would be asked to rate their experience after losing a child, losing an intimate partner or family member and a sudden health issue that turned out to be chronic.
Ethical considerations
The issue is sensitive because the targeted older adults might be already suffering from mental illness and asking them to review or rate their experience can be challenging. Nevertheless, the subjective wellbeing of participants should be kept in mind in every study (Jamshed, 2014). Therefore questions shall be asked only after outlining a specific reason behind the asking the question.
Scope and Problems
The previous studies focussed primarily on secondary research to understand the loneliness issue. However, the present study has been proposed so that gap can be fulfilled and the impact of the risk factors of loneliness can be identified. The relationship between loneliness and life events would be explored using a focussed group interview method. The tool is simple and has the potential to gather relevant data. In group interviews, the older adults are likely to feel comfortable while sharing their experience because they will find solace in another person who has also experienced similar events. They are likely to feel a sense of belonging while sharing their experiences. An attempt to understand the origin of the risk factors will be fulfilled and it will be possible to identify the real-life implications of loneliness, thereby, finding an answer to the research question. Understanding the implications might be useful in creating more awareness in residential care homes.
References
Aung, K., Nurumal, M. S., & Wan Bukhar, W. N. S. (2017). Loneliness among elderly in nursing homes. International Journal for Studies on Children, Women, Elderly And Disabled, 2, 72-78.
de Jong Gierveld, J., Keating, N., & Fast, J. E. (2015). Determinants of loneliness among older adults in Canada. Canadian Journal on Aging/La Revue canadienne du vieillissement, 34(2), 125-136.
Flick, U. (2015). Introducing research methodology: A beginner’s guide to doing a research project. Sage.
Grenade, L., & Boldy, D. (2008). Social isolation and loneliness among older people: issues and future challenges in community and residential settings. Australian Health Review, 32(3), 468-478.
Jamshed, S. (2014). Qualitative research method-interviewing and observation. Journal of basic and clinical pharmacy, 5(4), 87.
Kumar, R. (2019). Research methodology: A step-by-step guide for beginners. Sage Publications Limited.
Stanley, M., Moyle, W., Ballantyne, A., Jaworski, K., Corlis, M., Oxlade, D., … & Young, B. (2010). ‘Nowadays you don’t even see your neighbours’: loneliness in the everyday lives of older Australians. Health & social care in the community, 18(4), 407-414.
Tackling loneliness in older Australians and aged care. (2020). Health Times. Retrieved 11 May 2020, from https://healthtimes.com.au/hub/aged-care/2/practice/hw/tackling-loneliness-in-older-australians-and-aged-care/4144/
Victor, C. R., & Bowling, A. (2012). A longitudinal analysis of loneliness among older people in Great Britain. The Journal of psychology, 146(3), 313-331.