Literature Review

Literature Review

Literature Review

A study conducted by O’Rourke et al. (2018) addressed the issue of loneliness and social connectedness and found that engaging in purposeful activities and maintaining contact with a social network were two valuable strategies to decrease loneliness. Interventions designed to address loneliness and social isolation included personal contact, reminiscence, and support groups. O’Rourke et al. (2018) considered contact with a relative or visitor as a component of intervention that targets multiple factors such as belonging, caring, and social support.

Verma and Kumar (2018) found a significant difference in the level of quality of life and social relationships of older adults living in a senior living facility, when compared to older adults living with family. The level of loneliness was high among older adults living in senior living facilities, which negatively correlated with physical health, psychological health, and social relationships (Verma & Kumar, 2018). Social technology can address the interpersonal well-being of older adults, regardless of living accommodations (Chen & Schulz, 2016). Hasan and Linger (2016) identified connection, self-esteem, productivity, occupation, self-sufficiency, control, and enjoyment as outcomes of using social technology.

Older adults can rely on social technology to aid in alleviating feelings of social isolation (Andrews et al., 2019). According to a study by Chopik (2016), an increased rate of social technology use among older adults was associated with improved selfrated health and subjective well-being, and fewer onsets of chronic illnesses and depressive symptoms. Chen and Shulz (2016) found social technology interventions fostered social support, social contacts, social connectivity, and social networks among the participants. Andrews et al. (2019) found that social technology was a successful intervention and provided a helpful distraction from intrusive thoughts in older adults. Additionally, the older adults were highly motivated to use social technology as a treatment method to support mental health by promoting selfreliance, averting loneliness, and improving mood.

Moving into an assisted living facility brings new challenges regarding social exclusion. A lack of family connections can decrease the feeling of belonging for older adults (Miller, 2019). Drageset et al. (2011) found that more than half of the participants residing in a nursing home experienced loneliness. Family visitation to the facility is one component that can decrease the adverse effects of social exclusion, such as an improvement on an individual’s quality of life (Miller, 2019; Puurveen et al, 2018). Satisfaction with the level of emotional connection to loved ones was an essential component of decreasing loneliness (Drageset et al., 2011). Miller (2019) identified seven different barriers to visiting family members residing in a nursing home, which further increased social isolation. The barriers were psychological, health, family and staff relationship, employment and finances, time for travel, transportation, and other miscellaneous obstacles. Social technology is a medium with the potential to combat the effects of these barriers.

Approximately half of older adults watch television (TV) as the main source of company to combat loneliness (Öngün et al., 2016). Papa et al. (2017) utilized an easy-to-use technological interface that appealed to the older adult population to improve social participation. Choprik (2016) found that half of the participants identified learning to use new technology to be difficult and time-consuming, while the other half mentioned it was too expensive, challenging, and difficult to keep up with as the nature of technology continuously changes. However, older adults found it easier to navigate new technology when it is embedded in items they already use, such as a TV or telephone (Papa et al., 2017). To achieve user-friendliness for the older adult population, technology was embedded into a TV. Social TV was defined as “the idea of using communication technology to connect TV viewers to create remotely shared experiences around TV content” (Papa et al., 2017, p. 45). Interviewees discussed the many benefits of the technology, such as the usefulness to counteract social isolation, ease of use, accessibility, and extended possibilities of communication (Papa et al., 2017). A study by Coelho et al. (2017) utilized a television-based social media interface that featured printed photo sharing and multiple interactive functions, including remote control, voice, and gestures. Participants reported high usability and improved social interactions with relatives, both online and offline.

Intergenerational Reminiscence Activities

A study conducted by Morganti et al. (2016) supported that reminiscence or reflecting on past experiences and people is an effective way of decreasing loneliness among older adults. Findings demonstrated that older adults’ emotional and social loneliness significantly decreased after Intergenerational Reminiscence (IR) activities that included memories from newspaper clippings, letters, photos, videos, and postcards. In this instance, the term intergenerational refers to the memory of individuals no longer alive and the older adults they left behind. Through the use of IR, with and without the utilization of technology, feelings of social isolation decreased while self-esteem increased. The IR activities were perceived as enjoyable and engaging by older adults (Morganti et al., 2016). West et al. (2007) found that older adults identified a common memory aid to be a scrapbook or photo album. A digital scrapbook was created with features including photos, videos, and audio clips with captions. The digital scrapbook provided adequate support for reminiscence and was effective for memory sharing (West et al., 2007).

Tsai and Tsai (2015) examined the attitudes and predictors of videoconferencing use among family visitors to nursing homes. The mode of technology used provided live audio and visual telecommunication systems was found to have positive effects for residents transitioning into a nursing home facility. Additionally, videoconferencing was associated with reduced depression and loneliness among older adults living in nursing homes (Tsai & Tsai, 2015). Tsai and Tsai (2015) concluded that families could benefit more if videoconferencing were accessible across various devices such as smartphones or tablets. The need to develop “more interactive content for video conferencing, such as a family-oriented picture program that can help broaden topics of conversation” was also identified (Tsai & Tsai, 2015, p. 843). Chen and Schulz (2016) found that social technology interventions resulted in significant reductions in loneliness among study participants. Overall, it was found that social technology interventions enhanced interaction between generations and kept residents more connected with others, such as family and friends, outside of the nursing home (Chen & Schulz, 2016).

Justification for Study

Research findings suggest social technology can be beneficial for decreasing loneliness in older adults; however, established literature on the use of social technology for reducing loneliness in the older adult population is limited. Social technology as a medium for research is relatively new and expensive, which may account for the lack of publications available. Research analyzing the use of photographs through a technological interface in decreasing loneliness and social isolation is also scarce. The current study attempts to bridge the gap in existing research on the use of social technology to reduce social isolation and loneliness among older adults. Researchers of the current study hypothesized that social connectedness through participants’ use of social technology, in the form of photographs and voice recordings, will have a positive effect on depression and associated loneliness, as measured respectively, utilizing the Patient Health Questionnaire 9th edition (PHQ-9) and participant report through a researcher created survey.