ELDERLY WORRIES

Rameshbhai, 64 years old, a retired clerk from the State Bank of India is sitting in the living room of his flat worrying about how he would manage the house next month. He had failed to anticipate the rising costs of living when he took voluntary retirement at the age of 51 years. He had 9 years of service left but felt that he would be able to invest the retirement package for a better return. The stock market debacles, inflation, the marriage of his three daughters and the declining returns of his investments have now brought him to a state where he has to worry about his two square meals a day. The financial worries are just the tip of the glacier for Rameshbhai. His wife Vanitaben and he also face loneliness the whole day. The demands of the cleanliness of the house are not as much as they have stopped caring as much for it. There are hardly any visitors except the youngest daughter who is married in the same city, while the other two are in different cities and only visit twice in a year. Vanitaben’s flailing health does not allow them to socialize as much also. Often both of them pray for death as an end to this misery.

Rameshbhai and Vanitaben are going through the crisis of their last epoch of life. The successful resolution of this involves a process of life review and achieving a sense of peace and wisdom through coming to terms with how their lives were lived. A successful resolution is characterized by the sense of having lived the life well while a less successful solution would be characterized by feeling that life was too short, that the choices were not wise and a bitterness that there will never be a chance to live life over. There would be no substitutions of the people who were present in this life. There is acceptance of the responsibility and tolerance of the proximity of death and the goal is to achieve a detached yet active concern with life. When the attempt to attain integrity has failed, there may be a deep disgust with the world and contempt for the people and society. This disgust masks a fear of death and sense of despair that time is too short to attempt another life and alternative roads. Rameshbhai and Vanitaben are facing the stresses of aging. There is an empty nest as the daughters have left for their own journeys in life. There is loss of job, physical loss and changes in body image and the loss of financial resources, social status and much of the social network. The loss of contemporaries through death and illnesses brings not only psychological deprivation but also a void that usually remains unfilled. Forming new friendships is difficult in this age. Physical limitations and loss of friends are often frequently associated with restricted mobility, which leads to further social isolation and increased difficulty in pursuing the tasks of daily living. While strong social support is effective in buffering the effects of stress, the perception of loss of support results in increased vulnerability.

What should Rameshbhai and Vanitaben do?

There has to be an increased sense of inner unity with an increase of good judgment and an increase in the capacity to do well according to their own standards. The goal is to establish a least restrictive environment. You have to maintain your self-esteem and joy of living in the face of deteriorating health. You have to look back at your life experiences and become better at managing stressful life events having learned strategies that are more effective. You have to initiate a process of “selective optimization”- an accommodative process of rescaling goals to match your limitations and the demands of the environment and investing the fewer resources available in personally salient activities that maintain self-esteem. You have to increase your social network, as this is the most protective network in your life. The disengagement from the social contacts and the development of the more inward focus has resulted in a feeling of social isolation. You have to let go of the acquaintances and peripheral individuals and save your energies for contacts with close friends and family members. This would give a higher level of satisfaction. You should also consider moving to an old age home. Look at various places, consider the pros and cons of this move and take the decision. You may feel that this is your best choice. You will find people of your own stage of life and this may help you stem the downward scaling of your self-esteem. You may feel that there is a loss of privacy and that you have to adjust to different kinds of people. Initially it might feel unnatural to be with people whom you have never met and to spend your whole day with them, be dependent on the staff for your daily care, but it does take away the responsibility of maintaining the home from your shoulders. Your growing limitations and deteriorating health would be cared for. Another issue to consider is your physical and mental health. Both of you should have regular physical check-ups to ensure that you do not get surprised by any physical problems. You should also come to terms with the two main psychosocial crises – retirement and impending spousal loss. Both of these rank very high in the life stressors scale and lead to loneliness and adjustment problems. Perhaps you can start working these issues with each other and review your life together and the moments that you have spent together so that there are no feelings of abandonment later. The last issue is about financial security. Go in for low but safe returns instead of high-return risky schemes. Your daughters could also assist you in maintaining your standard of living as before. Perceived financial security acts as a very supportive factor. Life may not have much to offer now, but it is still worth living.