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Strategies employed by older people to manage loneliness: systematic review of qualitative studies and model development

  • Kalpa Kharicha (a1), Jill Manthorpe (a2), Steve Iliffe (a1), Nathan Davies (a1) and Kate Walters (a1)...



To (i) systematically identify and review strategies employed by community dwelling lonely older people to manage their loneliness and (ii) develop a model for managing loneliness.


A narrative synthesis review of English-language qualitative evidence, following Economic and Social Research Council guidance. Seven electronic databases were searched (1990–January 2017). The narrative synthesis included tabulation, thematic analysis, and conceptual model development. All co-authors assessed eligibility of final papers and reached a consensus on analytic themes.


From 3,043 records, 11 studies were eligible including a total of 502 older people. Strategies employed to manage loneliness can be described by a model with two overarching dimensions, one related to the context of coping (alone or with/in reference to others), the other related to strategy type (prevention/action or acceptance/endurance of loneliness). The dynamic and subjective nature of loneliness is reflected in the variety of coping mechanisms, drawing on individual coping styles and highlighting considerable efforts in managing time, contacting others, and keeping loneliness hidden. Cognitive strategies were used to re-frame negative feelings, to make them more manageable or to shift the focus from the present or themselves. Few unsuccessful strategies were described.


Strategies to manage loneliness vary from prevention/action through to acceptance and endurance. There are distinct preferences to cope alone or involve others; only those in the latter category are likely to engage with services and social activities. Older people who deal with their loneliness privately may find it difficult to articulate an inability to cope.


Corresponding author

Correspondence should be addressed to: Kalpa Kharicha, Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK. Phone: 020 7830 2392. Email: Orcid: 0000-0002-2975-2084.


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Andersson, L. (1998). Loneliness research and interventions: a review of the literature. Aging and Mental Health, 2, 264272.
Barke, J. (2017). Community-based research and approaches to loneliness prevention. Working with Older People, 21, 115123.
Cattan, M., Newell, C., Bond, J. and White, M. (2003). Alleviating social isolation and loneliness among older people. International Journal of Mental Health Promotion, 5, 2030. doi:10.1080/14623730.2003.9721909.
Cattan, M. and White, M. (1998). Developing evidence-based health promotion for older people: a systematic review and survey of health promotion interventions targeting social isolation and loneliness among older people. Internet Journal of Health Promotion, 13, 19.
Cattan, M., White, M., Bond, J. and Learmouth, A. (2005). Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing & Society, 25, 4167.
Cohen-Mansfield, J. and Perach, R. (2015). Interventions for alleviating loneliness among older persons: a critical review. American Journal of Health Promotion, 29, e109–e125.
Critical Appraisal Skills Programme (CASP) (2017). CASP Qualitative Checklist. Available at:; last accessed 12 February 2018.
Davies, N., Crowe, M. and Whitehead, L. (2016). Establishing routines to cope with the loneliness associated with widowhood: a narrative analysis. Journal of Psychiatric and Mental Health Nursing, 23, 532539.
de Jong-Gierveld, J. (1987). Developing and testing a model of loneliness. Journal of Personality and Social Psychology, 53, 119.
Dickens, A., Richards, S. H., Greaves, C. J. and Campbell, J. L. (2011). Interventions targeting social isolation in older people: a systematic review. BMC Public Health, 11, 647.
Dykstra, P. A. (2009). Older adult loneliness: myths and realities. European Journal of Ageing, 6, 91100. doi:10.1007/s10433-009-0110-3.
ElderJr., G. H. Jr., G. H., and Johnson, M. K. (2003). The life course and aging: Challenges, lessons, and new directions. In R. A. Settersten (Ed.), Invitation to the life course. Toward New Understandings of Later Life (pp. 49–81). Amityville, NY: Baywood.
Findlay, R. A. (2003). Interventions to reduce social isolation amongst older people: where is the evidence? Ageing & Society, 23, 56475658.
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, doi:10.1111/hsc.12367.
Graneheim, U. H. and Lundman, B. (2010). Experiences of loneliness among the very old: the Umeå 85+ project. Aging & Mental Health, 14, 433438.
Hagan, R., Manktelow, R., Taylor, B. J. and Mallett, J. (2014). Reducing loneliness amongst older people: a systematic search and narrative review. Aging and Mental Health, 18, 683693.
Hauge, S. and Kirkevold, M. (2012). Variations in older persons’ descriptions of the burden of loneliness. Scandinavian Journal of Caring Sciences, 26, 553560.
Holt-Lunstad, J., Smith, T. B. and Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Medicine, 7, e1000316. Available at:
Honigh-de Vlaming, R., Haveman-Nies, A., Bos-Oude Groeniger, I., de Groot, L. and van ’t Veer, P. (2014). Determinants of trends in loneliness among dutch older people over the period 2005–2010. Journal of Aging and Health, 26, 422440. Available at:
Kharicha, K. et al. (2017). What do older people experiencing loneliness think about primary care or community based interventions to reduce loneliness? A qualitative study in England. Health and Social Care in the Community, 25, 17331742. doi:10.1111/hsc.12438.
Kirkevold, M., Moyle, W., Wilkinson, C., Meyer, J. and Hauge, S. (2013). Facing the challenge of adapting to a life ‘alone’ in old age: the influence of losses. Journal of Advanced Nursing, 69, 394403.
Lou, V. W. Q. and Ng, J. W. (2012). Chinese older adults’ resilience to the loneliness of living alone: a qualitative study. Aging & Mental Health, 16, 10391046. doi:10.1080/13607863.2012.692764.
Luanaigh, C. Ó. and Lawlor, B. A. (2008). Loneliness and the health of older people. International Journal of Geriatric Psychiatry, 23, 12131221. doi:10.1002/gps.2054.
Mental Health Foundation (2010). The Lonely Society. London: The Mental Health Foundation.
Peplau, L. A. and Perlman, D. (1982). Perspectives on Loneliness. In Peplau, L. A. and Perlman, D. (Eds.), Loneliness: A Sourcebook of Current Theory, Research and Therapy (pp. 120). Chichester: John Wiley and Sons.
Pettigrew, S. and Roberts, M. (2008). Addressing loneliness in later life. Aging & Mental Health, 12, 302309.
Popay, J. et al. (2006). Guidance on the Conduct of Narrative Synthesis in Systematic Reviews: A Product from the ESRC Methods Programme (Version 1). Lancaster: Lancaster University.
Roos, V. and Klopper, H. (2010). Older persons' experiences of loneliness: a South African perspective. Journal of Psychology in Africa, 20, 281289.
Smith, J. M. (2012). Toward a better understanding of loneliness in community-dwelling older adults. The Journal of Psychology, 146, 293311. doi:10.1080/00223980.2011.602132.
Stanley, M., Moyle, W., Ballantyne, A., Jaworski, K., Corlis, M. and Oxlade, D. (2010). ‘Nowadays you don't even see your neighbours’: loneliness in the everyday lives of older Australians. Health & Social Care in the Community, 18, 407414. doi:10.1111/j.1365-2524.2010.00923.x.
Strauss, A. and Corbin, J. (2008). Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Newbury Park, CA: Sage Publications.
Sullivan, M. P., Victor, C. R. and Thomas, M. (2016). Understanding and alleviating loneliness in later life: perspectives of older people. Quality in Ageing and Older Adults, 17, 168178.
Taube, E., Jakobsson, U., Midlov, P. and Kristensson, J. (2016). Being in a bubble: the experience of loneliness among frail older people. Journal of Advanced Nursing 72, 631640. doi:10.1111/jan.12853.
Tong, A., Flemming, K., McInnes, E., Oliver, S. and Craig, J. (2012). Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology, 12, 181. Available at:
Tong, A., Sainsbury, P. and Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19, 349357.
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, 10091016.
Victor, C., Scambler, S., 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 and Society, 25, 357375. doi:10.1017/S0144686X04003332.
Victor, C., et al. (2002). Has loneliness amongst older people increased? An investigation into variations between cohorts. Ageing and Society, 22, 585597. doi:10.1017/S0144686X02008784.
Weiss, R. S. (1973). Loneliness: The experience of emotional and social isolation. Cambridge, MA: The MIT Press.
Wilson, C. and Moulton, B. (2010). Loneliness among older adults: a national survey of adults 45+. Prepared by Knowledge Networks and Insight Policy Research. Washington, DC: AARP.
Windle, K., Francis, J. and Coomber, C. (2011). SCIE Research Briefing 39: Preventing Loneliness and Social Isolation: Interventions and Outcomes. London: Social Care Institute for Excellence.



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