Experiences and social constructions of loneliness in later life: Collaborative focus group discussions in Germany

BACKGROUND: Ageing in place (AIP) policies seek to address the growing demand for healthcare needs among ageing populations. Loneliness has been identified as a challenge to AIP, as the number of people living alone at home is growing. OBJECTIVE: To understand older adults' perspectives on loneliness associated with AIP and to use these insights to inform health professional practice and health policy for the development of patient-centered solutions. METHODS: To identify issues of significance to the participants, we employed collaborative focus group discussions (FGD). From a set of eight topics presented, participants selected topics to discuss. Loneliness emerged as a prominent theme in the discussions. Six FGDs among twenty-seven older adults and patients of rehabilitation clinics were conducted. RESULTS: The methodological approach provided unparalleled access to older adults' experiences of loneliness. The study's participants experience poor quality of social contact and associate loneliness with negative physical and mental consequences. While mobility loss and physical inaccessibility are described as factors for becoming lonely, preventive strategies, such as reevaluating social contacts in the absence of intimacy, suggest that the distinction between emotional and social loneliness may coincide in lived experience, indicating that preventive measures should consider their fluid boundaries. CONCLUSION: Assessing loneliness requires taking individual perspectives into account, as mere quantification of social contacts is insufficient for evaluation or intervention design. To help cope with loneliness, health professionals are an important social interface and can become a substitute for close relationships. This should be reflected in professional roles and in developing complementary technologies and policies.