How older adults express loneliness in everyday life: a qualitative content analysis

Background Loneliness among older adults is a significant public health concern, associated with mental and physical health outcomes. Although loneliness is widely studied, less is known about how older adults’ express loneliness in everyday language. Understanding these expressions is important for improving screening instruments and communication strategies. The aim of this study is to describe how older adults express their everyday experiences of loneliness. Methods A descriptive qualitative design was employed using semi-structured face-to-face interviews with 16 community-dwelling older adults aged 80 years and above living in Sweden. Participants were purposively sampled from a national panel study based on prior reports of loneliness. Interviews were transcribed and analyzed using inductive manifest content analysis. The analysis focused on the words and phrases that the participants used when they talked about loneliness. Results An overarching theme of difficulty in expressing loneliness was identified. Three main categories described how loneliness was expressed: (1) Feelings of loneliness, including descriptions of unpleasant emotions, varying intensity, and fluctuation over time (2). Indirect expressions of loneliness, where participants described loneliness through experiences such as boredom, slowness, emptiness, or through reactions to loneliness such as shame, and resignation (3). Relational expressions, where loneliness was framed in terms of missing social contact, lack of meaningful relationships, and perceived separation from others. Conclusions Older adults often express loneliness indirectly, using language that reflects their experiences without explicitly labeling them as loneliness. Approaches that only rely on direct questions of loneliness may therefore overlook older adults who express their negative experience without explicitly naming loneliness. Incorporating indirect expressions into screening, communication, and intervention strategies may improve the detection and support of loneliness in older populations.