The preliminary effects of laughter therapy on loneliness and death anxiety among older adults living in nursing homes: A nonrandomised pilot study

Int J Older People Nurs. 2018 Dec;13(4):e12206. doi: 10.1111/opn.12206. Epub 2018 Jul 13.


Objectives: This study evaluated the preliminary effect of laughter therapy on the level of loneliness and death anxiety of older adults.

Methods: This was a quasi-experimental study with a nonequivalent control group pretest-posttest design. The study participants were older adults living in two nursing homes set up by foundations located in the capital of Turkey. A total of 50 older adults formed the intervention group (n = 20) and control group (n = 30). The intervention group received laughter therapy twice a week for 5 weeks. The control group received no intervention. Data were collected using a socio-demographic form, the De Jong Gierveld Loneliness Scale (DJGLS) and the Turkish Death Anxiety Scale (TDAS).

Results: After laughter therapy, the DJGLS total and subscale (emotional and social loneliness) scores decreased among older adults in the intervention group (p < 0.005). While there were no significant differences for overall TDAS, death uncertainty and pain subscales scores between the intervention and control group after laughter therapy, there was a significant decrease in TDAS exposure subscale scores of the intervention group (p < 0.005).

Discussion: The results suggest that laughter therapy can be used to decrease levels of loneliness and death anxiety among older adults living in nursing homes.

Implications for practice: Anxiety regarding death and loneliness are important issues that affect quality of life in older adults. This first pilot study demonstrates the beneficial effects of laughter therapy on loneliness and death anxiety in nursing home residents. Nurses can incorporate laughter therapy into routine programmes in nursing homes.

Keywords: death anxiety; laughter therapy; loneliness; nursing; older adults.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude to Death*
  • Female
  • Humans
  • Laughter Therapy*
  • Loneliness / psychology*
  • Male
  • Nursing Homes
  • Treatment Outcome
  • Turkey