A scoping review of friendship intervention for older adults: lessons for designing intervention for people with aphasia

Purpose: Map the landscape of friendship interventions/programs for older adults to guide intervention/program development inclusive of the unique needs of older people with aphasia (PWA). Methods: A search query of multiple databases was completed for articles published before 4 January 2021. Studies included all the following: (1) participants aged 55 years or older; (2) addressed an intervention/program designed to prevent social isolation and/or friendship loss; (3) used an outcome variable related to social isolation and/or friendship; and (4) published in a peer-reviewed journal. Title and abstract screening were conducted using Covidence software, which tracked disagreements across the study team. All studies included in the full-text review were identified as relevant by a minimum of two study authors, and a consensus was reached on all full-text reviews. Data were extracted according to (1) theoretical frameworks used; (2) interventionist and discipline; (3) participant characteristics; (4) intervention/program replicability; (5) format of intervention/program; (6) measures used in the intervention/programs; (7) and, reported effects of intervention/programs on individuals. Results: A total of 40 articles with 42 intervention/programs were included and represented 4584 intervention/program participants ranging in age from 40 to 104 years. Intervention/programs involved a wide range of theoretical frameworks (e.g., theories of loneliness, feminist theory, positive psychology). Disciplines such as psychology and exercise science informed intervention/programs. Interventionists included many types of individuals like therapists, volunteers and home health aides. Intervention/programs often lacked adequate description for replication and included individual and group formats, most commonly delievered in the participants homes. Outcomes usually included self-report measures of loneliness, social networks, or well-being, and intervention/programming was primarily educational, activity-based, or networking-based in nature. Conclusions: The intervention/programs reviewed yield important lessons to support innovation in developing friendship intervention/programs for older PWA as most yielded positive results and were acceptable to participants.IMPLICATIONS FOR REHABILITATION People with aphasia want their friendships addressed as part of their rehabilitation; however, the research literature has little guidance in this area. Studies reviewed of friendship intervention/programs for older adults yielded helpful lessons for consideration in developing this type of intervention/programming for people with aphasia. Interprofessional teams made up of rehabilitation professionals should address friendship for people with aphasia in both research and clinical practice.