title: What do older people experiencing loneliness think about primary care or community based interventions to reduce loneliness? A qualitative study in England.
abstract: Loneliness in later life is a common problem with poor health outcomes. However, interventions to prevent or ameliorate loneliness have a weak evidence base. The views of older people experiencing or at risk of loneliness in the community are important in identifying features of potential support, but have been little studied. Twenty-eight community dwelling people, aged 65 and over who reported being 'lonely much of the time' or identified as lonely from the de Jong Gierveld six-item loneliness scale in a larger study, participated in in-depth interviews, between June 2013 and May 2014. Views and experiences on seeking support from primary care and community based one-to-one and group based activities, including social and shared interest groups, were explored. Interviews were recorded and transcribed. Thematic analysis was conducted by a multidisciplinary team, including older people. Using two different measures of loneliness enabled a spectrum of loneliness experience to be explored. Two-thirds of the participants were the 'younger old' and all were able to leave their homes independently. Older people with characteristics of loneliness were generally knowledgeable about local social and community resources but, for the majority, community and primary care based services for their loneliness were not considered desirable or helpful at this point in their lives. However, group based activities with a shared interest were thought preferable to one-to-one support (befriending) or groups with a social focus. Descriptions of support as being for loneliness and specific to older people discouraged engagement. Older people experiencing or at risk of loneliness did not consider that primary care has a role in alleviating loneliness because it is not an illness. They thought primary care practitioners lack understanding of non-physical problems and that a good relationship was necessary to discuss sensitive issues like loneliness. For many, loneliness was a complex and private matter that they wished to manage without external support.
authors.affiliation: Primary Care and Population Health, University College London, London, UK.
authors.forename: Kalpa
authors.initials: K
authors.lastname: Kharicha
authors.affiliation: Department of Primary Care & Population Studies, University College London, London, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: Kings College London, London, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.affiliation: Primary Care & Health Sciences, Keele University, Staffs, UK.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Chew-Graham
authors.affiliation: School of Health, Community and Education Studies, Northumbria University, Newcastle upon Tyne, UK.
authors.forename: Mima
authors.initials: M
authors.lastname: Cattan
authors.affiliation: CRIPACC, Faculty of Health and Human Sciences, University of Hertfordshire, Hatfield, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Goodman
authors.affiliation: Lay Member, London, UK.
authors.forename: Maggie
authors.initials: M
authors.lastname: Kirby-Barr
authors.affiliation: Lay Member, Essex, UK.
authors.forename: Janet H
authors.initials: JH
authors.lastname: Whitehouse
authors.affiliation: Primary Care and Population Health, University College London, London, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004739:England; D005260:Female; D006801:Humans; D057187:Independent Living; D008132:Loneliness / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D024382:Professional Role; D036301:Qualitative Research; D012847:Single Person / Q000523:psychology; D012919:Social Behavior; D012944:Social Support
keywords: community based interventions; loneliness; older people; primary care