Practice question

What approach should I take if I think an older person is lonely?

Nurses need the knowledge and skills to identify older people who are lonely so they can choose the appropriate service or intervention.

Nurses need the knowledge and skills to identify older people who are lonely so they can choose an appropriate service or intervention

Lonely
Nurses play a vital role in reaching out to isolated older people Picture: Alamy

The normal human emotion of loneliness is a sign of wanting contact with people and it is known that prolonged exposure to loneliness can have a devastating effect on a person’s well-being.

The link between loneliness and cardiovascular disease has been established, but recent research has identified that people who experience loneliness are twice as likely to develop Alzheimer’s disease (Wilson et al 2007).

Loneliness can be as harmful to the health of older people as smoking 15 cigarettes a day (Holt-Lunstad et al 2010).

Older people may be at increased risk due to: health, sensory and mobility difficulties; the death of a partner or close friend; divorce; retirement or redundancy; giving up driving; low income; moving into a care home; or hospital admission (National Institute for Health and Care Excellence 2016).

Nurses can play a vital role in reaching people at risk of loneliness, particularly those who live in isolation whose only regular human contact is with healthcare professionals (Victor et al 2009). According to the Campaign to End Loneliness (2011), three quarters of GPs (76%) report that up to five patients a day attend surgery primarily because they are lonely. This gives nurses ideal opportunities to reach out to them.

Consultation

Once a person at high risk of loneliness has been identified, the nurse should initiate a discussion during the consultation. This may be as part of a comprehensive geriatric assessment, transition to a care home, routine heath check or home visit. View tools available to measure the levels of loneliness here.

Once it has been established that someone is lonely, a person-centred response involving discussion with the person is required. This will establish the person’s circumstances and needs, and allow the nurse to identify an appropriate local service or intervention to boost the person’s well-being.

Research demonstrates group-based, one-to-one and technology interventions achieve the best results. Where the barriers to leaving a home are too great to overcome, befriending services are highly valued. Face-to-face is the preferred method, but phone calls can be a useful alternative (Cattan et al 2005).

Given the prevalence of loneliness among older people, and the negative effect it has on their health and well-being, nurses in all settings should develop the skills to sensitively identify the individual circumstances and needs of people at risk. Nurses also need the local knowledge to offer lonely older people appropriate services or interventions. 


About the author

Vicki_Leah

Vicki Leah is consultant nurse (older people) at University College Hospital in London


 

 

Further information

  • Victor C, Scambler S, Bond J (2009) The social world of older people: Understanding Loneliness and Social Isolation in Later Life. Open University Press, Maidenhead.

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