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Ringing the changes: the role of telephone communication in a helpline and befriending service targeting loneliness in older people



The drive to deliver services addressing loneliness in older people by telephone and online makes it increasingly relevant to consider how the mode of communication affects the way people interact with services and the capacity of services to meet their needs. This paper is based on the qualitative strand of a larger mixed-methods study of a national phoneline tackling loneliness in older people in the United Kingdom. The research comprised thematic analysis of four focus groups with staff and 42 semi-structured interviews with callers. It explored the associations between telephone-delivery, how individuals used the services and how the services were able to respond. To understand these associations, it was useful to identify some constituent characteristics of telephone communication in this context: namely its availability, reach and non-visual nature. This enabled various insights and comparison with other communication media. For example, the availability of the services attracted people seeking frequent emotional support but this presented challenges to staff. More positively, the ability of the services to connect disparate individuals enabled them to form different kinds of satisfying relationships. The evolution of mixed communication forms, such as internet-based voice communication and smartphone-based visual communication, makes analysis at the level of a technology's characteristics useful. Such a cross-cutting perspective can inform both the design of interventions and assessment of their suitability for different manifestations of loneliness.


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Address for correspondence: Claire Preston, Faculty of Health, Social Care & Education, Anglia Ruskin University, Young Street Site, East Road, Cambridge CB1 1PT, UK E-mail:


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Andrews, J. G., Gavin, N., Begley, S. and Brodie, D. 2003. Assisting friendships, combating loneliness: users’ views on a ‘befriending’ scheme. Ageing & Society, 23, 3, 349–62.
Attard, A. and Coulson, N. S. 2012. A thematic analysis of patient communication in Parkinson's disease online support group discussion forums. Computers in Human Behavior, 28, 2, 500–6.
Bargh, J. A. and McKenna, K. Y. 2004. The Internet and social life. Annual Review of Psychology, 55, 573–90.
Boddy, J., Smith, M. and Simon, A. 2005. Telephone support for parenting: an evaluation of Parentline Plus. Children & Society, 19, 4, 278–91.
Bos, A. E., Visser, G. C., Tempert, B. F. and Schaalma, H. P. 2004. Evaluation of the Dutch AIDS information helpline: an investigation of information needs and satisfaction of callers. Patient Education and Counseling, 54, 2, 201–6.
Boss, L., Kang, D.-H. and Branson, S. 2015. Loneliness and cognitive function in the older adult: a systematic review. International Psychogeriatrics, 27, 4, 541–53.
Bouwman, T. E., Aartsen, M. J., van Tilburg, T. G. and Stevens, N. L. 2016. Does stimulating various coping strategies alleviate loneliness? Results from an online friendship enrichment program. Journal of Social and Personal Relationships, 34, 6, 119.
Briggle, A. 2008. Real friends: how the Internet can foster friendship. Ethics and Information Technology 10, 1, 71–9.
Butler, S. S. 2006. Evaluating the Senior Companion Program: a mixed-method approach. Journal of Gerontological Social Work, 47, 12, 4570.
Cacioppo, J. T., Hawkley, L. C. and Thisted, R. 2010. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging, 25, 2, 453–63.
Cacioppo, S., Grippo, A. J., London, S., Goossens, L. and Cacioppo, J. T. 2015. Loneliness clinical import and interventions. Perspectives on Psychological Science, 10, 2, 238–49.
Caplan, S. E. 2006. Relations among loneliness, social anxiety, and problematic Internet use. CyberPsychology & Behavior 10, 2, 234–42.
Cattan, M., Kime, N. and Bagnall, A. 2011. The use of telephone befriending in low level support for social isolated older people – an evaluation. Health and Social Care in the Community, 19, 2, 198206.
Cattan, M., White, M., Bond, J. and Learmonth, A. 2005. Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing & Society, 25, 1, 4167.
Charlesworth, G., Shepstone, L., Wilson, E., Reynolds, S., Mugford, M., Price, D., Harvey, I. and Poland, F. 2008. Befriending carers of people with dementia: randomised controlled trial. British Medical Journal, 336, 7656, 1295–7.
Choi, M., Kong, S. and Jung, D. 2012. Computer and internet interventions for loneliness and depression in older adults: a meta-analysis. Healthcare Informatics Research, 18, 3, 191–8.
Cohen-Mansfield, J. and Perach, R. 2015. Interventions for alleviating loneliness among older persons: a critical review. American Journal of Health Promotion, 29, e10925.
Cole, S. W., Capitanio, J. P., Chun, K., Arevalo, J. M., Ma, J. and Cacioppo, J. T. 2015. Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation. Proceedings of the National Academy of Sciences of the United States of America, 112, 49, 15142–7.
Cotten, S. R., Anderson, W. A. and McCullough, B. M. 2013. Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis. Journal of Medical Internet Research, 15, e39.
Coyle, C. and Dugan, E. 2012. Social isolation, loneliness and health among older adults. Journal of Aging and Health, 24, 8, 1346–63.
Dahlberg, L. 2004. Internet research tracings: towards non-reductionist methodology. Journal of Computer Mediated Communication, 9, 3.
Dean, J. and Goodlad, R. 1998. Supporting Community Participation: The Role and Impact of Befriending. Joseph Rowntree Foundation, York, UK.
Department of Health 2012. Caring for Our Future: Reforming Care and Support. Department of Health, The Stationery Office, London.
Department for Work and Pensions 2013. Policy Paper 2010 to 2015 Government Policy: Older People. Updated 2015. Available online at [Accessed 3 May 2017].
Deters, F. G. and Mehl, M. R. 2013. Does posting Facebook status updates increase or decrease loneliness? An online social networking experiment. Social Psychological and Personality Science, 4, 5, 579–86.
Elder, A. 2014. Excellent online friendships: an Aristotelian defense of social media. Ethics and Information Technology, 16, 4, 287–97.
Findlay, R. A. 2003. Interventions to reduce social isolation amongst older people: where is the evidence? Ageing & Society, 23, 5, 647–58.
Foresight, Government Office for Science 2015. Present and Future Configuration of Health and Social Care Services to Enhance Robustness in Older Age. Available online at [Accessed 10 May 2016].
Garattini, C., Wherton, J. and Prendergast, D. 2012. Linking the lonely: an exploration of a communication technology designed to support social interaction among older adults. Universal Access in the Information Society, 11, 2, 211–22.
Gardiner, C., Geldenhuys, G. and Gott, M. 2016. Interventions to reduce social isolation and loneliness among older people: an integrative review. Health and Social Care in the Community, 26, 2, 147157.
Gerst-Emerson, K. and Jayawardhana, J. 2015. Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults. American Journal of Public Health, 105, 5, 1013–9.
Gierveld, J. D. 1998. A review of loneliness: concept and definitions, determinants and consequences. Reviews in Clinical Gerontology, 8, 1, 7380.
Gierveld, J. D. and Fokkema, T. 2015. Strategies to prevent loneliness. In Sha'ked, A. and Rokach, A. (eds), Addressing Loneliness: Coping, Prevention and Clinical Interventions. Volume 1, Psychology Press, New York, 218–30.
Greenhalgh, T., Wherton, J., Sugarhood, P., Hinder, S., Procter, R. and Stones, R. 2013. What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare. Social Science & Medicine, 93, 8694.
Hackett, R. A., Hamer, M., Endrighi, R., Brydon, L. and Steptoe, A. 2012. Loneliness and stress-related inflammatory and neuroendocrine responses in older men and women. Psychoneuroendocrinology, 37, 11, 1801–9.
Hawkley, L. C., Thisted, R. A., Masi, C. M. and Cacioppo, J. T. 2010. Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychology and Aging, 25, 1, 132–41.
Holt-Lunstad, J., Smith, J. T. and Layton, B. J. 2010. Social relationships and mortality risk: a meta-analytic review. PLOS Medicine, 7, 7, 120.
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T. and Stephenson, D. 2015. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10, 2, 227–37.
Jaremka, L. M., Fagundes, C. P., Peng, J., Belury, M. A., Andridge, R. R., Malarkey, W. B. and Kiecolt-Glaser, J. K. 2015. Loneliness predicts postprandial ghrelin and hunger in women. Hormones and Behavior, 70, 5763.
Khvorostianov, N., Elias, N. and Nimrod, G. 2012. ‘Without it I am nothing’: the internet in the lives of older immigrants. New Media & Society, 14, 4, 583–99.
Lauder, W., Mummery, K., Jones, M. and Caperchione, C. 2006. A comparison of health behaviours in lonely and non-lonely populations. Psychology, Health & Medicine, 11, 2, 233–45.
Lester, H., Mead, N., Graham, C. C., Gask, L. and Reilly, S. 2012. An exploration of the value and mechanisms of befriending for older adults in England. Ageing & Society, 32, 2, 307–28.
Lindley, S. E., Harper, R. and Sellen, A. 2008. Designing for elders: exploring the complexity of relationships in later life. In England, D. (ed), Proceedings of the 22nd British HCI Group Annual Conference on People and Computers: Culture, Creativity, Interaction. Volume 1, British Computer Society, Swindon, 77–86.
Local Government Association and the Campaign to End Loneliness 2012. Combatting Loneliness: A Guide for Local Authorities. Available online at [Accessed 10 May 2016].
Martina, C. M. S. and Stevens, N. L. 2006. Breaking the cycle of loneliness? Psychological effects of a friendship enrichment program for older women. Aging and Mental Health, 10, 5, 467–75.
Masi, C. M., Chen, H.-Y., Hawkley, L. C. and Cacioppo, J. T. 2011. A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review, 15, 3, 219–66.
McNeil, J. K. 1995. Effects of nonprofessional home visit programs for subclinically unhappy and unhealthy older adults. Journal of Applied Gerontology, 14, 3, 333–42.
Mead, N., Lester, H., Chew-Graham, C., Gask, L. and Bower, P. 2010. Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis. British Journal of Psychiatry, 196, 2, 96101.
Mental Health Foundation 2012. Lifelines: Evaluation of Mental Health Helplines. Mental Health Helplines Partnership, Peterborough, UK.
Miles, M. B. and Huberman, A. M. 1994. Qualitative Data Analysis: An Expanded Sourcebook. Sage, London.
Moore, S. and Preston, C. 2015. The Silver Line: Tackling Loneliness in Older People. Anglia Ruskin University, Cambridge.
Morahan-Martin, J. and Schumacher, P. 2003. Loneliness and social uses of the Internet. Computers in Human Behavior, 19, 6, 659–71.
Nef, T., Ganea, R. L., Müri, R. M. and Mosimann, U. P. 2013. Social networking sites and older users – a systematic review. International Psychogeriatrics, 25, 7, 1041–53.
Newall, N., McArthur, J. and Menec, V. H. 2015. A longitudinal examination of social participation, loneliness, and use of physician and hospital services. Journal of Aging and Health, 27, 3, 500–18.
Nimrod, G. 2010. Seniors’ online communities: a quantitative content analysis. The Gerontologist, 50, 3, 382–92.
Nimrod, G. 2013. Applying gerontographics in the study of older Internet users. Participations: Journal of Audience & Reception Studies, 10, 2, 4664.
O'Shea, E. 2006. An economic and social evaluation of the Senior Help Line in Ireland. Ageing & Society, 26, 2, 267–84.
Peerenboom, L., Collard, R. M., Naarding, P. and Comijs, H. C. 2015. The association between depression and emotional and social loneliness in older persons and the influence of social support, cognitive functioning and personality: a cross-sectional study. Journal of Affective Disorders, 182, 2631.
Perlman, D. and Peplau, L. A. 1981. Toward a social psychology of loneliness. In Gilmour, R. and Duck, S. (eds), Personal Relationships 3: Personal Relationships in Disorder. Academic, London, 3143.
Pollock, K., Armstrong, S., Coveney, K. and Moore, J. 2010. An evaluation of Samaritans telephone and email emotional support service. University of Nottingham, Nottingham, UK.
Richards, D. and Viganó, N. 2013. Online counseling: a narrative and critical review of the literature. Journal of Clinical Psychology, 69, 9, 9941011.
Seepersad, S. 2015. Helping the ‘poor get richer’ – successful internet loneliness intervention programs. In Sha'ked, A. and Rokach, A. (eds), Addressing Loneliness: Coping, Prevention and Clinical Interventions. Volume 1, Psychology Press, New York, 231–40.
Sønderby, L. C. and Wagoner, B. 2013. Loneliness: an integrative approach. Journal of Integrated Social Sciences, 3, 1, 129.
Stevens, N. L. 2001. Combating loneliness: a friendship enrichment programme for older women. Ageing & Society, 21, 2, 183202.
Sturges, J. E. and Hanrahan, K. J. 2004. Comparing telephone and face-to-face qualitative interviewing: a research note. Qualitative Research, 4, 1, 107–18.
US Senate, Special Committee on Aging 2017 Aging Without Community: The Consequences of Isolation and Loneliness. Available online at [Accessed 30 August 2017].
Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S. and Hanratty, B. 2016. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart, 102, 13, 1009–16.
Victor, C. R., Scambler, S. J., Bowling, A. and Bond, J. 2005. The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain. Ageing & Society, 25, 6, 357–75.
Weiss, R. S. 1973. Loneliness: The Experience of Emotional and Social Isolation. MIT Press, Cambridge, Massachusetts.
Wilson, R. S., Krueger, K. R., Arnold, S. E., Schneider, J. A., Kelly, J. F., Barnes, L. L., Tang, Y. and Bennett, D. A. 2007. Loneliness and risk of Alzheimer disease. Archives of General Psychiatry 64, 2, 234–40.



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