It was no surprise to researcher Judith Teicke that many older people are lonely. But even she was taken aback by what her team at the Benevolent Society uncovered when it spoke to 185 older people and 62 carers about their lives. “I was bowled over by the human need for contact,” she said. Many spoke about their sense of isolation. Here is how one woman put it: “I miss my good friends sometimes because my family don’t come up that often to see me …. I’m often by myself quite a lot of the day. I’ve television just coming out of my ears – I mean there’s nothing else other than to watch that damn thing all the time.”
Loneliness is a public health issue. Loneliness makes people sick and depressed. It’s as serious a risk to health as smoking. It’s a problem for people of all ages. But over the age of 80, with so many losses endured of loved ones and health, loneliness can be particularly acute. Another recent survey, by Better Care, a community care franchise, found loneliness was nominated by its staff as the biggest concern of their elderly clients. Yet in Australia we ignore the subject. Despite a major Productivity Commission inquiry into aged care, and the scheduled overhaul of our aged care system, with its strong emphasis on home care, loneliness is missing from the discussion. In the UK it’s a huge topic. A lobby group called the Campaign to End Loneliness is active, prominent, and armed with research: it claims half of Britain’s elderly say the television is their main company. Age UK, the peak lobby group, runs a major “befriending” program to try to combat loneliness among the elderly.
But here the emphasis of government-funded programs is on the delivery of practical help to elderly people in their homes. That’s hugely important. People need meals delivered, home maintenance, home nursing care, help with showering and dressing. But many also desperately want someone to talk to. Even more, they want a genuine connection to other human beings. Often the home care workers who deliver the meals, fix leaky taps and clean houses don’t have much time to chat.
“As a country we haven’t cracked this, we’re not doing this right,” said Judith, who is the senior researcher and evaluation officer at the Benevolent Society. The project didn’t set out to investigate loneliness. Rather it sought to evaluate the Benevolent Society’s success in meeting the needs of its home care clients. What it found was high levels of social isolation and psychological distress. Findings released at last week’s Social Policy Research Conference at the University of NSW show almost one-third were socially isolated. When asked what she wanted from the service, one client summed it up: “Company more than anything else is the main thing.”
It’s not always easy to tell who’s lonely. Just because an elderly person lives alone doesn’t mean they feel lonely. They may be content in their own company; perhaps they were never sociable. On the other hand, a surprising finding from the survey was that people who lived with others could still feel desperately alone. A spouse caring for a partner with dementia, for example, could be shunned by friends. Said one woman: “… people who knew [my husband] really well, they don’t come near you any more…..because he can’t have a conversation with you. I have one friend that rings me on a regular basis and that’s it. Everybody leave you. Sometimes you’re just very lonely because you have somebody here in the physical but they can’t talk to you….”
Where are the families, the adult children? Some are busy, interstate, overseas, indifferent, or focussed on the practical matters of caring for elderly parents. But even the best adult children may be no substitute for friends. I’ve written before about Australian research that shows having a diverse group of friends in older age is good for just about every aspect of life. Having adult children as your main contact just doesn’t confer the same benefits. (But they help).
And what about retirement villages? Should we encourage our elderly parents to move in to ward off a looming loneliness crisis? It works for some. But it’s no panacea, as research by Professor Wendy Moyle, of Griffith Health Institute, reveals. They can be tight, unfriendly places in which the newly-bereaved shut themselves away. In one big village she studied, the 12 residents on the management committee knew each other but no-one else. “If all that’s on offer is five o’clock drinks and tennis, the same 10 per cent go; the rest are in their homes,” she said.
She worked on a project to transform the village into a less lonely place. Members of the management committee went door-to-door delivering a series of “fact sheets” about the neighbourhood. Over several visits they got to know people, and invited them to community events. “It takes quite a concerted effort to get the whole community engaged,” she said.
What counts in combatting loneliness, Professor Moyle has found from extensive research into the subject, is creating relationships that matter. This goes beyond bus outings and social events. Older people are amazingly resilient. They are active in keeping positive and busy. But they may need help.
On a national level, we need to value older people, and in our home care policies we need to put more emphasis on the importance of relationships.
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