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Negative self-perceptions and loss of meaningful relationships among factors perpetuating loneliness

Kitzmüller G, Clancy A, Vaismoradi M, Wegener C, Bondas T. "Trapped in an empty waiting room" - The existential human core of loneliness in old age: A meta-synthesis Qualitative Health Research. 2018;28(2):213-230.

Review question

      In what ways do older adults experience loneliness and how can it be effectively addressed?


      Loneliness among older adults poses significant challenges because it is associated with a higher risk of mortality and reduced quality of life. Loneliness is often influenced by culture, gender, personal resources, living situation and family status.

      While there is a wide range of interventions to reduce older adults’ perceived loneliness, they rarely factor in individual subjective experiences.

      This systematic review synthesizes research evidence on loneliness as perceived and experienced by older adults.

How the review was done

      A detailed search of a number of electronic databases was conducted to identify studies published between 2001 and 2016. Studies that focused on the perspectives of older adults (60+) regarding loneliness were included in the systematic review.

      A total of 11 studies were included in the review after assessing their eligibility.

      The authors did not acknowledge any funding sources for this review.

What the researchers found

      Loneliness experienced by older adults was described as being “trapped in an empty waiting room”.

      Four factors emerged from this review that can exacerbate loneliness : 1) negative imprisoning emotions; 2) the loss of meaningful interpersonal relationships, 3) negative self-perceptions; and 4) a struggle to maintain the energy to endure.

      The quality of social contacts is more important than the quantity — meaning that engaging with those who demonstrate a lack of concern or care is of little benefit to older adults. It is important for older adults to develop and maintain meaningful social ties with others of their own generation with whom they share common experiences.

      It is important for older adults to feel valued in their community. Health and social care workers can help facilitate the development of supportive networks and activities for older adults.

      The sentiment that life is meaningless appeared to be the most critical factor associated with loneliness among older adults.


      Loneliness in old age can be difficult to prevent as it often influenced by factors that are a consequence of aging, such as facing multiple losses.

      Informal and family caregivers as well as health and social care workers should work together to address this multifaceted issue. They should aim to promote quality relationships and support activities that foster positive self-reflection and self-appreciation. For instance, art interventions and storytelling can enhance interpersonal relationships and develop self-esteem. These activities should be enjoyable and individualized to older adults so that they can resonate with them.


Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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