+44 3308180992Review Article - Journal of Research in Nursing and Midwifery ( 2025) Volume 14, Issue 1
Received: 14-Oct-2024, Manuscript No. JRNM-25-150104; Editor assigned: 17-Oct-2024, Pre QC No. JRNM-25-150104 (PQ); Reviewed: 31-Oct-2024, QC No. JRNM-25-150104; Revised: 09-Feb-2025, Manuscript No. JRNM-25-150104 (R); Published: 16-Feb-2025, DOI: 10.14303/2315-568X.2025.067
Loneliness among geriatric individuals is a critical public health concern, leading to adverse mental, physical, and social health outcomes. Senior citizens who experience isolation due to factors such as childlessness, divorce, unemployment, or the loss of loved ones are at a higher risk of developing serious medical conditions. The altered functions of the central nervous system due to inactivity, poor personal hygiene, and lack of social engagement contribute to deteriorating health in the elderly. This study explores the causes, attributes, and consequences of loneliness in geriatric populations and highlights the significance of addressing this issue through effective nursing care and preventive interventions. Applying nursing theories such as Orem's self-care deficit model can help in mitigating the negative effects of loneliness by promoting self-care and social engagement among elderly individuals. The findings emphasize the need for comprehensive geriatric care strategies to enhance the quality of life and well-being of senior citizens.
Geriatric loneliness, Isolation and mental health, Elderly care and nursing interventions, Genomic instability in aging, Social support for senior citizens
Loneliness in geriatric or senior citizens at home is very dangerous cause of diseases in geriatrics in resulting from childless family, divorced persons, unmarried senior citizens those are alone because health is a complete state of mental, physical, social, personal and spiritual wellbeing (Nicholson Jr NR, 2009). The functions of central nervous system are altered due to inactivity and immobilization (Nordin T et al., 2023). Some geriatric patients are isolated in resulting from their disorders, retirement of jobs and weakness due to old age (Bolmsjo I et al., 2019). Isolation in geriatric patients may affects insight, mood and affections. Most of geriatric patients are isolated due to loss of someone, unemployment, retirement and mental health disorders. Human cannot survive without love and belongings (Chen CC et al., 2001). Geriatric patients need affection love and belongings because they are isolated due to many reasons (Brocklehurst H et al., 2008). Geriatric patients may develop the depression due to isolation therefore they need to engage in some kinds of activities to prevent from mental health disorders. Many old aged clients are ignored in isolation. Isolated patients need more concentrated nursing care to prevent from fall injury as well (Aroogh MD et al., 2020). Health care workers should be assessed the patient at the time of Admission regarding fall risk assessment to find out the cause and provide the treatment (Zhang D et al., 2023). Poor personal hygiene is most dangerous factor in geriatrics due to loneliness in geriatrics. Basically, these patients are lonely in resulting from retirement of job, immobility due to disorders, weakness in advanced age and loos of someone in families (Moeyersons M et al., 2022).
Purpose of the concept analysis on loneliness in geriatrics
To identify the causes of loneliness in geriatrics (Kim J et al., 2021). To know about factors affecting on quality of life in geriatrics. To understand the concept of loneliness in geriatrics. There are many issues in geriatrics related to loneliness (Cohen-Mansfield J et al., 2020).
Cross sectional study has been conducted in institute of Lahore, sample size was 16 old age persons to identify and rank the loneliness according to this scale (Neves BB et al., 2019). Basically, loneliness is a cause of different health problems in human beings according to basic needs of life it is dangerous thing in senior citizens (McInnis GJ et al., 2001).
Attributes of senior citizens and geriatrics
Genomic instability: There is the unresolved DNA variant in old age patients due to aging process cardiac dysfunction associates in this due to cardio myocytes due to natural aging. Pluripotent stem cells are differentiated by cardio myocytes. (HGPS) Human Hutchinson Guildford Progeria syndrome (Abitov IR et al., 2016). Natural aging of the mouse heart cannot be contributed due to genomic instability. Cellular death and degeneration due to aging process and somatic cells degeneration in the human body can leads to multiple disorders in aged peoples. In the genomic instability mutation of chromosomes, DNA and somatic cells are crucial factors leads to multiple disorders in the body such cardiomyopathy, renal failure, loss of memory and stoke. Genomic instability cannot be stopped because it is a natural phenomenon of human body (Langford CP et al., 1997).
Dysregulated nutrient detection: In a physiological process of human beings' iron role is very crucial for morphology and energy. RBC morphology cannot be completed without iron. Iron maintenance in body reduce risk of metabolic diseases sometime overload of iron and deficiency of iron simultaneously occurred (Eskimez Z et al., 2019). Iron stores in the human body in hepatic macrophages and spleen. Old aged patients are prone to deficiency of vitamin D, Calcium, folic acid, vitamin B12 and iron due to poor nutritional status. Due to lack of resources of sunlight exposures they are prone to vitamin D deficiency.
Poor personal hygiene: Poor personal hygiene is most dangerous factor in geriatrics due to loneliness in geriatrics. Basically, these patients are lonely in resulting from retirement of job, immobility due to disorders, weakness in advanced age and loos of someone in families. Due to poor personal hygiene care in geriatrics may affect the skin and hair infections for example fungal infection, parasitic infections and bacterial infection. They may be experiencing opportunistic infection due to cut in skin and trauma. Personal hygiene in old age lonely patients consists of taking bath, hand washing, oral care, pedicure and manicure therefor they need assistance.
Isolation: Isolation in geriatric patients may affects insight, mood and affections. Most of geriatric patients are isolated due to loss of someone, unemployment, retirement and mental health disorders. Human cannot survive without love and belongings. Geriatric patients need affection love and belongings because they are isolated due to many reasons. Geriatric patients may develop the depression due to isolation therefore they need to engage in some kinds of activities to prevent from mental health disorders. Many old aged clients are ignored in isolation. Isolated patients need more concentrated nursing care to prevent from fall injury as well. Health care workers should be assessed the patient at the time of admission regarding fall risk assessment to find out the cause and provide the treatment.
Cases of loneliness
Model case: A 70-year-old male resident of Gulistan-e-Johar diagnosed with Diabetes Mellitus and Hypertension for 30 years, he is also a patient of bipolar diagnosis type I. He is isolated due to no family members at home he takes care himself. He doesn't care his personal hygiene. He does not care his dressing and grooming. He some time watches TV and sometime reads newspaper. He is not aware regarding preventive measures of fall at home so he is at risk of fall. He sometimes takes help from neighbors. He is also diagnosing with dysregulated nutrient detection in which a physiological process of human beings' iron role is very crucial for morphology and energy. RBC morphology cannot be completed without iron. Iron maintenance in body reduce risk of metabolic diseases sometime overload of iron and deficiency of iron simultaneously occurred. Iron stores in the human body in hepatic macrophages and spleen. Old aged patients are prone to deficiency of vitamin D, calcium, folic acid, vitamin B12 and iron due to poor nutritional status. He is also diagnosing with genomic instability, there is the unresolved DNA variant in old age patients due to aging process cardiac dysfunction associates in this due to cardio myocytes due to natural aging. Pluripotent stem cells are differentiated by cardio myocytes Human Hutchinson Guildford Progeria Syndrome (HGPS). Natural aging of the mouse heart cannot be contributed due to genomic instability. Cellular death and degeneration due to aging process and somatic cells degeneration in the human body can leads to multiple disorders in aged peoples. In the genomic instability mutation of chromosomes, DNA and somatic cells are crucial factors leads to multiple disorders in the body.
Borderline case of loneliness in old aged patients
A 72-year-old female. She is diagnosing with genomic instability, there is the unresolved DNA variant in old age patients due to aging process cardiac dysfunction associates in this due to cardio myocytes due to natural aging. Pluripotent stem cells are differentiated by cardio myocytes. (HGPS) Human Hutchinson Guildford Progeria Syndrome. Natural aging of the mouse heart cannot be contributed due to genomic instability. She does not care his personal hygiene due to lack of activity due to disease and poor nutritional status. She lives in a flat alone because she is widow and no having any children. She is feeling loneliness due to disrespect in neighbors nobody is agree to help her because they not are having time for her help because neighbors do perform duties in different fields and business.
Alternative case of loneliness in old aged patients
A 73-year-old male lives in old home because he is widower and not having family members. He is feeling loneliness due to isolation. Old home nurses provide care to him but he is depressed all the time. He irritates whereas old home provides services to him. He sometimes does not take food due to lonely he wants affection and love of someone or family members but it is not possible. Isolation is the cause of loneliness. Isolation in geriatric patients may affects insight, mood and affections. Most of geriatric patients are isolated due to loss of someone, unemployment, retirement and mental health disorders. Human cannot survive without love and belongings. Geriatric patients need affection love and belongings because they are isolated due to many reasons.
Contrary ease of loneliness in old aged patients
A 69-year-old female diagnosed with diabetes mellitus and hypertension. She lives with his family and all family members are very caring with her. She is having 2 sons and 3 daughters. 1 son is married. Her husband is alive he is businessman in film industry. She is happy with her family members. She takes dry fruits. She goes to garden with his family in evening daily. She uses branded products to eat. She wears branded and fashionable dresses of famous designers because no doubt she is rich lady. She is having three cars to go out anywhere with her driver. She likes hyper star mall to shopping in Karachi. She is master's in business administration MBA in health from Baqai University. Finally, she is mentally physical healthy and she is having health seeking behavior. She likes to do everything herself.
Antecedents
Old aged patients and senior citizens are more likely on risk of loneliness because they are alone due to loss of someone, divorce, disease process and unemployment, there are many preceding factors of loneliness those should be observed by the researchers. Researched has been conducted in Cambridge University cross sectional survey, preceding factors were neighborhood cohesion, self-care deficit, purpose in life, anxiety. Adjustment of preceding factors in this study is that result of study is that lack of physical activity, psychological factors, increased purpose in life, decreased depression were more effective in loneliness in geriatrics.
Consequences
Research has been published in e-clinical medicines part of the lancet discovery science. Risk of stroke in chronic loneliness due to chronic loneliness. Social isolation is a risk of mental health issues. National institute of aging NIA provides fund to shelter homes and old homes. In this study higher risk of stroke find out 1.05, 95% CI (Confidence Interval). Due to disability and mortality risk of stroke will be increased. Although loneliness is a risk factor of cardiovascular diseases, depression, stroke, migraine, anxiety, mental health issues, physical deformities to immobilization, anemia due to lack of intake of food. In this article a story of an 89 years-old-female was admitted in a hospital she needed to self-care because she was self-care deficits. Finally, she was died and her son was claimed the power of attorney.
Nursing theory
Orem self-care deficit model of nursing theory consist of self-care deficit instructions Orem said that the person should care himself to treat the disease and prevent from complications of disease. Everyone is having natural abilities just encourage the patients to do self-care in self-care deficit disorders. They patients need assistance and education to motivation. It is need based nursing theory. Conclusion in this research is that the self-care motivation by health care workers to old age patients nearly above 85 plus age is effective. Self-care deficit model should be applied to prevent the old age patients from deformity and immobilization in loneliness or isolation.
Loneliness in geriatrics is a significant factor contributing to mental and physical health deterioration. The lack of social interaction and support leads to various health concerns, including depression, cardiovascular diseases, and weakened immunity. Addressing loneliness in senior citizens requires a multidimensional approach, including social engagement, healthcare interventions, and psychological support. Nursing care models such as Orem's self-care deficit model can be instrumental in fostering self-care and improving the well-being of elderly individuals. By implementing targeted interventions and community-based support systems, the adverse effects of loneliness can be minimized, ultimately enhancing the quality of life for the aging population.
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