Loneliness: a concept relevant to the care of dying persons.

Loneliness, whether conceptualized as a basic "fact" of human existence or as a painful, subjective experience in response to changes or deficiencies in the quality or quantity of a person's social relationships, has been recognized as an experience feared or felt by human beings since antiquity. As health care professionals, nurses have observed and responded to loneliness as an actual or potential problem amenable to nursing intervention. Being a subjective experience and one which may or may not be connected to the more objective condition of social isolation or aloneness, loneliness has puzzled scholars and researchers across disciplines. Although the nature of loneliness as a relational deficit is beginning to be explicated, particularly through the efforts of social psychologists, there are still major questions to be answered with regard to antecedents, manifestations, and interventions. Dying persons may represent a particularly vulnerable group, especially those dying in an acute care/cure-oriented setting. Since the limited knowledge about the nature of loneliness has been acquired primarily through studying college students or young adults, the question of whether or not their experience is comparable to that of other groups remains to be answered. Nurses continue to make clinical judgments about the loneliness of their patients. They basically are guided by a knowledge of affiliative functioning, and their interventions reflect a goal of optimal, social functioning for individuals experiencing or at-risk for loneliness.