Existential Loneliness in Nursing Homes: a Qualitative Approach to Life Experiences

Authors

DOI:

https://doi.org/10.54790/rccs.139

Keywords:

existential loneliness, emotional well-being, residential care homes, older adults, life trajectories, end of life, interviews

Abstract

This study explores the existential loneliness experienced by individuals residing in nursing homes, focusing on their life experiences. Adopting a deductive approach—guided by a script containing predefined themes—and employing a reflective thematic analysis, 34 semi-structured interviews with nursing home residents in Seville were analyzed to gain an in-depth understanding of their biographical narratives. Existential loneliness was found to be a pervasive aspect of daily life, closely associated with factors such as awareness of the imminent proximity of death, the normalization of the end of life, the absence of a life project, the experience of vicarious happiness through family, and the existential void created by the loss of close companions. To enhance the emotional and existential well-being of nursing home residents, fostering meaningful relationships and experiences within and outside the nursing home setting is essential.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Juan Manuel García-González, Pablo de Olavide University

Professor of sociology at the Universidad Pablo de Olavide. His research focuses on ageing, centenarians, public health and loneliness. He coordinates the Demography and Social Research in Health research group and directs the Cruz Roja Sevilla Chair in Loneliness Studies.

Ignacio de Loyola González Salgado, University of Huelva

Assistant professor in the Department of Sociology at the Universidad Pablo de Olavide. He holds a degree in sociology from the University of Salamanca, a master’s degree in territorial and population studies from the Autonomous University of Barcelona and a PhD in social sciences from the University of Salamanca. His research focuses on social inequalities in health, qualitative research methodology, urban sociology and the sociology of health. He has participated in several research projects both as principal investigator and as a member of research teams.

Lucía R. Hernes, Pablo de Olavide University

Degree in sociology and a master’s degree in gender and equality from the Universidad Pablo de Olavide. She is currently an FPU predoctoral researcher in the Department of Sociology at the same university, where she is completing her doctoral thesis on social inequalities in the experience of chronic joint disease. Her principal research interests include health, ageing, loneliness and the analysis of inequalities, all from a gender perspective.

Cristina Granados Martínez, Pablo de Olavide University

Degrees in political science and sociology, as well as a master’s degree in methodologies applied to public policy, from the Universidad Pablo de Olavide. She currently works as a research technician on a Knowledge Generation Project funded by the Ministry of Education focusing on supportive environments and housing for people with intellectual disabilities. She combines this work with doctoral research on intellectual disability and loneliness. She has served as coordinator and lecturer for the university’s specialised programme on education and autonomous and independent living for people with intellectual disabilities. Her principal research interests focus on loneliness, inclusive education and intellectual disability.

References

Barbosa Neves, B., Sanders, A. y Kokanović, R. (2019). «It’s the worst bloody feeling in the world»: Experiences of loneliness and social isolation among older people living in care homes. Journal of Aging Studies, 49, 74-84. https://doi.org/10.1016/j.jaging.2019.100785

Bolmsjö, I., Tengland, P. A. y Rämgård, M. (2019). Existential loneliness: an attempt at an analysis of the concept and the phenomenon. Nursing Ethics, 26(5), 1310-1325. https://doi.org/10.1177/0969733017748480

Borgstrom, E. (2016). Social death. QJM: An International Journal of Medicine, 110(1), 5-7. https://doi.org/10.1093/qjmed/hcw183

Bowlby, J. (1982). Attachment and loss: Retrospect and prospect. American Journal of Orthopsychiatry, 52(4), 664-678. https://doi.org/10.1111/j.1939-0025.1982.tb01456.x

Braun, V. y Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Braun, V. y Clarke, V. (2021). Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches. Counselling and Psychotherapy Research, 21(1), 37-47. https://doi.org/10.1002/capr.12360

Braun, V. y Clarke, V. (2022). Thematic analysis: A practical guide. Sage.

Carr, S. y Fang, C. (2023). A gradual separation from the world: a qualitative exploration of existential loneliness in old age. Ageing & Society, 43(6), 1436-1456. https://doi.org/10.1017/S0144686X21001252

de Jong Gierveld, J. (1998). A review of loneliness: concept and definitions, determinants and consequences. Reviews in Clinical Gerontology, 8(1), 73-80.

de Jong Gierveld, J., Van Tilburg, T. G. y Dykstra, P. A. (2018). New ways of theorizing and conducting research in the field of loneliness and social isolation. En A. L. Vangelisti y D. Perlman (Eds.), The Cambridge Handbook of Personal Relationships (pp. 391-404). Cambridge University Press. https://doi.org/10.1017/9781316417867.031

Ettema, E. J., Derksen, L. D. y Leeuwen, E. V. (2010). Existential loneliness and end-of-life care: a systematic review. Theoretical Medicine and Bioethics, 31(2), 141-169. https://doi.org/10.1007/s11017-010-9141-1

Folstein, M. F., Folstein, S. E. y McHugh, P. R. (1975). «Mini-mental state»: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. https://doi.org/10.1016/0022-3956(75)90026-6

Forbes, S. (2001). This is heaven’s waiting room. Journal of Gerontological Nursing, 27(11), 37-45. https://doi.org/10.3928/0098-9134-20011101-10

García-González, J. M. y del Rey, A. (2021). Research on individuals aged one hundred and over: Protocol from the Sevilla and Castilla y León centenarian studies. International Journal of Qualitative Methods, 20. https://doi.org/10.1177/16094069211031125

Gil Álvarez, M., Haugan, G., Larsson, H., Saarelainen, S.-M., Duppen, D. y Dezutter, J. (2023). Mapping Existential Loneliness: A Scoping Review on Existential Loneliness/Isolation Conceptualizations and Operationalizations. Journal of Humanistic Psychology. https://doi.org/10.1177/00221678231193780

Goffman, E. (1961/2001). Internados: ensayos sobre la situación social de los enfermos mentales (7ª ed.). Amorrortu.

Green, J. y Thorogood, N. (2018). Qualitative methods for health research (4ª ed.). Sage.

Hajek, A., Brettschneider, C., Lange, C., Posselt, T., Wiese, B., Steinmann, S., ... AgeCoDe Study Group (2015). Longitudinal predictors of institutionalization in old age. PLOS One, 10(12), e0144203.

Ho, K. H., Mak, A. K., Chung, R. W., Leung, D. Y., Chiang, V. C. y Cheung, D. S. (2021). Implications of COVID-19 on the loneliness of older adults in residential care homes. Qualitative Health Research, 32(2), 279-290. https://doi.org/10.1177/10497323211050910

Jansson, A., Karisto, A. y Pitkälä, K. (2021). Loneliness in assisted living facilities: an exploration of the group process. Scandinavian Journal of Occupational Therapy, 28(5), 354-365. https://doi.org/10.1080/11038128.2019.1690043

Jansson, A. H., Karisto, A. y Pitkälä, K. H. (2023). Listening to the voice of older people: Dimensions of loneliness in long-term care facilities. Ageing & Society, 43(12), 2894-2911. https://doi.org/10.1017/S0144686X21001975

Johnson, M. (2013). Biography and generation: spirituality and biographical pain at the end of life in old age. En R. G. M. Silverstein (Ed.), Kinship and Cohort in an Aging Society: From Generation to Generation (pp. 176-190). Johns Hopkins University Press.

Kitzmüller, G., Clancy, A., Vaismoradi, M., Wegener, C. y Bondas, T. (2017). ‘Trapped in an empty waiting room’ - the existential human core of loneliness in old age: a meta-synthesis. Qualitative Health Research, 28(2), 213-230. https://doi.org/10.1177/1049732317735079.

Lapane, K. L., Lim, E., McPhillips, E., Barooah, A., Yuan, Y. y Dube, C. E. (2022). Health effects of loneliness and social isolation in older adults living in congregate long term care settings: A systematic review of quantitative and qualitative evidence. Archives of Gerontology and Geriatrics, 102, 104728. https://doi.org/10.1016/j.archger.2022.104728

Lara, E., Martín-María, N., De la Torre-Luque, A., Koyanagi, A., Vancampfort, D., Izquierdo, A. y Miret, M. (2019). Does loneliness contribute to mild cognitive impairment and dementia? A systematic review and meta-analysis of longitudinal studies. Ageing Research Reviews, 52, 7-16. https://doi.org/10.1016/j.arr.2019.03.002

Larsson, H., Beck, I. y Blomqvist, K. (2023). Perspectives on existential loneliness. Narrations by older people in different care contexts. International Journal of Qualitative Studies on Health and Well-being, 18(1), 2184032. https://doi.org/10.1080/17482631.2023.2184032

Larsson, H., Rämgård, M. y Bolmsjö, I. (2017). Older persons’ existential loneliness as interpreted by their significant others – an interview study. BMC Geriatrics, 17, 138. https://doi.org/10.1186/s12877-017-0533-1

Larsson, H., Saarelainen, S. M., Sjöberg, M., Dezutter, J. y Haugan, G. (2024). Existential loneliness and meaning-in-life in the lived experience of nursing home residents. International Journal of Care and Caring, 1-19. https://doi.org/10.1332/23978821Y2024D000000047

Mansfield, L., Victor, C., Meads, C., Daykin, N., Tomlinson, A., Lane, J., Gray, K. y Golding, A. (2021). A conceptual review of loneliness in adults: Qualitative evidence synthesis. International Journal of Environmental Research and Public Health, 18, 11522. https://doi.org/10.3390/ijerph182111522

Miralles Rojano, Á. y Rey Reñones, C. (2015). Evolución del modelo de atención residencial, una propuesta de centro de mayores. Gerokomos, 26(4), 132-136.

Misiak, M. M., Bethell, J., Chapman, H. y Sommerlad, A. (2025). How can care home activities facilitate social connection in residents? A qualitative study. Aging & Mental Health, 29(1), 25-35. https://doi.org/10.1080/13607863.2024.2345130

Molas-Tuneu, M., Jerez-Roig, J., Minobes-Molina, E., Coll-Planas, L., Escribà-Salvans, A., Farrés-Godayol, P., ... Naudó-Molist, J. (2023). Soledad social y emocional en personas mayores que viven en residencias geriátricas de España: un estudio transversal. Anales de Psicología, 39(3), 465-477. https://doi.org/10.6018/analesps.530641

Paque, K., Bastiaens, H., Van Bogaert, P. y Dilles, T. (2018). Living in a nursing home: A phenomenological study exploring residents’ loneliness and other feelings. Scandinavian Journal of Caring Sciences, 32(4), 1477-1484. https://doi.org/10.1111/scs.12599

Playfair, C. (2010). Human relationships: an exploration of loneliness and touch. British Journal of Nursing, 19(2), 122-126. https://doi.org/10.12968/bjon.2010.19.2.46301

Prieto-Flores, M. E., Forjaz, M. J., Fernández-Mayoralas, G., Rojo-Pérez, F. y Martínez-Martin, P. (2011). Factors associated with loneliness of noninstitutionalized and institutionalized older adults. Journal of Aging and Health, 23(1), 177-194. https://doi.org/10.1177/0898264310382658

Rico-Uribe, L. A., Caballero, F. F., Olaya, B., Tobiasz-Adamczyk, B., Koskinen, S., Leonardi, M., ... Miret, M. (2016). Loneliness, social networks, and health: a cross-sectional study in three countries. PLOS One, 11(1), e0145264. https://doi.org/10.1371/journal.pone.0145264

Saarelainen, S., Mäki-Petäjä-Leinonen, A. y Pöyhiä, R. (2020). Relational aspects of meaning-in-life among older people – a group-interview gerontechnology study. Ageing & Society, 42(5), 1035-1053. https://doi.org/10.1017/S0144686X20001300

Sanchini, V., Sala, R. y Gastmans, C. (2022). The concept of vulnerability in aged care: a systematic review of argument-based ethics literature. BMC Medical Ethics, 23, 84. https://doi.org/10.1186/s12910-022-00819-3

Saumure, K. y Given, L. M. (2008). Convenience sample. En L. M. Given (Ed.), The SAGE encyclopedia of qualitative methods (vol. 1, pp. 124-125). Sage.

Schreier, M. (2018). Sampling and generalization. En U. Flick (Ed.), The SAGE handbook of qualitative data collection (pp. 84-98). Sage. https://doi.org/10.4135/9781526416070.n6

Simard, J. y Volicer, L. (2020). Loneliness and isolation in long-term care and the COVID-19 pandemic. Journal of the American Medical Directors Association, 21(7), 966-967. https://doi.org/10.1016/j.jamda.2020.05.006

Sjöberg, M., Beck, I., Rasmussen, B. H. y Edberg, A. K. (2018). Being disconnected from life: meanings of existential loneliness as narrated by frail older people. Aging & Mental Health, 22(10), 1357-1364. https://doi.org/10.1080/13607863.2017.1348481

Sjöberg, M., Edberg, A. K., Rasmussen, B. y Beck, I. (2019). Being acknowledged by others and bracketing negative thoughts and feelings: frail older people’s narrations of how existential loneliness is eased. International Journal of Older People Nursing, 14(1), e12213. https://doi.org/10.1111/opn.12213

Smith, C. B., Wong, K. L. Y., To-Miles, F., Dunn, S., Gregorio, M., Wong, L., ... Hung, L. (2023). Exploring experiences of loneliness among Canadian long-term care residents during the COVID-19 pandemic: A qualitative study. International Journal of Older People Nursing, 18(1), e12509. https://doi.org/10.1111/opn.12509

Sundström, M., Edberg, A. K., Rämgård, M. y Blomqvist, K. (2018). Encountering existential loneliness among older people: perspectives of health care professionals. International Journal of Qualitative Studies on Health and Well-Being, 13(1), 1474673. https://doi.org/10.1080/17482631.2018.1474673

Thornberg, R. y Charmaz, K. (2014). Grounded theory and theoretical coding. En U. Flick (Ed.), The SAGE handbook of qualitative data analysis (pp. 153-169). Sage. https://doi.org/10.4135/9781446282243.n11

van Wijngaarden, E., Leget, C. y Goossensen, A. (2015). Ready to give up on life: The lived experience of elderly people who feel life is completed and no longer worth living. Social Science & Medicine, 138, 257-264. https://doi.org/10.1016/j.socscimed.2015.05.015

Victor, C. R. (2012). Loneliness in care homes: A neglected area of research? Aging Health, 8(6), 637-646. https://doi.org/10.2217/ahe.12.65

Wijesiri, H. S. M. S. K., Samarasinghe, K. y Edberg, A. K. (2019). Loneliness among older people living in care homes in Sri Lanka. International Journal of Older People Nursing, 14(4), e12253. https://doi.org/10.1111/opn.12253

Yalom, I. D. (1980). Existential psychotherapy. Basic Books.

Zhao, X., Zhang, D., Wu, M., Yang, Y., Xie, H., Li, Y., ... Su, Y. (2018). Loneliness and depression symptoms among the elderly in nursing homes: A moderated mediation model of resilience and social support. Psychiatry Research, 268, 143-151. https://doi.org/10.1016/j.psychres.2018.07.011

Published

2026-07-06

How to Cite

García-González, J. M., González Salgado, I. de L., R. Hernes, L., & Granados Martínez, C. (2026). Existential Loneliness in Nursing Homes: a Qualitative Approach to Life Experiences. CENTRA Journal of Social Sciences, 5(2), 35–58. https://doi.org/10.54790/rccs.139

Funding data