Saturday, 19 October 2013

Loneliness - a simple problem with complex answers.

Jeremy Hunt has been talking about the national shame of loneliness of the elderly in the UK (http://www.theguardian.com/politics/2013/oct/18/jeremy-hunt-uk-families-asia-elderly) . I feel like I have been harking on about this to anyone who will listen to me for ages. Perhaps even you, dear reader, is getting bored of my fixation with this issue.

But bear with me. Companionship is not just a nicety of civilised living. Loneliness is recognised risk factor for ill health, and it is a bell-weather for how society functions. The way we treat the elderly is a symptom of how fast, and how much, the functioning of modern society has changed. The pattern of our lives has altered so much that we have not yet adapted to deal with an issue that has not troubled previous generations in the way that it currently troubles us.

There are a number of truths that we need to consider: that individuals are living longer, that elderly individuals are often living not just longer lives, but significant periods of their lives in poor health; that families are now smaller and more dispersed. I would encourage you to absorb the impact of those three factors, to get away from the idea that somehow the elderly in our society are lonely because their families and communities have stopped caring about them. It is unhelpful to blame the attitude of families, and communities, in the way they care for the elderly, because it fails to acknowledge that the issue we have with the elderly is not just the result of a change in the way we care, but also of some profound changes in the way we live.

Perhaps your view on the issue is shaped by your direct experience. Perhaps you know of children who travel hundreds of miles each week to check in on their parents who live in a different town. Perhaps you have seen the worry, the stress and the anxiety caused by wanting to help, but not being able to, due to the insurmountable obstacles of the need to work, and the impossibility of moving cities.

Perhaps you know people who take no interest in their parents or grandparents. These people undoubtedly exist, but is theirs an attitude borne out of a habit of our age, or is it more complex than that?

Jeremy Hunt suggests that the start of an answer is simple: take a lesson from Asian families who tend to care for their elderly relatives at home. It might be that easy, but I doubt it.

The issue is underpinned by the impact of social mobility. Where I live, my neighbour was born in the house she still lives in. Her  brother lives across the road, and her son lives three doors away. In this context, it would be possible to take on a care burden. But she is relative rarity. For children growing up in Dorset today, the majority of them will have to move away to further their education, and to seek employment opportunities. In a world of heightened opportunities (recent recessions notwithstanding) the price we have had to pay for greater autonomy and choice in our life patterns has been the requirement to relocate. This won't change.

Add to this the rising reality of prolonged old age, and prolonged dependency in old age, on a scale never previously seen before, and one can really start to question to validity of any assertion that the main solution to loneliness in old age starts and ends at home with the family. That is not to say that it wouldn't be ideal - it is surely preferable to the elderly to be surround by their kin. The issue is that it is not practicable.

Where do we start in the search for practicable solutions? Any approached needs to be many pronged: it starts with consideration of how the frail elderly among us can be afforded the opportunity to interact with the people near us. This perhaps starts with some concept of surrogacy: if you are not supporting your own parents and grandparents, then perhaps there is something that you can do to support the parents or grandparents of someone else, who live near you. With small beginnings, the impact of paying this kind of volunteering forward could really begin to tell.

But the future for modern society needs to consider the impact it can have on stemming the tide of elderly disability: socially engage, mentally stimulated, and physically active elderly men and women accumulate illness and frailty less quickly than those who are not. Embedding not just a role, but a reciprocal obligation of society to accommodate the elderly, and the elderly to take part, heralds a future in which the elderly not just have a role, but a community network that enjoys their input, and then supportively wraps them up, as they become less able to take an active part.

What does that look like? It could be anything, but it to me, it looks like the elderly reading with primary school children, running workshops to teach children about the past, and the skills they developed over time. It involves cross-generational community projects, play schemes, sharing of hobbies, interests and sports through  local clubs. It looks like whatever you want it to look like, because it looks like whatever you make it.

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