Many parts of society need to come together to better address the problems caused by loneliness in later life.

The devastating impact of loneliness in later life became evident to me when, some years ago, I met an octogenarian and his daughter in Kolkata during my research.

After his wife died, he divided his property among his four children and moved to a rented two-bedroom apartment to stay close to his daughter. She was the only one willing to provide care for him.

An otherwise healthy and sociable person, he was diagnosed with severe depression about ten months after relocating. In another six months, he passed away.

Adjusting to an unknown neighbourhood and forging new relationships in later life was daunting for him. His daughter cared a lot about him but was unable to move him into her marital home. Living alone after becoming a widower took a deadly toll.

Public health crisis

Loneliness as a public health crisis looms large among older people in India.

Conventionally, it has been the moral responsibility of adult children in India to support their parents in later life. Filial piety is considered an important virtue by law, which obligates adult children with the means to look after their parents. The national policy also encourages families to undertake the maximum amount of care work possible.

Although the percentage of children living with their parents is still high in India, adult children settling out of their parents' city for education or work is also not uncommon.

Societally, so much more can be done to check the pervasiveness of loneliness among older citizens.

Some ways are moving to a care home so one can live with others from similar backgrounds and be free from arranging daily care for oneself; joining offline or online forums to socialise with those from the same age group; or purchasing companionship services from care companies.

There is no one right way to address loneliness as it is extremely complex and contextual.

Sometimes, older people may be hesitant to relocate to care homes, which they imagine to be morose environments where people only speak about ailments and death, but research shows this isn't necessarily so.

Care homes may be classified as paid or charity homes. In a few care homes in Kolkata and Delhi, it is common to celebrate festivals, go on outings and involve residents in recreational programmes that include interaction with school children.

Bonding with younger generations

Many old people in these care homes believed interacting with young students was enjoyable and alleviated feelings of loneliness to some extent.

Intergenerational bonding is often expressed in newer ways.

Supporting elderly parents may assume the form of remittances as opposed to living together. Those with access to technology may stay in touch through video calls, for example.

Children with greater means may hire attendants, install digital surveillance technology to monitor their parents' activities or purchase comprehensive companionship and healthcare packages for their parents.

The market offers a wide and innovative array of eldercare services. However, this is not accessible to those who cannot afford these services and hence can perpetuate class disparities.

Vulnerabilities like loneliness and anxieties in later life stemming from lack of care and support feed into projects being developed by corporate companies. The market has also reinvented filial piety and intergenerational solidarity.

For example, luxurious residential housing projects are being imagined around ideas of intergenerational community that claim to support the care needs of residents, such as through full-time medical support, and address loneliness experienced by older people through intergenerational activities.

Tech companies offer online communities that allow interaction, including dating opportunities, but also presume some understanding of technology by older people.

Companion services

Some eldercare companies also employ younger people to provide companionship services to older clients.

These companions function as proxies for people's children and undertake different types of work such as paying electricity bills, providing reminders for medicines and taking them out on walks or to the doctor. Care companions build an emotional connection with the people they look after and many clients look forward to their visits and become dependent on them.

Regular visits to check on the wellbeing of older people even without forming strong bonds can also be a useful measure to tackle loneliness.

This was found to be the outcome of the Pronam initiative. Pronam is a public-private partnership between the Kolkata Police and The Bengal, a private non-profit organisation of eminent personalities from West Bengal, catering to the needs of older people who do not live with their relatives.

Pronam members get together several times throughout the year to celebrate most festivals and occasions such as International Women's Day and Rabindra Jayanti. They organise health camps, provide ambulance services, make frequent visits to older people's homes and also run a 24-hour helpline.

A Pronam employee spoke of how she spent time on the phone chatting with an older person with dementia in the wee hours of the night to help them fall asleep. This not only highlights the need for companionship in later life but also shows the potential that exists outside the family system to cultivate a compassionate society.

Age-friendly environments

Home visits were mostly made by young girls in their early 20s. They follow a standard procedure at every visit which includes enquiring about the wellbeing of the older people and informing them about upcoming events. While they do not form close bonds, several older people felt comforted knowing that the police were providing them support and they could rely on Pronam staff for different things.

Loneliness can be dehumanising when it is stigmatised or trivialised. Local communities and the state have a big role to play in co-creating age-friendly environments. Neighbourhood clubs and resident welfare associations can partner with state governments on projects but resources need to be allocated to ensure they remain sustainable.

Relying wholly on market-based services to combat the loneliness experienced by older people is limiting as it raises questions of affordability and may disempower individuals by transferring power to corporations to dictate the terms of care. It can also produce an exploited class of care workers.

More research is needed to explain the causes of loneliness faced by older people due to the complex intersections of their age with caste, sexuality, class and social mobility.

It's about time experiences of loneliness were discussed publicly and not restricted to sharing with close confidants only.

Originally published under Creative Commons by 360info™.

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