As I’ve gained more experience working with my older adult clients, I believe there is one aspect to the work that is the hardest for me not to take home every day. To be present with another person’s loneliness is one of the most heart wrenching feelings to sit with. Loneliness is also perhaps the most pervasive theme I have seen over my time working with older adults. I felt compelled to share my experiences and thoughts on working with clients who are living with such extreme loneliness because so many of my clients have been bringing it up more recently. The clients’ feelings of loneliness don’t even really have to be said since they are so very much felt as soon as I walk into the room. I personally struggle to know how to help my clients with such extreme loneliness.

I have found some solace in the thought that my sheer consistent presence alone helps to relieve some of their loneliness, for whatever that hour a week can do. Idealistically, the thoughts of encouraging the older adults to get involved in more activities, to try and introduce them to fellow residents, or to start a weekly group came to me early on in my work as a counselor. When I worked to put these ideas to practice, they did not seem to have the impact on the older adults’ loneliness that I had wished. Many of my clients tell me that they have little interest in the types of activities offered to them and bringing the residents together for some sort of weekly group seemed to help occupy their thoughts for some time, but ultimately the older adults were left with a large portion of their days alone and unoccupied.

The feelings of loneliness seem to go so incredibly deep into each one of the individuals living with it. The older adult has lost so much of the life they were use to in the death of loved ones, movement out of his/her home, loss of function, and declining health. These ideas left me to think that relieving my clients’ loneliness even a little bit would take more than a simple addition to their daily schedules. Loneliness was the result of the multiple losses experienced in such a small amount of time. It became a goal with some of my clients to work on building up their energy and motivation for doing things, this goal would best be reached by working on expressing and exploring the feelings surrounding the client’s loneliness.

Another important point that I have been building upon as I continue to learn how to help my clients grow from their loneliness is the idea that the older adult must first work to accept the multiple changes in their lives. I have found myself doing a great deal of research into grief counseling and working on my own approaches in helping my clients grieve over their losses and the major changes that have uprooted their entire lives. Secondly, what I like to call “the challenge of reinventing hope” is a collaborative effort between the client and counselor to help the older adult feel and believe they have more life worth living. This challenge is an ongoing and continually wavering effort as the older adult experiences more losses, health issues, and decline in functioning. However as a counselor working with older adults, my own belief in the life they have left to live must be the constant source of strength when the client’s belief in their own life falters. Another aspect I have found that helps to reinvent such hope in the older adult’s life is involving his or her family or other support system in his or her care. Talking with the older adult’s family, friends, and the staff they are closest to within the facility allows for a more complete effort in ensuring other individuals can provide the needed support.

I think it helps me to share some thoughts about specific clients, so I wanted to share with you a particular client whose loneliness left me near tears every time I left her room. One of the facilities I work in has a respiratory unit in which the residents are connected to respirators 24/7 due to various respiratory conditions. One of my clients is a 76 year old woman who recently moved to this unit due to her severe lung disease. Not only had she recently moved into this facility and been connected forever from that point on to this respirator, but her husband passed away within two weeks of her move, and her home of 45 years was put up for sale. Everything this client ever owned was gone and she was left to share a room with another woman for the rest of her life. The effects of these losses and changes were understandably overwhelming. Every time I visited this client, she cried and even sobbed. It was during those moments I sat with her simply holding her hand in silence. When she was able to muster up actual words, she expressed her extreme loneliness. The respirator made it difficult to move around, leaving her mostly confined to her room. However she also had little desire to do anything with the grief she was living with. I spoke with staff to encourage frequent visits from staff and an effort on their part to really allow this client to get to know them, so she felt more comfortable in her new setting. I also was able to talk with this client’s daughter and brother, encouraging their consistent presence. This client’s presentation was more complex than just her extreme loneliness, but in working to help her through the grief process and encourage the continual presence of staff and family, my client’s desire for life seemed to grow little by little as time went on. This woman is still one of my active clients; however she appears to be feeling much more hopeful about her new setting and future. She still struggles with other challenges and feelings, but in maintaining my own hope, always being present with her, and constantly encouraging the staff and family to add their support, this client’s motivation for life remains strong and willing.

As my experiences deepen within my counseling work with older adults, I believe working with loneliness will always weigh heavy on my own heart. Every time I sit with another person’s loneliness, I still have moments of not knowing what to say or where to go with a session. Each person’s loneliness is a unique feeling only they will ever experience. However as a counselor my goal is to be present with their loneliness and allow a space to grieve and reinvent hope for the life left to live. As always, I’d love to hear your thoughts and experiences! Feel free to email me at lee.kehoe@gmail.com. Thanks for reading!

Lee Kehoe is a licensed counselor working with the older adult population. It is her passion to serve the older adult population through counseling, research, and advocacy efforts, with the hope of raising awareness to the growing needs of older adults and their families.