Print QRF Li

Questionnaire 1

Loneliness Quick Check history

Low risk of loneliness

According to the information provided, it is unlikely for this person to develop loneliness. Nonetheless, you can proceed to Step 3 and administer the Revised UCLA Loneliness Scale for further evaluation or proceed to Steps 4 and 5 containing tips and support tools for further discussion with the person, according to your clinical judgement.

Instructions: Please tick when the statement applies to the person you are assessing.

LQC - Loneliness Quick Check		Yes	No
1	The person has recently retired or became unemployed (max two years)
2	The person does not have close family or friends/social network
3	The person doesn't have an intimate relationship
4	The person has recently become widowed (within last year)
5	The person has mobility issues within their living space
6	The person has lack of access to local transportation (e.g. not driving, not access to buses or someone to take them to places)
7	The person does not have easy access to basic products/services near their home.
8	The person has recently changed surroundings in the last month.
9	The person has mental and/or physical health problems (including visual or hearing impairments, obesity etc).
10	The person does not use the internet
Socio demographic risk factors		Yes	No
11	Age: 80+
12	Gender: female.
13	Income: low (i.e. need of financial support)
14	Member of a vulnerable group (i.e. migrants, persons with disability, etc.)
15	Crisis situation in home country (i.e. pandemic, financial, political etc.) in the person's country