Ethical issues when interviewing older people about loneliness: reflections and recommendations for an effective methodological approach

Abstract

Loneliness among older people is perceived as a global public health concern, although assumptions that old age is a particularly lonely time for everyone are not accurate. While there is accumulating quantitative and qualitative evidence on the experience and impact of loneliness amongst older adults, there is little exploration of methodological issues that arise in engaging with older adults particularly through research-oriented conversations. The sensitivity and stigma often attached to loneliness means that interviewing research participants presents ethical challenges for researchers navigating complex emotional responses. This paper presents reflections from three research projects that used research interviews to explore accounts of loneliness experienced by older people. The everyday methodological decisions of research teams are often hidden from view, but through a critical examination of reflexive accounts of fieldwork, this paper makes visible the internal and external negotiations of researchers responding to ethical complexity. The paper explores the key decisions that researchers make during interviews about loneliness: how to introduce the topic; how to phrase questions about loneliness; when to ask the questions; how to deal with the stigma of loneliness and respond to ageism; and how to manage the participant–researcher relationship post-interview. The paper concludes with recommendations for appropriately navigating ethical complexity in loneliness research, thus contributing to an effective qualitative methodological approach to researching loneliness in later life.

Understanding the psychological experiences of loneliness in later life: qualitative protocol to inform technology development

“…Written informed consent will be obtained from all participants prior to data collection. We will be explicit about the focus on loneliness in all recruitment material 36…”

“…The interviewer will always end the interview of a positive note 36. If a sensitive topic is disclosed shortly before the end of the interview, the researcher will check in with the participant and go back to a positive topic previously discussed.…”

“…We developed the topic guide with a multidisciplinary team with expertise in psychology, gerontology, product design, smart composite materials and artificial intelligence. In line with recent guidelines on interviewing older adults about loneliness, 36 we will begin the interview using a third-person approach by asking participants how they define the term ‘loneliness’. We will then move onto exploring participants own personal experiences.…”

“…This study has been approved by Research Ethics Committees at King’s College London (reference number: LRS/DP-21/22-33376) and the University of Sussex (reference number: ER/JH878/1). The researcher conducting interviews is skilled in qualitative methods relating to sensitive topics in health and ageing and will adopt an ethical positioning of engagement and mutual respect 36. Regular clinical supervision with a qualified health psychologist will take place to support the interviewer with emotional aspects of conversations.…”

Talking really does matter: Lay perspectives from older people on talking about suicide in later life

“…For the participants, talking about suicide and aging can be sensitive, potentially stigmatizing and distressing (Jovicic and McPherson, 2020 ). The interview topics were designed to allow the participants to say as much as or as little as possible about their own experiences by framing questions in the third person and using open language, for example, “How would you describe?,” “What is your understanding of?,” and “What do you think would help?” (Naughton-Doe et al, 2022 ). The progression and timing of questions considered any potential for interview fatigue.…”