Reducing Loneliness and Isolation Among Older Adults in Residential Care

This research proposal aims to investigate the effectiveness of internet interventions and computer training in reducing social isolation and loneliness among older adults living in a residential care centre. The study will recruit 80 older people from 3 aged care and residential homes across the city. The participants belonging to the age group of 65-85 years will be selected. The research will encompass a quantitative analysis where the participants will be made to undergo a survey by providing numbers on a likert scale for demonstrating their feelings and satisfaction score.

Running head: INTRODUCTION TO RESEARCH METHODS
Reducing loneliness and isolation among older adults living in residential care
Name of the Student-
Name of the ELA-
Subject Code- PSY10005
Date of Submission-
Word Count-1617 (including in-text citations)

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Abstract
There has been an enormous increase in older population (people aged more than 65 years old)
since the last decade. This enormous increase is considered as an imperative matter of social
concern in all nations. This population is at an increased likelihood of suffering from a plethora
of psychosocial problems, such as, social isolation, loneliness, mood disorders and depression.
These factors are responsible for threatening the quality of their lives by several ways.
Prevalence of loneliness has been significantly associated with reduced daily activities, cognitive
impairment, health abnormalities, and suicidal ideations. The advent of computer technology,
which includes the internet, has brought about huge changes in the society. It provides better
opportunities for communicating in daily lives, shopping, and banking, playing games, health
maintenance and seeking leisure activities. This research proposal will illustrate a design that
will be implemented for measuring the effectiveness of the internet in reducing feelings of
loneliness among older people living in residential care services.
Keywords: loneliness, older adults, internet, computer

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Table of Contents
Introduction......................................................................................................................................3
Aim/Objective..................................................................................................................................3
The research problem..................................................................................................................3
The research question..................................................................................................................4
The aim........................................................................................................................................4
The hypothesis.............................................................................................................................4
Literature review..............................................................................................................................4
Significance of the research.............................................................................................................6
Theoretical contributions.............................................................................................................6
Practical outcomes.......................................................................................................................6
Significance to the field...............................................................................................................6
Proposed Research Methodology....................................................................................................7
Participants..................................................................................................................................7
Sampling method.........................................................................................................................7
Methodology................................................................................................................................7
Design framework.......................................................................................................................7
Data collection.............................................................................................................................8
Ethical considerations..................................................................................................................8

3INTRODUCTION TO RESEARCH METHODS
Scope and Problems.........................................................................................................................8
Breadth of the research................................................................................................................8
Limitations of the research..........................................................................................................9
Potential problems.......................................................................................................................9
References......................................................................................................................................10

4INTRODUCTION TO RESEARCH METHODS
Introduction
Loneliness is considered as serious mental health disorders that exist across the wide
spectrum of aged care and residential care facilities. Loneliness has been portrayed as an
essential part of human existence in the Bible as well as the Greek mythology. In recent years,
isolation has become a part of the ageing experience. Increased geographical and social mobility,
reduced intergenerational living and increase in number of one person households adds to the
loneliness (Perissinotto, Cenzer & Covinsky, 2012). This health concern is often associated with
stigma and stereotypes related to personal failure that makes older adults feel ignored or not
accepted. A study conducted in the year 2013 suggested that more than half residents at an aged
care home experienced loneliness (55% of 296 residents) (Victor & Bowling, 2012).
Manifestation of these feelings are also correlated with the development of several health
disorders such as, depression, cardiovascular diseases, increased falls in elderly and recurrent
hospitalizations to the emergency department. Such older residents who demonstrate depression
and loneliness are more susceptible to exhibit agitation and aggressive behaviour and are found
to engage in conflicts with the staff frequently (Steptoe, Shankar, Demakakos & Wardle, 2013).
This research proposal will focus on interventions to effectively reduce loneliness among elderly
people living in residential homes.
Aim/Objective
The research problem
Social isolation creates detrimental effects on the health of older people and has been
identified as a major risk factor for increased mortality and morbidity.

5INTRODUCTION TO RESEARCH METHODS
The research question
 Can computer usage prevent social isolation and loneliness among the elderly?
 Can internet use alleviate loneliness among older adults?
The aim
The purpose of the research proposal is to investigate the effectiveness of internet
interventions and computer training in reducing social isolation and loneliness among older
adults living in a residential care centre.
The hypothesis
Computer proficiency and internet engagement will reduce loneliness among older adults
and will create a positive effect on the quality of life.
Literature review
Several electronic databases such as, CINAHL and MEDLINE were extensively searched
to extract peer reviewed articles published in English, not prior to 2012. Several key search terms
and boolean operators helped in locating multiple articles that evaluated the effects of
information technology and internet use in reducing loneliness in the elderly. The systematic
review conducted by Chen and Schulz (2016) explores the effects of information and
communication technologies on prevention of social isolation in elderly people. Inclusion of 25
publications after a thorough search of electronic databases provides evidences that suggest that
ICT interventions are effective in reducing perceived social isolation among the elderly. Most
studies included in the review demonstrate a positive correlation of computer usage and internet
with lowered social isolation.

6INTRODUCTION TO RESEARCH METHODS
Similar findings are demonstrated by a randomized controlled trial that examines the
effect of internet on loneliness and social isolation in independent and assisted older living
communities. Randomisation of older adults into three groups namely, the ICT treatment, true
control and attention control is followed by 8 weeks of computer and internet training for
communicating with friends and family in the sample group. Measurement of the socioemotional
outcomes over a period of 1 year demonstrated that ICT makes it easier for them to
communicate, reduces feelings of loneliness and makes them feel more connected to family and
friends (Cotten, Anderson & McCullough, 2013).
The quasi-experimental study conducted by Blažun, Saranto and Rissanen (2012)
evaluates the self-reported amount of loneliness among older people in Slovenia and Finland and
suggests a statistically significant difference in loneliness reduction between the countries among
people who complete the ICT course. The effects of computer proficiency and engagement in
alleviating levels of loneliness are therefore established.
On examining the impacts of internet usage in depression among the elderly, Cotten,
Ford, Ford and Hale (2012) suggest that internet makes a positive contribution on the mental
wellbeing of retired older persons (≥50 years) and also reduces depression by an approximate
rate of 20-28%. This is also supported by results of a study that tests social support and
loneliness as potential mediators for modifying relationship between well-being and internet
usage.
Data analysis indicates that internet use is a significant predictor of reduced loneliness,
enhanced life satisfaction and increased social support (Heo, Chun, Lee, Lee & Kim, 2015).
Another meta-analysis also suggests the effectiveness of internet interventions in reducing

7INTRODUCTION TO RESEARCH METHODS
loneliness among the elderly. It emphasized on the role of the intervention in reinforcing social
support, thereby improving communication and eliminating loneliness (Choi, Kong & Jung,
2012).
Significance of the research
Theoretical contributions
The research proposal aims at investigating the implications of teaching older adults the
usage of internet and computer skills. Several debates exist on determining whether use of the
internet decreases or increases social isolation among older people. Although multiple trials have
been carried out to show the benefits of internet usage on reducing loneliness and isolation
among the elderly, as shown in the literature review, there exist some studies that find computer
training and internet of little or negligible benefit (Yao & Zhong, 2014). Hence, this research
might serve as an important source of reference for other researchers, students and data analysts
who intend to apply the intervention in improving their overall wellbeing and mental health.
Practical outcomes
The research is based on the assumption that increasing the computer proficiency and
internet literacy among older adults will help in improving loneliness experienced at residential
care and aged care homes. Implementing appropriate interventions related to internet usage will
increase their social connectivity and communication with family and friends. The usage of
internet will also enrich the lives of the isolated elderly.

8INTRODUCTION TO RESEARCH METHODS
Significance to the field
Effects of loneliness on mortality are greater than other established risk factors such as,
sedentary lifestyle and obesity. Thus, the research will play an important role in reducing
mortality rates.
Proposed Research Methodology
Participants
The study will recruit 80 older people (regardless of their gender) from 3 aged care and
residential homes across the city. The participants belonging to the age group of 65-85 years will
be selected. Inclusion criteria will include a minimum of 11 years of education and should have
been retired for 5 years on an average. Residents suffering from cognitive and severe mental
decline will not be included in the study to prevent inaccurate results. There will be no
differentiation based on race or gender.
Sampling method
80 participants will be randomized to two groups namely, the sample group (receiving the
intervention) and the rest to the control group (without access to the internet). Randomization
will result in an unbiased assessment of the effects of the proposed intervention on the equal
number of participants among the 2 groups (Treweek et al., 2013).
Methodology
The research will encompass a quantitative analysis where the participants will be made
to undergo a survey by providing numbers on a likert scale for demonstrating their feelings and
satisfaction score. This will help in obtaining real data and will assist in monitoring the success
of the intervention.

9INTRODUCTION TO RESEARCH METHODS
Design framework
The study will be based on an experimental design where the predictor variable (internet
usage) can be manipulated to identify the cause-and-effect relationship. The research will
involve an experimental group that will be subjected to the intervention and a placebo group that
will exist in inert or non-manipulative conditions (Furtak, Seidel, Iverson & Briggs, 2012).
Data collection
Participants from both the groups will be subjected to completion of surveys, for 5 times
over a year. One survey will be carried out before the intervention begins, another at the end of
the 8-weeks of internet usage and the remaining three at the end of 4, 7 and 12 months after the
intervention. The UCLA Loneliness Scale will be provided to the participants to measure their
feelings on lack of companionship, being left out and isolated from friends and family (Neto,
2014). A 3-point likert scale will be used for measuring their responses (ranging from 1-5). The
scale measure will be based on mean of the scores.
The Mann-Whitney U test will be used for statistically evaluating the responses of the
participants. It will help in determining if the levels of loneliness differed based on the amount of
internet usage by the older participants (Fagerland, 2012).
Ethical considerations
Prior consent shall be taken from the administrators of the residential facilities from
which the participants will be selected. The older residents shall be informed about the objectives
of the study and their consent will be taken before randomization.

10INTRODUCTION TO RESEARCH METHODS
Scope and Problems
Breadth of the research
The proposed research will only investigate the effects of internet usage on perceptions of
loneliness and social isolation among the older adults living in residential settings, rather than
their own house. The study will not evaluate the effects of the proposed intervention on
prevalence of depression, suicidal ideations or mood disorders in the target population. Older
residents identified suffering from severe physical disability such as paralysis, and mental
disorders such as, dementia and schizophrenia will not be included in the study.
Limitations of the research
Limitations of the proposed study include the presence of small sample size and lack of
access to internet in most households (Bacchetti, 2013). The latter contributes to the limited
computer literacy and proficiency among the older adults. Thus, an extensive training was
required for most of the participants.
Potential problems
Communicating with older adults living in the residential care facilities may create
difficulties owing to the fact that they are often scared to communicate to unknown people and
may fail to understand the implications of the research intervention on their lifestyle and
wellbeing. There may be loss of potential number of participants at the end of the study due to
health complications and death, thereby giving misleading results.

11INTRODUCTION TO RESEARCH METHODS
References
Bacchetti, P. (2013). Small sample size is not the real problem. Nature Reviews
Neuroscience, 14(8), 585-585. doi:10.1038/nrn3475-c3
Blažun, H., Saranto, K., & Rissanen, S. (2012). Impact of computer training courses on reduction
of loneliness of older people in Finland and Slovenia. Computers in Human
Behavior, 28(4), 1202-1212. https://doi.org/10.1016/j.chb.2012.02.004
Chen, Y. R. R., & Schulz, P. J. (2016). The effect of information communication technology
interventions on reducing social isolation in the elderly: A systematic review. Journal of
medical Internet research, 18(1), e18. doi:10.2196/jmir.4596
Choi, M., Kong, S., & Jung, D. (2012). Computer and internet interventions for loneliness and
depression in older adults: a meta-analysis. Healthcare informatics research, 18(3), 191-
198. https://doi.org/10.4258/hir.2012.18.3.191
Cotten, S. R., Anderson, W. A., & McCullough, B. M. (2013). Impact of internet use on
loneliness and contact with others among older adults: cross-sectional analysis. Journal
of medical Internet research, 15(2), e39. doi: 10.2196/jmir.2306
Cotten, S. R., Ford, G., Ford, S., & Hale, T. M. (2012). Internet use and depression among older
adults. Computers in human behavior, 28(2), 496-499.
https://doi.org/10.1016/j.chb.2011.10.021

12INTRODUCTION TO RESEARCH METHODS
Fagerland, M. W. (2012). t-tests, non-parametric tests, and large studies—a paradox of statistical
practice?. BMC Medical Research Methodology, 12(1), 78. https://doi.org/10.1186/1471-
2288-12-78
Furtak, E. M., Seidel, T., Iverson, H., & Briggs, D. C. (2012). Experimental and quasi-
experimental studies of inquiry-based science teaching: A meta-analysis. Review of
educational research, 82(3), 300-329. https://doi.org/10.3102/0034654312457206
Heo, J., Chun, S., Lee, S., Lee, K. H., & Kim, J. (2015). Internet use and well-being in older
adults. Cyberpsychology, Behavior, and Social Networking, 18(5), 268-272.
https://doi.org/10.1089/cyber.2014.0549
Neto, F. (2014). Psychometric analysis of the short-form UCLA Loneliness Scale (ULS-6) in
older adults. European Journal of Ageing, 11(4), 313-319. DOI-
https://doi.org/10.1007/s10433-014-0312-1
Perissinotto, C. M., Cenzer, I. S., & Covinsky, K. E. (2012). Loneliness in older persons: a
predictor of functional decline and death. Archives of internal medicine, 172(14), 1078-
1084. doi:10.1001/archinternmed.2012.1993
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and
all-cause mortality in older men and women. Proceedings of the National Academy of
Sciences, 110(15), 5797-5801. doi: 10.1073/pnas.1219686110
Treweek, S., Lockhart, P., Pitkethly, M., Cook, J. A., Kjeldstrøm, M., Johansen, M., ... & Jones,
R. (2013). Methods to improve recruitment to randomised controlled trials: Cochrane

13INTRODUCTION TO RESEARCH METHODS
systematic review and meta-analysis. BMJ open, 3(2), e002360. doi: 10.1136/bmjopen-
2012-002360
Victor, C. R., & Bowling, A. (2012). A longitudinal analysis of loneliness among older people in
Great Britain. The Journal of psychology, 146(3), 313-331.
https://doi.org/10.1080/00223980.2011.609572
Yao, M. Z., & Zhong, Z. J. (2014). Loneliness, social contacts and Internet addiction: A cross-
lagged panel study. Computers in Human Behavior, 30, 164-170.
https://doi.org/10.1016/j.chb.2013.08.007