title: Being in a Bubble: the experience of loneliness among frail older people.
abstract: OBJECTIVE
  The aim of this study was to explore the experience of loneliness among frail older people living at home.
  
  
  BACKGROUND
  Loneliness is a threat to the physical and psychological well-being with serious consequences if left unattended. There are associations between frailty and poor psychological well-being, implying that frail older people who experience loneliness are vulnerable.
  
  
  METHODS
  Qualitative content analysis, focusing on both latent and manifest content.
  
  
  METHODS
  Frail older people (65+ years), living at home and who have experienced various levels in intensity of loneliness, were purposively selected from a larger interventional study (N = 12). For this study, 'frail' means being dependent in activities of daily life and having repeated contacts with healthcare services. Data were collected between December 2009-August 2011. Semi-structured interviews were performed, audio recorded and transcribed verbatim.
  
  
  RESULTS
  The analysis resulted in the overall theme 'Being in a Bubble', which illustrates an experience of living in an ongoing world, but excluded because of the participants' social surroundings and the impossibility to regain losses. The theme 'Barriers' was interpreted as facing physical, psychological and social barriers for overcoming loneliness. The theme 'Hopelessness' reveals the experience when not succeeding in overcoming these barriers, including seeing loneliness as a constant state. A positive co-existing dimension of loneliness, offering independence, was reflected in the theme 'Freedom'.
  
  
  CONCLUSIONS
  The findings suggest that future strategies for intervening should target the frail older persons' individual barriers and promoting the positive co-existing dimension of loneliness. When caring, a person centred approach, encompassing knowledge regarding physical and psychological aspects, including loneliness, is recommended.
authors.affiliation: Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Malmö, Sweden.
authors.forename: Elin
authors.identifier: http://orcid.org/0000-0002-1384-4291
authors.initials: E
authors.lastname: Taube
authors.affiliation: Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Malmö, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Jakobsson
authors.affiliation: Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Malmö, Sweden.
authors.forename: Patrik
authors.initials: P
authors.lastname: Midlöv
authors.affiliation: Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
authors.forename: Jimmie
authors.initials: J
authors.lastname: Kristensson
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D012934:Social Isolation / Q000523:psychology*; D058992:Social Participation / Q000523:psychology*; D013548:Sweden
keywords: frail elderly; frailty; loneliness; nursing; older people; qualitative research; quality of life