Sep 12th 2021

Loneliness, loss and regret: what getting old really feels like – new study

by Sam Carr and Chao Fang

 

Sam Carr Senior Lecturer in Education with Psychology, University of Bath.  

Chao Fang Research Associate, University of Bath

 

Paula* had not been living in her retirement apartment for very long when I arrived for our interview. She welcomed me into a modern, comfortable home. We sat in the living room, taking in the impressive view from her balcony and our conversation unfolded.

Paula, 72, told me how four years ago she’d lost her husband. She had been his carer for over ten years, as he slowly declined from a degenerative condition.

She was his nurse, driver, carer, cook and “bottle-washer”. Paula said she got used to people always asking after her husband and forgetting about her. She told me: “You are almost invisible … you kind of go in the shadows as the carer.”

While she had obviously been finding life challenging, it was also abundantly clear that she loved her husband dearly and had struggled profoundly to cope with his death. I asked Paula how long it took for her to find her bearings, and she replied:

Nearly four years. And I suddenly woke up one day and thought, you idiot, you are letting your life fade away, you have got to do something.

There were photographs of Paula’s late husband on the wall behind her. I noticed a picture of him before his illness took hold. They seemed to be at some sort of party, or wedding, holding glasses of champagne. He had his arm around her. They looked happy. There was a picture of her husband in a wheelchair too. In this picture they both looked older. But still happy.


 
 

This story is part of Conversation Insights
The Insights team generates long-form journalism and is working with academics from different backgrounds who have been engaged in projects to tackle societal and scientific challenges.


Losing her husband had left Paula with an irreplaceable void in her life that she was still working out how to fill. In our interview, I glimpsed the extent of the deep, unavoidable sense of loneliness that losing a spouse can create for the bereaved partner – a painful theme our team would revisit many times in our interviews with older people.

The Loneliness Project

The pandemic brought the longstanding issue of loneliness and isolation in the lives of older people back into the public consciousness. When COVID-19 hit, we had only just completed the 80 in-depth interviews which formed the dataset for what we called The Loneliness Project – a large-scale, in-depth exploration of how older people experience loneliness and what it means for them.

I (Sam) am a psychologist with a particular interest in exploring human relationships across the lifespan. Chao, meanwhile, is a research associate based in the Centre for Death and Society at the University of Bath. His research focuses on bereavement experiences and exploring emotional loneliness of people living in retirement communities. For the last two years, we’ve been working on the Loneliness Project with a small research team.

Above all, the project sought to listen to older people’s experiences. We were privileged to hear many people, like Paula, talk to us about their lives, and how growing old and ageing creates unique challenges in relation to loneliness and isolation.

The research – now published in Ageing and Society – generated over 130 hours of conversations and we started to make sense of what our participants told us with an animated film.

We found that ageing brings about a series of inevitable losses that deeply challenge people’s sense of connection to the world around them. Loneliness can often be oversimplified or reduced to how many friends a person has or how often they see their loved ones.

But a particular focus for us was to better understand what underpins feelings of loneliness in older people on a deeper level. Researchers have used the term “existential loneliness” to describe this deeper sense of feeling “separated from the world” – as though there is an insurmountable gap between oneself and the rest of society. Our objective was to listen carefully to how people experienced and responded to this.

The older people in our study helped us to better understand how they felt growing old had affected their sense of connecting to the world – and there were some core themes.

Loss

For many, ageing brought about an inevitable accumulation of losses. Put simply, some of the people we spoke to had lost things that had previously been a major part of feeling connected to something bigger than themselves.

Loss of a spouse or long-term partner (over half of our sample had lost their long-term spouse) was particularly palpable and underlined the deep-rooted sense of loneliness associated with losing someone irreplaceable. Reflecting on the loss of her husband, Paula said:

When he was gone, I didn’t know where I fitted anymore. I didn’t know who I was anymore because I wasn’t [upset] … You just existed. Went shopping, when you needed food. I didn’t want to see people. I didn’t go anywhere.

There was evidence of how painful this irreplaceable void was for people. Douglas, 86, lost his wife five years before speaking to us. He tried his best to articulate the sense of hopelessness, despair – and sheer loss of meaning – it had created for him. He said it hadn’t stopped being difficult, despite the passing of time, adding: “They say it gets better. It never gets better.”

Douglas explained how he never stops thinking about his wife. “It’s hard for people to understand a lot of the time,” he said.

People also talked about how learning to live in the world again felt alien, terrifying and, frequently, impossible. For Amy, 76, relearning how to do the “little things in life” was a lonely and challenging experience.

It took me a long time … just to go down for breakfast on my own … I’d have to bring a paper or a book to sit with. And never ever, I would never, ever go and have a cup of coffee on my own in a coffee shop. So, I literally ‘learnt’ to do that. And that was a biggy, just going to a coffee shop and having a coffee.

Amy said going into busy places on her own was hard because she thought everyone was looking at her. “I would always do it with Tony, my husband, whatever … But to do it on your own, a biggy. It’s stupid, I know, but anyway, hey ho.”

For Peter, 83, the loss of his wife had created a painful void around feelings of touch and physical intimacy that had always made him feel less alone.

I suppose all my life sex has been lovemaking. I mean, we are really getting personal now, but when my wife died, I missed that so, so much. It’s much more enjoyable in old age, you know, because, I mean, if I said it to you you’d think oh good grief, that horrible old body and all the spots and bumps and cuts and wounds and … takes off a wooden leg and … takes out the eye. Sorry [laughs] … But it’s not anything like that because you know you are in the same boat … you get round it, some peculiar way, you accept it all.

Another man, Philip, 73, also described the pain in this loss of intimacy. He said:

At my wife’s funeral, I said the one thing I will miss most is a kiss goodnight. And blow me, afterwards, one of our friends came round, and she said, ‘well, we can send each other kisses if you like but by text every night’, and would you believe, we still are, we still do.

With the very old people we talked with, there was a sense that loss of close and meaningful connections was cumulative. Alice, 93, had lost her first husband, her subsequent partner, her siblings, her friends and, most recently, her only son. With a sense of sadness and weariness, she explained:

You know, underneath it all I wouldn’t mind leaving this world. Everyone has died and I think I’m lonely.

Researchers at Malmö University, Sweden, have described an acute sense of existential loneliness in very old age, that is partly a reflection of an accumulated loss of close connections.

The study found that the result can be understood as if the older person “is in a process of letting go of life. This process involves the body, in that the older person is increasingly limited in his or her physical abilities. The older person’s long term relationships are gradually lost and finally the process results in the older person increasingly withdrawing into him or herself and turning off the outside world”.

‘A stiff upper lip’

Studies of loneliness have highlighted how an inability to communicate can bring about a feeling that “the soul is incarcerated in an insufferable prison”.

This was reflected in our study too. Many of our participants said they had trouble communicating because they simply didn’t have the tools required to convey such complicated emotions and deeper feelings. This led us to contemplate why some older people might not have developed such essential emotional tools.

Research has suggested that older people born in the first half of the 20th century were unwittingly indoctrinated into the concept of the “stiff upper lip”. Through most of their lives – including wartime, peacetime employment, conscription to military service, and family life – there was a requirement to maintain high levels of cognitive control and low levels of emotional expression.

Some of our participants seemed to be implicitly aware of this phenomenon and how it had shaped their generation. Polly, 73, explained it succinctly for us:

If you don’t think about it, if you don’t give it words, then you don’t have to feel the pain … How long is it since men cried in public? Never cry. Big boys don’t cry. That is certainly what was said when I was growing up. Different generation.

People said that wartime childhoods had “hardened them”, led to them suppressing deeper feelings and feeling the need to maintain a sense of composure and control.

For example, Margaret, 86, was a “latchkey child” during the war. Her parents went out at 7am and she had to get up and make her own breakfast at the age of nine. She then had to catch a tram and a bus to get to school and when she got back at night her parents would still be out, working late.

So I used to light the fire, get the dinner ready. But when you are a child, you don’t think about it, you just do it. I mean, no way did I count myself as a neglected child, it was just the way it was in the war, you just had to do it …“

Margaret said it was "just an attitude”. She went to 11 schools, travelled around the country because of the war and had nothing really to do with other people. She added: “I think it makes you a little bit hard … I think sometimes I am a hard person because of it.”

As interviewers who have grown up in a culture that is perhaps more permissive of emotional expression than had been the case for many of the people we interviewed, it was sometimes difficult for us to witness how deep-rooted people’s inability to express their suffering could be.

Douglas was clearly struggling deeply after the death of his wife. But he lacked the tools and relationships to help him work through it. He said he had nobody who was close to him who he could confide in. “People never confided in my family. It was different growing up then,” he added.

Heavy burdens

The burden of loneliness for older people is intimately connected to what they are alone with. As we reach the end of our lives, we frequently carry heavy burdens that have accumulated along the way, such as feelings of regret, betrayal and rejection. And the wounds from past relationships can haunt people all their lives.

Gerontologist professor, Malcolm Johnson, has used the term “biographical pain” to describe psychological and spiritual suffering in the old and frail that involves profoundly painful recollection and reliving of experienced wrongs, self-promises and regretted actions.

He has written that: “Living to be old is still considered to be a great benefit. But dying slowly and painfully, with too much time to reflect and with little or no prospect of redressing harms, deficits, deceits, and emotional pain, has few redeeming features.”

Many of those we spoke to told us how hard it was to be left alone with unresolved pain. For example Georgina, 83, said she learned in early childhood that she was “a bad person … stupid, ugly”. She remembered her brother, as an older man, dying in hospital, “connected to all these machines”. However, she could neither forgive nor forget the abuse he had inflicted upon her during childhood. “My faith told me to forgive him but, ultimately, he scratched me in my soul as a kid,” she added.

People carried memories and wounds from the past that they wanted to talk about, to make sense of and to share. Susan, 83, and Bob, 76, talked about painful and difficult memories from their early family lives.

Susan spoke about how she had a nervous breakdown when her family “disowned” her after she fell pregnant at the age of 17. She said:

I come from this secret family. We all had to present as expected. If you didn’t, you were out, and that was the bottom line. I look back on my life and I wonder that I survived.

While Bob remembered a life of violence at the hands of his father. “I copped so many hidings from him. Then one night … my old man had a bad habit. He would get up and walk past you and smack you in the ribs. I sensed it coming, I was out of my chair in a flash, I caught him, crossed his hands over his wrists, and jammed my knuckle into his Adam’s Apple. That was family life,” he said.

Janet, 75, explained to us that she felt what was lacking from her life was a space where she could talk about, make sense of, and reflect on the biographical pain she had accumulated.

This is what I miss a lot, a private space to talk … All my life I’ve suffered … and some things I do find very hard … With everything that’s gone wrong, I would like to talk to somebody, no advice, I want to let off steam, make sense of it all, I suppose. But it doesn’t happen.

Your life mattered

Thinking about how older people can be supported must involve a fuller understanding of what loneliness really means for them. Some of our own efforts have focused on ways of helping older people retain a sense that they are valued in the world and that they matter.

For example, the Extraordinary Lives Project sought to listen to older people’s recollections, wisdom and reflections. Sharing these recollections with others, including younger generations, has been mutually beneficial and helped older people to feel that the lives they have lived counted for something.

There is also a need to consider how to support older people in relation to coping with some of the inevitable losses ageing creates that threaten their sense of connection to the world. Organisations seeking to connect people going through these struggles can play a role in developing a sense of “coping together”.

Such organisations already exist in relation to support for widows, provision of spaces like death cafes to talk about death and dying and improving access to and awareness of psychological and emotional therapies for older people.

So support is out there but it is often fragmented and difficult to find. A core challenge for the future is to create living environments in which these mechanisms of support are embedded and integrated into older people’s communities.

Listening to all these experiences helped us to appreciate that loneliness in later life runs deep – much deeper than we might think. We learned that growing old and approaching the end of life create unique sets of circumstances such as loss, physical deterioration and biographical pain and regret that can give rise to a unique sense of disconnection from the world.

Yet people can and did find their way through the significant challenges and disruptions that ageing had posed them. Before I (Sam) left her apartment, Paula made me a cup of tea and a ham sandwich and told me:

It’s funny, you know, I had a building which I had inherited, and I had some money in the bank but who was I, what was I anymore? That was my main challenge. But now, four years later, I’ve moved to a retirement village and I’m noticing there’s just a little thrill associated with being able to do exactly as I please – and if people say, ‘Oh but you should do this,’ I go, ‘No, I shouldn’t!’

*All names in this article have been changed to protect the anonymity of those involved.


 

For you: more from our Insights series:

To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. Subscribe to our newsletter.

Sam Carr, Senior Lecturer in Education with Psychology, University of Bath and Chao Fang, Research Associate, University of Bath

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Browse articles by author

More Essays

Oct 10th 2021
EXTRACT: "Born in Zanzibar in 1948, Gurnah came to Britain in the 1960s as a refugee. Being of Arab origin, he was forced to flee his birthplace during the revolution of 1964 and only returned in 1984 in time to visit his dying father. Until his retirement, he was a full-time professor of English and postcolonial literatures at the University of Kent in Canterbury."
Oct 7th 2021
EXTRACT: "As the 25th James Bond film No Time to Die hits the cinemas, we are once again reminded of the way that disability is depicted negatively in Hollywood films. The new James Bond film features three villains, all of who have facial disfigurements (Blofeld, Safin and Primo). If you take a closer look at James Bond villains throughout history, the majority have facial disfigurements or physical impairments. This is in sharp contrast to the other characters, including James Bond, who are able-bodied and presented with no physical bodily differences. Indeed, many films still rely on outdated disability tropes, including Star Wars and various Disney classics. Rather than simply being part of a character’s identity, the physical difference is exploited and exaggerated to become a plot point and visual metaphor for villains" ----- "The British Film Institute (BFI) was the first organisation to sign up and has committed to stop funding films that feature negative representations depicted through scars or facial differences – a step in the right direction."
Oct 5th 2021
EXTRACT: "The trillions of microbes inside of our gut play many very important roles in our body. Not only does this “microbiome” regulate our metabolism and help us absorb nutrients from food into the body, it can also influence whether we are lean or obese."
Sep 16th 2021
EXTRACTS: "Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurised chamber. In the chamber, the air pressure is increased two to three times higher than normal air pressure. It is commonly used to treat decompression sickness (a condition scuba divers can suffer from), carbon monoxide poisoning,......" ---- "Blood flow to the brain is reduced in people with Alzheimer’s. This study showed increased blood flow to the brain in the mice receiving oxygen therapy, which helps with the clearance of plaques from the brain, and reduces inflammation – a hallmark of Alzheimer’s." ----- "The researchers then used these findings to assess the effectiveness of oxygen therapy in six people over the age of 65 with cognitive decline. They found that 60 sessions of oxygen therapy, over 90 days, increased blood flow in certain areas of the brain and significantly improved the patients’ cognitive abilities – improved memory, attention and information processing speed."
Sep 14th 2021
EXTRACT: "Hollywood for years called on Charles Boyer to typify one French look –  bedroom eyes, sly maneuverings, the dismissive look. A face of another type, the massive mug and narrow eyes of Charles de Gaulle, provides the same disdain of the foreigner but also a superiority based on his belief in his own destiny."
Sep 12th 2021
EXTRACT: "The burden of loneliness for older people is intimately connected to what they are alone with. As we reach the end of our lives, we frequently carry heavy burdens that have accumulated along the way, such as feelings of regret, betrayal and rejection. And the wounds from past relationships can haunt people all their lives."
Sep 5th 2021
EXTRACT: "Gardens help restore the ability to concentrate on demanding tasks, providing the perfect space for a break when working from home in a pandemic. Natural things – such as trees, plants and water – are particularly easy on the eye and demand little mental effort to look at. Simply sitting in a garden is therefore relaxing and beneficial to mental wellbeing."
Aug 17th 2021
EXTRACT: "Whether or not a person achieves remission, reducing blood sugar levels is important in managing the negative effects of type 2 diabetes and reducing risk of complications. But when it comes to choosing a diet, the most important thing is to pick one that suits you – one that you’re likely to stick to long term."
Aug 10th 2021
EXTRACT: "In our latest study, we show that by taking the microbiome from young mice and transplanting them into old mice, many of the effects of ageing on learning and memory and immune impairments can be reversed. Using a maze, we showed that this faecal microbiota transplant from young to old mice led to the old mice finding a hidden platform faster."
Aug 3rd 2021
EXTRACT: "Fukuyama argued that political struggle causes history. This struggle tries to solve the problem of thymos – an ancient Greek term referring to our desire to have our worth recognised. This desire can involve wanting to be recognised as equal to others. But it can also involve wanting to be recognised as superior to others. A stable political system needs to accommodate both desires." .... "Counter-dominant spite can weaken liberal democracies. During the 2016 Brexit referendum, some people in the UK voted Leave to spite elites, knowing this could damage the country’s economy. Similarly, during the 2016 US presidential election some voters supported Donald Trump to spite Hillary Clinton, knowing his election could harm the US. "
Jul 31st 2021
EXTRACT: "If we want to live in a world that is good for pollinators, as well as the rest of us, big changes are needed in our environment, and our food system. This is why many beekeepers change their diet and their shopping, eating more locally grown vegetables that aren’t treated with pesticides. ...... Being willing to buy fruit and vegetables that may have the occasional insect living in it is better for us and for nature. To live more harmoniously with the natural world, we need to relax about larvae in the lettuce and slugs in the spinach."
Jul 22nd 2021
EXTRACT: "You’d think our brush with mortality through the pandemic would have brought some of this home to us. You’d think it would give us pause for thought about what really matters to us: the kind of world we want for our children; the kind of society we want to live in. And for many people it has. In a survey carried out during lockdown in the UK, 85% of respondents found something in their changed conditions they felt worth keeping and fewer than 10% wanted a complete return to normal."
Jul 20th 2021
EXTRACT: "English artist Damien Hirst’s latest project, “The Currency”, is an artwork in two forms. Its physical form is 10,000 unique hand-painted A4 sheets covered in colourful dots. In the same way as paper money, each sheet includes a holographic image of Hirst, a signature, a microdot and – in place of a serial number – a small individual message. The second part of the artwork is that each of these hand-painted sheets has a corresponding NFT (non-fungible token). NFTs are digital certificates of ownership which exist on the secure online ledgers that are known as blockchains. ---- The way that “The Currency” works is that collectors will not be buying the physical artwork immediately. Instead, they will pay US$2,000 (£1,458) for the NFT and then have a year to decide whether they want the digital or the physical version. Once the collector selects one, the other will be destroyed. ---- So what is going on here, and what does it tell us about art and money?"
Jul 20th 2021
EXTRACT: "Ellison was an abstract expressionist painter, who, having come to New York City from West Texas in 1962, was as he said “unable to find traction” as a painter. At the same time, he began collecting ceramic objects and educating himself about this field of art as he went along. In 2009 he bestowed on the Metropolitan Museum of Art over 300 extraordinary examples of American ceramics, spanning the years 1876 through 1956. Since then, Ellison has gifted to the Museum over 600 works – including a significant collection of European art pottery in 2013, and most recently over 125 modern and contemporary clay vessels and objects – making the Museum one of the most significant repositories of Art Pottery in the world. ---- The current exhibition presents nearly 80 pieces drawn from Ellison’s latest donation, and it is a thoroughly captivating show; even where (or perhaps especially where) the works are outlandish, bizarre, sometimes almost monstrous, but nonetheless enthralling."
Jul 11th 2021
EXTRACT: "Over the course of England’s journey to the Euro 2020 final, one of the most fascinating plays has been happening just off the pitch. Whenever the TV camera cuts to the team’s manager Gareth Southgate, he is occasionally seen standing alone on the edge of the field, urging his team on. ---- But most of the time he is deep in conversation with his assistant Steve Holland. ---- A recent study of English football culture points to a shift away from what the authors term “Beckhamisation”, after the former England captain and Manchester United star player David Beckham – a popular and instantly recognisable symbol of that period of football history (though, it is not suggested the culture was his creation). ---- During the 1990s, the study claims, this “Beckhamisation” saw high octane management practices imported from the corporate world into football. ---- In recent years, this has been replaced by “Southgatism”, a leadership style which that study describes as “modest, self-deprecating, down to earth, diverse and progressive”. "
Jun 30th 2021
EXTRACT: "New York’s Museum of Modern Art is currently presenting an exhibition devoted to an in-depth review of Paul Cézanne’s drawings. If there is any criticism to be made of this extraordinary show, it is that it is frankly overwhelming: with roughly 280 pencil, ink and gouache drawings and watercolors (and even a handful of oil paintings), there is so much to take in that two or three visits to the exhibition may be required to do it justice."
Jun 25th 2021
EXTRACT: "Cognitive flexibility provides us with the ability to see that what we are doing is not leading to success and to make the appropriate changes to achieve it." .... "Flexible thinking is key to creativity – in other words, the ability to think of new ideas, make novel connections between ideas, and make new inventions." .... "The good news is that it seems you can train cognitive flexibility."
Jun 17th 2021
EXTRACT: "Confronting our complex history and ultimately embracing a more equitable, balanced, and humble culture may be a tall order in these fractious times. But that makes it even more imperative that we fully reckon with who we are and who we are capable of becoming."
Jun 11th 2021
EXTARCT: "A further health benefit of hiking is that it’s classed as “green exercise”. This refers to the added health benefit that doing physical activity in nature has on us. Research shows that not only can green exercise decrease blood pressure, it also benefits mental wellbeing by improving mood and reducing depression to a greater extent than exercising indoors can."
Jun 10th 2021
EXTRACT: "“The greatness of a nation and its moral progress,” Mahatma Gandhi said, “can be judged by the way its animals are treated.” If we apply that test to the world as a whole, how much moral progress have we made over the past two millennia? ...... That question is suggested by The Golden Ass, arguably the world’s earliest surviving novel, written around 170 CE, when Emperor Marcus Aurelius ruled the Roman Empire. Apuleius, the author, was an African philosopher and writer, born in what is now the Algerian city of M’Daourouch."