Loneliness
Loneliness is one of the greatest public health challenges of our time. Nursing and midwifery are uniquely placed to recognise loneliness and help people to re-establish their social connections.
Research shows that loneliness and social isolation are harmful to health. Lack of social connections can increase the likelihood of early death by 26%. That risk is comparable to smoking 15 cigarettes a day, and is higher than that caused by obesity and physical inactivity.
In just a few decades loneliness has escalated from a personal misfortune into a social epidemic.
Loneliness can affect anyone, at any age, in any circumstances.
It is damaging to both our physical and mental health.
It is crucial that all nurses, in every setting, recognise loneliness and have easy to access resources to offer the best advice.
"Loneliness is the feeling we get when our need for rewarding social contact and relationships is not met"
Loneliness means different things to different people
Five things people say loneliness is:
- Having nobody to talk to
- Feeling disconnected to the world
- Feeling left out
- Sadness
- Not feeling understood.
(Results from the BBC Loneliness Experiment, Qualter et al 2019)
Key insights around loneliness
- Loneliness is a subjective experience. It is not an issue that can be judged against objective measures, and there is no ‘one size fits all’ approach that will prevent everyone from feeling lonely.
- Because loneliness is stigmatised, people are often reluctant to admit to feeling lonely. Therefore tick-box approaches to referrals, in which people are simply asked whether or not they are lonely, are unlikely to be effective in identifying those most in need.
- Loneliness affects mental and physical health. The effect of loneliness and isolation can be as harmful to health as obesity or smoking 15 cigarettes a day lonely individuals are at higher risk of the onset of disability loneliness puts individuals at greater risk of cognitive decline.
- Long-term loneliness can damage our ability to relate to one another. People often need support to build their confidence and skills to engage with new activities, and may need someone to come along with them to groups and activities.
- The most lonely individuals may need significant one-to-one support before they are able to connect with wider groups and activities in the community.
- Some of the most lonely people are completely isolated from other people and services. People from particularly marginalised communities can be at significant risk of loneliness and may not be in contact with health services – so outreach will be needed.
- Tackling loneliness is therefore an important way of improving people’s overall health and wellbeing.
- Loneliness can be tackled in a range of ways. This includes supporting people to improve the quality of their existing relationships, working on their attitudes, expectations and skills around relationships, as well as providing new opportunities for social connection.
Related RCN resources
Related news
- British Red Cross, June 2020. Life after lockdown: tackling loneliness
- Campaign to End Loneliness, 16 July 2020. The psychology of loneliness. This report looks at how psychological approaches can help tackle loneliness
- Effects of Covid-19 on the most vulnerable. What are the challenges that lie ahead for the most vulnerable groups in the aftermath of COVID-19?
- Department for Digital, Culture, Media and Sport. Loneliness Annual Report January 2021
How wide is the problem?
Young respondents were more likely to report loneliness than older respondents.
16 - 24: sometimes lonely = 31%, often or very often lonely = 40%
25 - 34: sometimes lonely = 29%, often or very often lonely = 34%
35 - 44: sometimes lonely = 26%, often or very often lonely = 36%
45 - 54: sometimes lonely = 24%, often or very often lonely = 34%
55 - 64: sometimes lonely = 22%, often or very often lonely = 32%
65 - 74: sometimes lonely = 21%, often or very often lonely = 29%
75+: sometimes lonely = 22%, often or always lonely = 26%
(Results from the BBC Loneliness Experiment, Qualter et al 2019)
What are the effects of loneliness
- loneliness can have serious physical Implications including
- high blood pressure
- high cholesterol
- obesity / poor nutrition
- vasoconstriction
- increased cortisol
- increased interleuken
- increased inflammatory response
- prolonged, high cortisol levels can cause anxiety, depression, digestive problems, heart disease, sleep problems, and weight gain
- deficits in self-care and motivation, and shortfalls in nutrition, exercise and personal hygiene
- other groups of older people more at risk are those with chronic illnesses that undermine their energy and morale
- maintaining medication regimens, looking after hygiene, dealing with wounds, stomas and prosthetics may be much more difficult when patients ask, ‘Why am I bothering?’ or ‘Who is this all for?’
The hidden wound - how to identify loneliness
Nursing staff have unique opportunities for identifying loneliness.
Assessing if someone is lonely is an essential part of a nursing assessment, social connectedness has positive health implications and it is important we promote it. There are a wide range of assessment tools to help you identify loneliness but as a start one direct question should be asked:
How often do you feel lonely?
- often or always
- some of the time
- occasionally
- hardly ever
- never.
What helps people to overcome loneliness
The evidence is not one solution that suits everyone. Interventions need to be individual and people often need help accessing opportunities.
Activities to consider include:
- helping people understand that initiating and maintaining social connectedness are important to health
- ensuring people have transport
- ensuring people have money
- helping them access social media and new technologies
- have friends and links with people all ages
- encourage people to be engaged and accommodating
- ensure vision and hearing are assessed regularly
- help people acknowledge the changes that are occurring in their lives
- consider pets and virtual companions
- help individuals volunteer and share their talents and skills.
Measuring loneliness
British Red Cross (2019) Assessing progress in tackling loneliness. This independent report from the Loneliness Action Group assesses progress made against the Loneliness Strategy so far.
Office for National Statistics (2018) Introduction: Developing national indicators of loneliness. Why loneliness should be investigated, the rationale for national indicators across all ages and how we define loneliness.
What Works Wellbeing. Loneliness. Evidence, resources and guidance on understanding and tackling loneliness.
Children and young people
Childline. Feeling lonely. Information on how to trust others, living in care or moving around, and what you can do if you are feeling lonely.
Office for National Statistics (2018) Children’s and young people’s experiences of loneliness: 2018. Analysis of children's and young people’s views, experiences and suggestions to overcome loneliness.
The Children's Society (2019) Loneliness in childhood. Exploring loneliness and well-being among 10-17 year olds.
Adults
Mind. Loneliness. This page explains loneliness, including the causes of loneliness and how it relates to mental health problems. It gives practical tips to help manage feelings of loneliness, and other places you can go for support.
National Federation of Women’s Institutes (2018) Link Together to alleviate loneliness. A campaign toolkit to help support loneliness.
NHS. Feeling lonely. Resources to support loneliness.
Nuffield Health. 10 ways to take action against loneliness. Useful tips on how to take control of your loneliness.
Older adults
Age UK. Loneliness and isolation. Understanding the difference and why it matters.
Campaign to end loneliness. Threat to health. This page outlines the main research into the impact of loneliness on physical and mental health and wellbeing.
People living with cognitive impairment
Alzheimer's Society. Loneliness and depression. Advice and practical tips for people living with dementia who are feeling lonely or depressed.
Campaign to end loneliness. Loneliness and dementia.
Further resources
- Age.UK. Loneliness. This page provides advice, information and support on loneliness in later life.
- Be More Us. Be More Us aims to create a movement of people and organisations encouraging small moments of connection. Individuals and organisations can sign up to receive tips and ideas on how to feel more connected.
- British Red Cross. Life after lockdown: tackling loneliness. This research supports the need for a renewed government commitment to tackle loneliness during and after the coronavirus pandemic.
- British Red Cross. Barriers to belonging. This report is an exploration of loneliness among people from Black, Asian and Minority Ethnic (BAME) backgrounds.
- British Red Cross. Tackling loneliness: support for people feeling lonely. Resources to help tackle loneliness digitally.
- British Red Cross and VCS Emergencies Partnership. Mental Health: A VCS insights pack to help inform and shape collective responses to Covid-19.
- Campaign to End Loneliness. This campaign provides links to information, support and resources on loneliness and isolation.
- Campaign to End Loneliness. The psychology of loneliness. This report looks at how psychological approaches can help tackle loneliness.
- Department for Digital, Culture, Media and Sport. Loneliness Annual Report January 2021.
- Joseph Rowntree Foundation. Loneliness resource pack. A set of resources to help individuals, groups, communities and neighbourhoods take a closer look at – and to reduce – loneliness.
- Let's Talk Loneliness. Loneliness is an issue that can affect us all at some point in our lives. This website brings together organisations, resources and inspirational stories that are united in a shared aim, to get more people talking about loneliness.
- Minded for Families. I am lonely. An e-learning model to understand loneliness and how to identify or address if you are lonely. There is also a module on Transitions, Losses and Bereavement.
- NHS. Loneliness in older people. Older people are especially vulnerable to loneliness and social isolation - this page suggests ways to overcome loneliness, even if you live alone and find it hard to get out.
- Population Wellbeing Portal. Free education, training and professional development resources, to help deliver improvements in public health and prevention.
Page last updated - 30/03/2023
