Can physical design help reduce loneliness in the elderly: A theoretical exploration.

Background: Over the past several years, a new problem affecting the elderly population has been increasingly reported in popular press—the elderly population is dying as a result of loneliness and related factors at a rate greater than that of lack of medical care. The problem is so pervasive that loneliness is being described as an epidemic. Objective: The objective of this inquiry was to examine whether the physical design of the lived environments could contribute to reducing loneliness in the elderly population. Method: A combination of scoping and conceptual review of published literature was adopted for the study. The process involved multiple phases of searching, and a review was conducted at each stage. Databases targeted include PsycINFO, Academic Search Complete, PsycArticles, Psychology and Behavioral Sciences Collection, and SocINDEX. In all, 44 articles and books were subjected to in-depth analyses of underlying concepts, constructs, relationships, and empirical findings. Results: Several theories including meaning in life theory, lifespan ego-development theory, symbolic interaction theory, proxemics, and affordance theory suggest that the design of the physical environment may have a role in addressing loneliness in the elderly. A potential explanatory model articulating the causal pathway is presented in this article. Conclusions: Between theoretical propositions and empirical literature, there exist grounds to assert that a plausible causal pathway exists between the physical environment and loneliness in the elderly population. The explanatory pathway suggests that the physical design could play both a direct and moderating role in influencing loneliness.