"It's the worst bloody feeling in the world": Experiences of loneliness and social isolation among older people living in care homes.

Loneliness and social isolation in later life result in social exclusion, reduced well-being, and significant health problems. Yet, we have a limited understanding of the meanings that older people ascribe to loneliness and social isolation, and how they live through and cope with these issues. The scarce research on the topic largely reflects the experiences of older people living in the community. Less is known about the lived experiences of those in institutionalized settings, despite this group's vulnerability to loneliness and social isolation. To address this gap, we conducted a six-month multi-method qualitative study in two Australian care homes. The study included participant observation and interviews with twenty-two residents experiencing (or at risk) of loneliness and/or social isolation. Our findings show that participants understood loneliness and social isolation as relational and associated with oldering (age-related contexts, norms, status), personal troubles, and sickness. They therefore situated loneliness and social isolation as multidimensional phenomena: related to both structural (e.g., oldering) and agentic (e.g., personal choices) dimensions. Although participants acknowledged the structural aspects of loneliness and isolation, most felt it was their own responsibility to address it. They employed individual and social strategies to cope with and regulate disclosure of loneliness and isolation. Our study drew on interactionism and situationism (Erving Goffman) along with an emotion work approach (Arlie Hochschild) to provide a richer understanding of the lived experiences of loneliness and social isolation among frail older people living in care homes.