Alone or Lonely? Does the person you support have the ability to choose?

There is a difference between being alone and being lonely.  I think that being ‘alone’ is when you are by yourself and content with the situation while ‘loneliness’ is the unhappiness that arises when a person is on their own but would rather have the company of others.
When supporting a person with a communication disability we must consider that a person, who is observed to be on their own, may or may not be content with the situation.  I have encountered many support workers who have told me that the person they support likes to be on their own, rocking in the corner of the room or sat quietly on the sofa.  “Maybe… maybe not” is my reply.  How do we know for certain if a person wants to be on their own if they lack the very skills that a typical person would use to initiate an interaction with other people?
One way I explain the situation to the staff that I mentor is like this.  The people we support sometimes want to be on their own and they can often communicate this need to us, often in an extreme way – pushing, shouting, nipping or other challenging behaviours.  Likewise, the people we support can sometimes communicate when they would like to be with us perhaps by hugging, holding, dancing.  But there is a grey area in between these two poles where perhaps the people we support would like to be with us but feel unable to start the interaction, feeling anxious, lacking confidence, feeling fearful.  In this situation the people we support would be lonely (and suffering from loneliness) rather than being content with being alone.
How do I as a practitioner know that this might be the case? Because when I use an approach like intensive interaction or responsive communication it is at these times that I might approach someone, when the person is on their own and not pushing people away or becoming obsessed with sensory stimulation.  And when I  approach people sensitively at these time what do I find?  I often find that, if I have offered myself in the way that the person I am supporting needs me to be, such a person might begin to enjoy my company and show pleasure in being with another human being, rather than pushing me away as might be the case if they were happy being alone.
As I said above, there is a question (rather than certainty) over whether a person wants to be alone when they are observed to be by themselves.  We should be careful about assuming that a person with a severe communication disability (arising from autism, learning disabilities or dementia) is content if they are by themselves and we should be aware that this assumption can spring from our use of the same criteria that we use with our friends and family for determining whether a person wants be alone ie. assuming that if they are by themselves they are content and could reach out for human contact if they wanted.  For a person who lacks fundamental communication skills our assumption should rather be that ‘this person may not have the ability to reach out for the social contact that they desire and need’ and we should investigate how to approach the person sensitively to determine whether their isolation is in fact something they desire or would rather was not the case.  So, the next time you see someone by themselves, ask yourself this: is this person content with being alone or is loneliness damaging their mental health?