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Courage to face a Lonely Old Age

By Jenni Russell, Times 2014

When you are young you believe courage belongs to youth. It is overwhelmingly the young we see taking risks and being brave as they race cars, dive off rocks, snowboard off the edge of mountains and fight for their country.

It never occurs to you that it may take courage to grow old.

This week a leading psychiatrist from the Royal College of Psychiatry said that depression in the elderly was the country’s “next big public health problem”. Between 10 lmd 20 per cent of older adults in the community are clinically depressed and it is double that for people in care. It is under-diagnosed, under-treated and often confused with dementia. It is not much discussed and not a priority for public health. Yet as the vast majority of Britons will have a lengthy old age, finding a way to make it happier will matter very much to most of us.

“Everything is about loss,” a friend in her sixties told me bleakly. “You lose parents and friends. You lose your looks, your strength. Things hurt when you wake up in the morning. I used to love going out and I loved meeting people and now all of it makes me nervous because I know that my presence isn’t a gift any more. I matter less and I know it”.

No one would guess my friend had such anxieties. She isn’t officially depressed. She’s fortunate. She is successful and good-looking, she still works and has a partner. Even for the relatively privileged, ageing can be hard.

Another sixty something woman, widowed three years ago, who was left with a spacious house, a circle of good friends and quite enough money, tells me that she only gets through the days on betablockers.

“It’s the cold, hard loneliness-of-it – that’s so hard to bear,” she says. Every decision must be taken on her own, and her home echoes with her solitude. Most days nothing moves in the house, not a chair, not a teaspoon, unless it is moved by her. She is determinedly bright in company and tells no one, not even her friends, how she feels. She thinks they would be disconcerted and repelled by her neediness. “Loneliness is the last great unmentionable,” she says.

A man in his nineties, who has lived alone since his wife died, has both wealth and children to support him. Neither make up for the absence of daily intimacy. His mind is perfectly sharp but, since his stroke, walking is a daily terror, reading an immense effort and cooking, showering and dressing alone an impossibility. He can afford to pay for charming carers to visit every day, but most of his time is spent quite alone, enduring the emptiness of the hours. His children, who love him, have their own pressured lives. “Everyone is so busy,” he told me forlornly.

These problems are multiplied for poorer pensioners. One in six pensioners lives in poverty and one in seven close to it Age UK talks of the relentless discipline and resourcefulness required to live on a small fixed income. It is emotionally draining to worry constantly about whether to choose heating or cake, socks or phone calls. Friendships can fade because moving around becomes harder, entertaining people costs money, and confusion or forgetfulness make socialising less rewarding.

When anyone beyond the wealthy needs care at home, it’s the state that pays, but there is rarely time for the warm engagement people who are ill, lonely or confused so desperately need. Much care is provided by a shifting population of agency carers, often with limited English, who are allowed only 15 minutes to dress or feed or put an old person to bed. Physical needs are dealt with; emotional ones frequently ignored.

We need a revolution in how we deal with this. We can’t prevent physical deterioration or mental confusion, but much of what makes us sad as we age is dwindling social contact and the sense that we no longer command others’ interest, affection and respect. We must wake up to this hidden reality and respond to it with our friends and neighbours, but something more formal is needed too.

The most exciting idea comes from a science professor, Heinz Wolff. The· country can’t afford better state care, and in an individualistic age altruism won’t fill the gap. Instead we could all earn our own care in the future by using a time bank to help others now.

In a nationwide scheme, 45 minutes helping a neighbour to eat breakfast or go shopping would earn us 45 minutes’ help in our old age. Professor Wolff calculates that four or five hours a week of caring as an adult would earn us all the “care pension” we would need as we aged.

It’s a simple concept, but a brilliant one. It’s the Big Society in a nutshell – a social contract that could build bonds, make people happy and save the nation money. All it needs is an imaginative government to avert its gaze from the Miller furore and start planning for it now.