title: Facing the challenge of adapting to a life 'alone' in old age: the influence of losses.
abstract: OBJECTIVE
  The aim of this study is to explore older people's approaches to living a life characterized by losses and 'aloneness' and how this relates to loneliness.
  
  
  BACKGROUND
  Loneliness is closely related to social status and health condition. Older people are vulnerable to experiences of loneliness due to losses, which follow the ageing process.
  
  
  METHODS
  A qualitative interpretative design was used. Older people, aged 65 and above, living at home, in retirement villages, or in long-term care settings in Australia, Norway, and UK participated. Seventy-eight persons were included. Data were collected through open-ended interviews during autumn of 2006 and spring of 2007. The interviews were audio taped, transcribed, and analysed applying a hermeneutic, interpretative process.
  
  
  RESULTS
  Analyses revealed great differences in the way participants handled their life situation. Interviewees describing themselves as 'not lonely' viewed losses as normal, and they participated in meaningful activities, connected to other people and thrived in their own company. Those describing themselves as 'lonely' on the other hand, strove to create meaning in their lives, were overwhelmed by losses, had problems finding meaningful activities and difficulty keeping up social relations.
  
  
  CONCLUSIONS
  Loneliness was associated with overwhelming losses, inactivity, meaninglessness, and social isolation. The contrasting findings between 'not lonely' and 'lonely' older people have implications for nursing in that nurses must seek to identify those who need help in managing their loneliness and give guidance and support. More research is needed to develop interventions that are effective in reducing loneliness.
authors.affiliation: Faculty of Medicine, Institute of Health and Society, University of Oslo, Norway. marit.kirkevold@medisin.uio.no
authors.forename: Marit
authors.initials: M
authors.lastname: Kirkevold
authors.forename: Wendy
authors.initials: W
authors.lastname: Moyle
authors.forename: Charlotte
authors.initials: C
authors.lastname: Wilkinson
authors.forename: Julienne
authors.initials: J
authors.lastname: Meyer
authors.forename: Solveig
authors.initials: S
authors.lastname: Hauge
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001601:Bereavement; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008132:Loneliness / Q000523:psychology*; D008297:Male; D009664:Norway; D012934:Social Isolation / Q000523:psychology; D006113:United Kingdom