Resonances of Feeling Alone: A Systematic Review Unveiling Older Persons' Loneliness and Its Mechanisms in Residential Care Facilities.

Aim: To review older persons' lived experiences and perceptions of loneliness in residential care facilities and characterise mechanisms underlying their experiences through a comprehensive loneliness model.

Design: A systematic review synthesising qualitative research on the experiences of loneliness among older people living in residential care facilities.

Methods: This review followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines with quality appraisal conducted using the Critical Appraisal Skills Programme checklist.

Data Sources: Articles published in English (2014-2024) from CINAHL, PubMed, PsycINFO and Web of Science.

Results: Sixteen articles met inclusion criteria, representing 357 participants across 10 countries and regions. Three core themes of loneliness were identified: relational and individualised loneliness experiences, perception and emotional distress and the influence of context and cognitive processes in modulating loneliness. A conceptual model delineating the mechanisms of older residents' loneliness in residential settings was developed.

Conclusion: This review highlights the influence of older persons' residential context and cognitive processes, particularly their perceptions, in triggering loneliness. The perceptions of reduced social control and insufficient social connections in residential settings exacerbate older persons' loneliness, precipitating distressing emotional responses and diminished quality of life.

Implications: Residential care facilities have a crucial responsibility in establishing a supportive atmosphere conducive to positive social engagement for older residents. Future research must explore strategic transformations of older persons' perceptions through mechanistic targets and tailored care plans to reshape their social expectations within the context of residential care facilities, potentially mitigating loneliness.

Impact: This review addresses the problem of understanding the mechanisms and experiences of loneliness among older persons in residential care facilities. The findings highlight the critical need for supportive social environments and targeted interventions in residential care settings to improve residents' well-being and quality of life globally.

Reporting Method: Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.

Patient Or Public Contribution: No patient or public contribution.