Depression in elderly ‘one of greatest health challenges’

It has warned the Scottish Government that around 120,000 older Scots could be living with undiagnosed mental health conditions resulting from loneliness and isolation.

An estimated 60,000 over-65s will spend Christmas Day alone, an increase of 50 per cent on two years ago, while 80,000 say they feel especially lonely over the festive period.

One in four people in the age group experience depression when they feel lonely, with 16 per cent saying it leads to anxiety, according to a MHFS survey conducted in conjunction with Age Scotland.

Almost one-quarter don’t want to bother family or friends, 12 per cent wouldn’t talk to their GP about it, and one-fifth believe social media has replaced the face-to-face contact the vast majority cite as a major factor in relieving their depression.

Lee Knifton, head of MHFS, said: “Loneliness is one of the greatest public health challenges of our time. Indeed it’s as harmful as smoking 15 cigarettes a day.”

He added: “The mental health needs of older people need to be taken seriously and not just bundled as ‘older people’s problems’ as they too often are. It’s disappointing among the 40 actions of the new mental health strategy not one of them is specific to older people.”

Anne Simpson, 67, who lives in Musselburgh, East Lothian, has mostly lived alone since her marriage ended shortly after her family moved from Northern Ireland in the late 1980s.

Since then she has suffered from agoraphobia and has periods where she won’t go out for months.

“It’s hard to make friends when you move somewhere new,” she said.

“I have become isolated, but I have come to terms with fact depression is something that I have to live with.

“I have nice home and I am happy in it, but I don’t have many visitors as my daughter lives in Monifieth.

“I used to live in Edinburgh and started using a telephone service called PhoneLink, run by Caring In Craigmillar, which has been a blessing.

“There is a girl who has been there since the start who is like a friend, so it’s nice to know there is someone out there if you are a bit down.

“I am surprised they don’t run it in other communities but they are trying to get funding to roll it out more widely.”

Brian Sloan, chief executive of Age Scotland, said: “It’s heart breaking to think of so many older people suffering in silence, unwilling to reach out to family or friends for fear of being a burden.

“There’s a widespread belief people should simply get on with it and cope by themselves, suggesting serious mental health problems are going undiagnosed.

“We need to see action on a national scale to tackle the epidemic of loneliness and isolation.”

The charities have launched a 12-point plan for patients leaving hospital, including a “welcome home box” with useful advice, depression screening, training for nurses, mapping to identify communities with more older people, pairing schools with elderly accommodation, and more community services like day centres, befriending services, peer support and “Men’s Sheds”.

Professor Vanessa Burholt, of the Centre for Innovative Ageing, called for people to be more tolerant of older people with dementia who may struggle to remember their PIN numbers in shops or at ATMs, saying people can be “quite impatient”.

Meanwhile, a leading nurse has said “simple acts of companionship” could make the difference between life or death for lonely older people during the cold snap.

Professor Jane Cummings, chief nursing officer for England, said: “For vulnerable groups, social isolation combined with the health dangers of colder weather, is a lethal combination. We can all take steps to alleviate loneliness by looking out for family, friends and neighbours.”

Meeting for activity such as gardening helps but loneliness is a killer

By Professor Woody Caan, Editor, Journal of Public Mental Health

THERE are two dimensions to loneliness.

There is the objective sense of social isolation where people have few social contacts, and as we get older that becomes more common. Then there is subjective sense of feeling alone, abandoned and neglected.

Loneliness is a killer, it raises your chances of dying as an old person. People who are isolated are more likely to die in any given year and they are also more susceptible to two types of ill health: cardiovascular disease and depression, both of which are big problems in Scotland.

Isolation tends to get worse with age. We live in a society where older people are very much left to their own resources.

The Mental Health Foundation is concerned about what happens to older people when they leave hospital, and we should have a more active system for looking after these people. I did some work on people with an average age of 82 leaving a hospital in Cambridge. If they had one faceto-face contact with a friend or relative once a week, which was the threshold, they were still alive around six months after returning home.

Of the people who were sent home with no friend or family contact, roughly half were dead within six months.

They were a similar age with similar health problems.

Professionals were going into all of their homes and making sure they had food, with a very low level of contact that was about the same across the two groups.

Social care doesn’t necessarily get the chance to get to know the people, and that contact wasn’t enough to keep the isolated group alive.

So if you live to your 80s it’s important to maintain regular face-to-face contact with a relative or a friend.

I’m a big believer in mutual aid. There was a study done in Carlisle which found when older people came together to do something such as gardening, dancing or singing, this counteracts loneliness and gives a more positive sense of wellbeing to the person’s whole life. They look forward all week to seeing their new friends and doing something together.

Gardening had the biggest effect, because they were doing something active.

If older people have the opportunity to get together they may find the remedy to many of their own problems, but they may need a safe place to meet and the right transport.

There is another approach by a professor at Harvard who found a difference between generations. Americans in their 90s have such a sense of public spirit, turn out to vote, volunteer and get to know their neighbours, because they went through the Second World War and they know how to pull together with strangers.

People in their 60s, are on average more selfish and may do badly in old age because we haven’t built up skills with getting on with strangers.

I have mixed views on the impact on social media. I published a study recently of someone with 500 Facebook friends who described their life as lonely.

It fulfils a function, but it’s a poor substitute for friendship and belonging at all ages.