Many of us have heard a lonely older adult saying that he or she was waiting for death.
This feeling of sadness and loneliness is experienced by many older adults. Mother Teresa said that "the most terrible poverty is loneliness and the feeling of being unloved." This feeling of loneliness can be transient, in relation to life events, but it can also persist when declining physical and cognitive capacities prevent seniors from seizing opportunities to socialize.
Different risk factors can contribute to the feeling of solitude experienced by many older adults.(1) The death of a spouse may lead to symptoms of depression and withdrawal from social life. The negative consequences of widowhood seem particularly important among men. Older adults who live alone, and have few friends or family members experience greater loneliness. Women report more loneliness than men, especially because they live longer. Culture, personality traits and life experiences may also explain why some older adults experience a greater sense of loneliness than others.
Although we have a better understanding of the risk factors and impacts of loneliness, it is important to better understand the phenomenon of loneliness from the perspective of seniors.
What the research tells us
A systematic review of 11 qualitative studies examined the perspective of older adults experiencing loneliness and its negative effects on their well-being, satisfaction of their needs, and quality of life.(1) In this review, loneliness was defined as suffering caused by the lack of social interaction, both in quantity and quality. The title of the systematic review is particularly evocative: Trapped in an empty waiting room.
Four main themes emerged from the review: negative emotions, loss of meaningful interpersonal relationships, self-perception and coping strategies.
1. Negative emotions
Loneliness is seen by many older adults as a wall that separates them from their environment, leaving them helpless and imprisoned in a meaningless life.
Older adults experiencing loneliness reported being overwhelmed by negative emotions such as sadness and pain, as well as anger or disappointment when they felt neglected, rejected or misunderstood by their loved ones. Fear and anxiety were experienced by many of these older adults because they were afraid of being a burden to others, did not want to be forced to move, and felt vulnerable because of illness and diminished capacities.
Also, when the older adult is one of the last living representatives of his or her generation, the feeling of abandonment and the desire to die were often exacerbated.
2. The loss of meaningful interpersonal relationships
The death of a loved one contributes greatly to the feeling of loneliness. The quality of social relations is more important than quantity: older adults value authentic relationships with friends or neighbors rather than with family members who feel compelled to visit them.
Many older adults find it difficult to be neglected by family or friends who are busy living their own lives.
Loneliness is also more marked during significant moments of the day or the year: during meals, festivities, holidays, evenings and nights.
3. Self-perceptions
Older adults who say they are lonely often feel useless in their community, which affects their self-esteem. Having meaningful social roles, and knowing that they mean something to their loved ones, can greatly improve their self-esteem.
Retirement, loss of a driver's licence and the lack of public transportation to meet their travel needs, poor financial means, cognitive and physical decline, and the lack of appropriate services contribute to the social isolation of many older adults and their feeling of being worthless.
4. Coping strategies
Some older adults are ashamed to feel lonely and believe that they are responsible for this condition, which contributes to their withdrawal. Speaking of it remains difficult, because it is seen as an admission of weakness, a burden that they do not want to put on their family.
Depending on their health status and capacities, some older adults are trying to be more active, through gardening, volunteering, phoning friends or relatives, listening to television, caring for an animal, looking for comfort in religion, and other coping strategies to deal with solitude. The decline in their health and a lack of energy, however, prevent many of them from performing activities that would make them feel better.