To support and not to cure: general practitioner management of loneliness

Abstract

Loneliness is associated with numerous detrimental effects on physical health, mental health, cognition and lifestyle. Older adults are one of the groups at highest risk of loneliness, and indeed about 46% of older adults in England feel lonely. Those experiencing loneliness visit their general practitioner (GP) more frequently than those who are not, which has the capacity to put a strain on GPs and primary care waiting lists and costs. This study's aim was to explore GPs' views and experiences of loneliness within their older adult patients, and to understand GPs' awareness and feelings of agency within this. Nineteen UK GPs were recruited using purposive sampling and snowballing techniques. Individual semi‐structured interviews were conducted either in person or over the telephone. Data were analysed using thematic analysis. Four overarching themes were identified from the data: Whose responsibility is it anyway?, Pandora's box of shame; Keeping distance; and Community responsibility. Themes emphasise that GPs tend to hold a medicalised and individualistic view of loneliness. This intensifies stigma which in turn creates barriers to raising the topic. GPs felt powerless in their ability to fix the ‘problem’ and tended to believe that the solution had to lie in the community, the individual or in social care rather than in primary care. The findings are discussed in the context of literature on GP management of other social problems which give rise to similar issues concerning the restrictions of the medical model and the need for joined‐up approaches in which the GP is one part of a wider social support structure. It is suggested that it might be useful for training and support for GPs to address management of social problems jointly rather than training specific to loneliness which GPs tend to see as peripheral to their core remit.

Loneliness and Social Isolation as Risk Factors: The Power of Social Connection in Prevention

“…In another study aimed at understanding the general practitioners' perspective on their role, when interviewed, the practitioners' responses emphasized general perceptions of loneliness in medicalized and individualistic view. 24 This medicalized view may increase stigma, subsequently creating barriers to raising the topic. A primary finding was the physicians do not feel they have the skills or ability to "fix the problem" and felt that it was more of a personal community issue to solve rather than in primary care.…”

Loneliness in Old Age: An Unaddressed Health Problem

“…Physicians and other health and social service providers tend to be poorly trained and equipped to deal with loneliness (27). Patients are seldom asked about loneliness and providers do not have an approach to treating the "problem."…”

Healthcare Professionals’ Perceptions of Loneliness amongst Older Adults: A Qualitative Study

“…In relation to this, different studies have tried to find out the role of loneliness in both institutionalised and community-dwelling older adults [7,[29][30][31][32][33][34], comprehend healthcare professionals' experience on older adults' isolation [28] and evaluate strategies to reduce loneliness in older adults [35,36]. However, more research focusing on understanding healthcare professionals' perceptions of the phenomenon of loneliness in older adults is needed [28,37,38] since evidence suggests that healthcare professionals receive insufficient training to address this important issue [37,39,40]. Understanding how healthcare professionals depict and perceive loneliness amongst older adults would allow us to approach the problem from another angle so that we can develop interventions and preventive strategies that resonate with the healthcare professionals who will implement them [28,37,41].…”

“…However, more research focusing on understanding healthcare professionals' perceptions of the phenomenon of loneliness in older adults is needed [28,37,38] since evidence suggests that healthcare professionals receive insufficient training to address this important issue [37,39,40]. Understanding how healthcare professionals depict and perceive loneliness amongst older adults would allow us to approach the problem from another angle so that we can develop interventions and preventive strategies that resonate with the healthcare professionals who will implement them [28,37,41]. This could also make older adults feel better understood by healthcare professionals [35].…”