Defense Date


Graduation Date

Summer 8-8-2020

Submission Type


Degree Name

Doctor of Nursing Practice (DNP)


Doctor of Nursing Practice (DNP) Program


School of Nursing

Faculty Mentor

Catherine Johnson

Committee Member

Ted Smith

Committee Member

Mary Ellen Glasgow

Committee Member

Denise Lucas


loneliness, loneliness scale, community-dwelling older adults, social isolation



Loneliness is a subjective experience characterized by a profound decrease in the amount and the quality of desired social connectedness. Community-dwelling older adults are particularly vulnerable to loneliness because of age-related changes such as the loss of driving privileges, loss of a spouse, living alone, socioeconomic changes caused by retirement, and a lack of access to meaningful social activities. These factors diminish an older adult’s sense of belonging, the quality of their social relationships, and the degree to which they are socially engaged. Loneliness presents a significant threat not only to the psychosocial wellbeing of older adults, but also to their physical health. Loneliness potentiates and worsens morbidities such as hypertension, pain, anxiety, and depression (Smith, 2012). This quality improvement project seeks to educate a registered nurse at a home care agency in the use of the Revised-University of California Los Angeles (R-UCLA) loneliness scale, and the 3-item UCLA loneliness scale to reliably detect loneliness in patients. Home care clients identified as lonely chose a loneliness reducing strategy from a menu of options including therapies such as humor, music, reminiscence, scripture reading, and use of a loneliness telephone support line. Each loneliness strategy was facilitated by the patient’s in-home caregiver. Using a plan-do-study-act (PDSA) cycle, the program was able to affect a decreased experience of loneliness as measured by a decrease in the R-UCLA score after receiving a loneliness strategy. Participants in the quality improvement project included only clients of the home care agency and those at least 65 years and older. Additional consent was not required for the change activity as the quality improvement approach builds on the agency's current quality improvement activities. There was also no significant risk to patients. The project was exclusively funded by the home care agency. The report's findings are not generalizable, and they are limited to use at the specific implementation site.



Included in

Nursing Commons