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Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research Article

Older persons’ existential loneliness, as interpreted by their significant others - an interview study

Authors: Helena Larsson, Margareta Rämgård, Ingrid Bolmsjö

Published in: BMC Geriatrics | Issue 1/2017

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Abstract

Background

In order to better understand people in demanding medical situations, an awareness of existential concerns is important. Studies performed over the last twenty years conclude that when dying and death come closer, as in the case with older people who are stricken by infirmity and diseases, existential concerns will come to the fore. However, studies concerning experiences of existential loneliness (EL) are sparse and, in addition, there is no clear definition of EL. EL is described as a complex phenomenon and referred to as a condition of life, an experience, and a process of inner growth. Listening to someone who knows the older person well, as significant others often do, may be one way of learning more about EL.

Methods

This study is part of a larger research project on EL, the LONE study, where EL is explored through interviews with frail older people, their significant others and health care professionals. The aim of this study was to explore frail older (>75) persons’ EL, as interpreted by their significant others. The study is qualitative and based on eighteen narrative interviews with nineteen significant others of older persons. The data was analysed using Hsieh and Shannon’s conventional content analysis.

Results

According to the interpretation of significant others, the older persons experience EL (1) when they are increasingly limited in body and space, (2) when they are in a process of disconnecting, and (3) when they are disconnected from the outside world.

Conclusion

The result can be understood as if the frail older person is in a process of letting go of life. This process involves the body, in that the older person is increasingly limited in his/her physical abilities. The older person’s long-term relationships are gradually lost, and finally the process entails the older person’s increasingly withdrawing into him- or herself and turning off the outside world. The result of this study is consistent with previous research that has shown that EL is a complex phenomenon, but the implications of this research include a deepened understanding of EL. In addition, the study highlights the interpretations of significant others.
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Literature
3.
go back to reference Greisinger AJ, Lorimor RJ, Aday LA, Winn RJ, Baile WF. Terminally ill cancer patients. Their most important concerns. Cancer Pract. 1997;5(3):147–54.PubMed Greisinger AJ, Lorimor RJ, Aday LA, Winn RJ, Baile WF. Terminally ill cancer patients. Their most important concerns. Cancer Pract. 1997;5(3):147–54.PubMed
4.
go back to reference Albinsson L, Strang P. Existential concerns of families of late-stage dementia patients: questions of freedom, choices, isolation, death, and meaning. J Palliat Med. 2003;6(2):225–35.CrossRefPubMed Albinsson L, Strang P. Existential concerns of families of late-stage dementia patients: questions of freedom, choices, isolation, death, and meaning. J Palliat Med. 2003;6(2):225–35.CrossRefPubMed
5.
go back to reference Bolmsjö I. Existential issues in palliative care--interviews with cancer patients. J Palliat Care. 2000;16(2):20–4.PubMed Bolmsjö I. Existential issues in palliative care--interviews with cancer patients. J Palliat Care. 2000;16(2):20–4.PubMed
7.
go back to reference Beck I, Törnquist A, Broström L, Edberg AK. Having to focus on doing rather than being-nurse assistants’ experience of palliative care in municipal residential care settings. Int J Nurs Stud. 2012;49(4):455–64. Beck I, Törnquist A, Broström L, Edberg AK. Having to focus on doing rather than being-nurse assistants’ experience of palliative care in municipal residential care settings. Int J Nurs Stud. 2012;49(4):455–64.
8.
go back to reference Pessin H, Fenn N, Hendriksen E, DeRosa AP, Applebaum A. Existential distress among healthcare providers caring for patients at the end of life. Curr Opin Support Palliat Care. 2015;9(1):77–86.CrossRefPubMed Pessin H, Fenn N, Hendriksen E, DeRosa AP, Applebaum A. Existential distress among healthcare providers caring for patients at the end of life. Curr Opin Support Palliat Care. 2015;9(1):77–86.CrossRefPubMed
9.
go back to reference Dyrstad DN, Laugaland KA, Storm M. An observational study of older patients’ participation in hospital admission and discharge--exploring patient and next of kin perspectives. J Clin Nurs. 2015;24(11–12):1693–706. Dyrstad DN, Laugaland KA, Storm M. An observational study of older patients’ participation in hospital admission and discharge--exploring patient and next of kin perspectives. J Clin Nurs. 2015;24(11–12):1693–706.
10.
go back to reference Lowson E, Hanratty B, Holmes L, Addington-Hall J, Grande G, Payne S, Seymour J. From ‘conductor’ to ‘second fiddle’: older adult care recipients’ perspectives on transitions in family caring at hospital admission. Int J Nurs Stud. 2013;50(9):1197–205. Lowson E, Hanratty B, Holmes L, Addington-Hall J, Grande G, Payne S, Seymour J. From ‘conductor’ to ‘second fiddle’: older adult care recipients’ perspectives on transitions in family caring at hospital admission. Int J Nurs Stud. 2013;50(9):1197–205.
11.
go back to reference Mayers AM, Svartberg M. Existential loneliness: a review of the concept, its psychosocial precipitants and psychotherapeutic implications for HIV-infected women. Br J Med Psychol. 2001;74(Pt 4):539–53.CrossRefPubMed Mayers AM, Svartberg M. Existential loneliness: a review of the concept, its psychosocial precipitants and psychotherapeutic implications for HIV-infected women. Br J Med Psychol. 2001;74(Pt 4):539–53.CrossRefPubMed
12.
13.
go back to reference Yalom ID. Existential psychotherapy. New York: Basic Books; 1980. Yalom ID. Existential psychotherapy. New York: Basic Books; 1980.
14.
go back to reference Tillich P. The courage to be. 3rd ed. New Haven and London: Yale University Press; 2000. Tillich P. The courage to be. 3rd ed. New Haven and London: Yale University Press; 2000.
15.
go back to reference Frankl VE. Man’s search for meaning: an introduction to logotherapy. London: Hodder and Stoughton; 1987. Frankl VE. Man’s search for meaning: an introduction to logotherapy. London: Hodder and Stoughton; 1987.
16.
go back to reference Sand L, Strang P. Existential loneliness in a palliative home care setting. J Palliat Med. 2006;9(6):1376–87.CrossRefPubMed Sand L, Strang P. Existential loneliness in a palliative home care setting. J Palliat Med. 2006;9(6):1376–87.CrossRefPubMed
17.
go back to reference Nyström M. Aphasia–an existential loneliness: a study on the loss of the world of symbols. Int J Qual Stud Health Well-being. 2006;1(1):38–49.CrossRef Nyström M. Aphasia–an existential loneliness: a study on the loss of the world of symbols. Int J Qual Stud Health Well-being. 2006;1(1):38–49.CrossRef
18.
go back to reference Norell Pejner M, Ziegert K, Kihlgren A. Older patients in Sweden and their experience of the emotional support received from the registered nurse - a grounded theory study. Aging Ment Health. 2015;19(1):79–85. Norell Pejner M, Ziegert K, Kihlgren A. Older patients in Sweden and their experience of the emotional support received from the registered nurse - a grounded theory study. Aging Ment Health. 2015;19(1):79–85.
19.
go back to reference Abrahamsson K, Bernard B, Magnabosco L, Nazir A, Unroe KT. The experiences of family members in the nursing home to hospital transfer decision. BMC Geriatr. 2016;16:184.CrossRef Abrahamsson K, Bernard B, Magnabosco L, Nazir A, Unroe KT. The experiences of family members in the nursing home to hospital transfer decision. BMC Geriatr. 2016;16:184.CrossRef
20.
go back to reference Blindheim K, Thorsnes SL, Brataas HV, Dahl BM. The role of next of kin of patients with cancer: learning to navigate unpredictable caregiving situations. J Clin Nurs. 2013;22(5–6):681–9.PubMed Blindheim K, Thorsnes SL, Brataas HV, Dahl BM. The role of next of kin of patients with cancer: learning to navigate unpredictable caregiving situations. J Clin Nurs. 2013;22(5–6):681–9.PubMed
21.
go back to reference Esbensen BA, Thomé B. Being next of kin to an elderly person with cancer. Scand J Caring Sci. 2010;24(4):648–54. Esbensen BA, Thomé B. Being next of kin to an elderly person with cancer. Scand J Caring Sci. 2010;24(4):648–54.
22.
go back to reference Munck B, Fridlund B, Martensson J. Next-of-kin caregivers in palliative home care-from control to loss of control. J Adv Nurs. 2008;64(6):578–86.CrossRefPubMed Munck B, Fridlund B, Martensson J. Next-of-kin caregivers in palliative home care-from control to loss of control. J Adv Nurs. 2008;64(6):578–86.CrossRefPubMed
23.
go back to reference Funk L, Stajduhar K, Toye C, Aoun S, Grande G, Todd C. Part 2: home-based family caregiving at the end of life: a comprehensive review of published qualitative research (1998-2008). Palliat Med. 2010;24(6):594–607.CrossRefPubMed Funk L, Stajduhar K, Toye C, Aoun S, Grande G, Todd C. Part 2: home-based family caregiving at the end of life: a comprehensive review of published qualitative research (1998-2008). Palliat Med. 2010;24(6):594–607.CrossRefPubMed
24.
go back to reference Andershed B. Significant others in end-of-life care - part 1: a systematic review of the literature the five last years, January 1999-February 2004. J Clin Nurs. 2006;15(9):1158–69. Andershed B. Significant others in end-of-life care - part 1: a systematic review of the literature the five last years, January 1999-February 2004. J Clin Nurs. 2006;15(9):1158–69.
25.
go back to reference Digby R, Bloomer MJ. Families and caregivers of older people: expectations, communication and care decisions. Collegian. 2014;21(4):345–51.CrossRefPubMed Digby R, Bloomer MJ. Families and caregivers of older people: expectations, communication and care decisions. Collegian. 2014;21(4):345–51.CrossRefPubMed
27.
go back to reference Edberg AK, Bolmsjö I: Study protocol: Exploring existential loneliness among frail older people. The development phase of the LONE study. 2017. Edberg AK, Bolmsjö I: Study protocol: Exploring existential loneliness among frail older people. The development phase of the LONE study. 2017.
28.
go back to reference Medical Research Council. Developing and evaluating complex interventions: new guidance. London: Medical Research Council; 2008. Medical Research Council. Developing and evaluating complex interventions: new guidance. London: Medical Research Council; 2008.
29.
go back to reference Polit DF, Beck CT. Essentials of nursing research: appraising evidence for nursing practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2013. Polit DF, Beck CT. Essentials of nursing research: appraising evidence for nursing practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2013.
30.
go back to reference Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRefPubMed Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRefPubMed
31.
go back to reference Sjöberg M, Beck I, Rasmussen B, Edberg AK. Being disconnected from life-meanings of existential loneliness as narrated by frail older people. Accepted for publication in Aging Ment Health June, 2017. Sjöberg M, Beck I, Rasmussen B, Edberg AK. Being disconnected from life-meanings of existential loneliness as narrated by frail older people. Accepted for publication in Aging Ment Health June, 2017.
32.
go back to reference Whitaker A. The body as existential midpoint—the aging and dying body of nursing home residents. J Aging Stud. 2010;24(2):96–104.CrossRef Whitaker A. The body as existential midpoint—the aging and dying body of nursing home residents. J Aging Stud. 2010;24(2):96–104.CrossRef
33.
go back to reference Marcel G, Schilpp PA, Hahn LE. The philosophy of Gabriel Marcel. 1st ed. La Salle: Open Court Pub. Co.; 1984. Marcel G, Schilpp PA, Hahn LE. The philosophy of Gabriel Marcel. 1st ed. La Salle: Open Court Pub. Co.; 1984.
34.
go back to reference Wallerstedt B, Andershed B, Benzein E. Family members’ caregiving situations in palliative home care when sitting service is received: the understanding of multiple realities. Palliat Support Care. 2014;12(6):425–37.CrossRefPubMed Wallerstedt B, Andershed B, Benzein E. Family members’ caregiving situations in palliative home care when sitting service is received: the understanding of multiple realities. Palliat Support Care. 2014;12(6):425–37.CrossRefPubMed
35.
go back to reference Buber M. I and thou. 2nd ed. T&T Clark: Edinburgh; 1994. Buber M. I and thou. 2nd ed. T&T Clark: Edinburgh; 1994.
36.
go back to reference McCormack B, Dewing J, Breslin L, Coyne-Nevin A, Kennedy K, Manning M, Peelo-Kilroe L, Tobin C, Slater P. Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. Int J Older People Nursing. 2010;5(2):93–107.CrossRef McCormack B, Dewing J, Breslin L, Coyne-Nevin A, Kennedy K, Manning M, Peelo-Kilroe L, Tobin C, Slater P. Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. Int J Older People Nursing. 2010;5(2):93–107.CrossRef
37.
go back to reference Duffield C, Gardner G, Catling-Paull C. Nursing work and the use of nursing time. J Clin Nurs. 2008;17(24):3269–74.CrossRefPubMed Duffield C, Gardner G, Catling-Paull C. Nursing work and the use of nursing time. J Clin Nurs. 2008;17(24):3269–74.CrossRefPubMed
38.
go back to reference Lindberg C, Fagerström C, Sivberg B, Willman A. Concept analysis: patient autonomy in a caring context. J Adv Nurs. 2014;70(10):2208–21.CrossRefPubMed Lindberg C, Fagerström C, Sivberg B, Willman A. Concept analysis: patient autonomy in a caring context. J Adv Nurs. 2014;70(10):2208–21.CrossRefPubMed
39.
go back to reference Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22:63–75. Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inf. 2004;22:63–75.
Metadata
Title
Older persons’ existential loneliness, as interpreted by their significant others - an interview study
Authors
Helena Larsson
Margareta Rämgård
Ingrid Bolmsjö
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0533-1

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