Loneliness Experiences of Hmong Older Adults: A Constructivist Grounded Theory Study

Approximately 89 million Americans will be age 65 and older by 2050 in the United States. This older adult population is especially vulnerable to loneliness as a result of numerous age-related risk factors including loss of social support and declining health. In addition to these common risk factors, refugee older adults may face increased loneliness as a consequence of war-related trauma, loss, and marginalized cultural values in their host country. Despite their heightened vulnerabilities to loneliness, the experiences of refugee older adults remain understudied.

This is the first study aimed at understanding the loneliness experiences of community-dwelling Hmong older adults, an ethnic group resettled in the United States as refugees over 40 years ago. A constructivist grounded theory method guided by an intersectionality framework was used to address three aims: 1) to understand the concept of loneliness among community-dwelling Hmong older adults, 2) to explore the premigration, displacement, and postmigration experiences of loneliness among community-dwelling Hmong older adults, and 3) to examine how community-dwelling Hmong older adults cope with loneliness. Semi-structured individual interviews were conducted with 17 Hmong older adults age 65 and older residing in Sacramento and Fresno, California. Analysis of the data was an iterative process between coding the data, generating focused codes, and connecting the categories to establish a conceptual pattern.

Participants conceptualized loneliness as a negative experience represented through physical and emotional expressions and intensity, which were influenced by an intersectional identity. Factors that influenced their experiences of loneliness in the premigration, displacement, and postmigration phase were discussed as trust, loss, aging-related issues, isolation, sense of community, access to cultural community, instability, violence, and cultural adjustments. Their narratives offered several coping mechanisms including religious and spiritual beliefs, social support, wandering, activity engagement, and control and avoidance. These findings informed a conceptual model of loneliness that incorporated an intersectional identity, influencing factors, and coping mechanisms. Overall, the results provide nuanced cultural meanings and insight into the loneliness experiences of Hmong older adults. Implications for social work research, practice, and policy suggests the need for greater culturally- and linguistically-competent services informed by Hmong older adults.