The experience of loneliness among nursing homes residents and its relationship with independence level and activities of daily living: contemporary insights from North Macedonia

Loneliness is often experienced among nursing home residents and impacts their quality of life. This study explores possible variations in loneliness levels between 263 residents of public and private nursing homes in North Macedonia, including the relationship between independence levels, using the Katz index of independence in activities of daily living (Katz) index, and feelings of loneliness using the ‘De Jong-Gierveld loneliness scale’. This study revealed that 36.5% of older adults residing in nursing facilities reported experiencing minimal loneliness, while 11.8% reported experiencing severe loneliness. Regarding social loneliness, 27.0% of the residents reported a score of 0 (indicating no loneliness), whereas 22.8% reported significant social loneliness (scores of 4–5). In contrast, emotional loneliness exhibited a more balanced distribution, with 18.3% scoring 0 points and 13.0% scoring at the highest levels (scores of 5–6). The significant predictors can be grouped into two categories: 1. Structural factors: nationalities, educational level, and type of nursing home. 2. Social engagement factors: involvement in activities, frequency of visits, and contact via other means. Given the widespread prevalence of loneliness among older adults living in nursing homes, additional research is urgently needed to better comprehend how older adults interpret and experience this phenomenon.