Rachel Cartland decries the loneliness that besets many elderly couples - should one succumb to a chronic illness, it is little surprise that the other sometimes snaps

Loneliness is one of the modern plagues; not only does it gnaw away at the soul but it also makes physical illnesses worse than they would otherwise be. It can attack any age group but the elderly are particularly vulnerable as social circles shrink when regular employment is left behind. We like to put faith in the bonds of the extended Chinese family and the importance accorded to filial piety but almost 20 years ago an academic study of the elderly found that "levels of loneliness in China are now comparable with, or higher than, those observed in Western Europe; therefore, this is not just a problem seen in developed countries." The causes may include changing social attitudes, individual cases of estrangement within families and the busy lives that the modern cost of living necessitates. Whatever the reasons, the results can be dehumanizing, even tragic. The recent two tragedies within months involving two elderly couples, each with a chronically ill partner put to death to end her suffering, should serve as a wake-up call for decisive action.

It's easy to brush aside problems that do not immediately affect ourselves but from time to time we should all undertake the mental exercise of "walking in someone else's shoes" in order to learn the skills of compassion and empathy. Imagine then what it must be like to be one half of an elderly couple living in a bleak Hong Kong housing estate or in a run-down urban district where, either way, the two of you are all in all to each other, with no one else around to provide company, support or guidance. Imagine the underpinning of this fragile human ecosystem being torn away when one partner falls sick, and not just with an ailment from which recovery is possible but one which results in disability - physical or mental or both - that will last and worsen until life itself ends. Imagine the hellish daily round as one frail older person struggles to meet the care needs of the other and is no longer even able to enjoy the relief of pleasant conversation or shared memories. Imagine the struggle to take an incapacitated or easily disturbed partner to appointments in our crowded public medical facilities where the hustle and bustle is such that it is impossible to strike up a rapport with any of the harried staff, to raise the concerns that trouble the carer or to receive useful supplementary advice. The sad fact is that this is the reality of life for many of our fellow senior citizens today. When one half of such partnerships snaps under the strain and a violent tragedy occurs we are shocked but all too often the reaction is transitory rather than proving a genuine spur to constructive solutions.

The sad aspect of this situation is that there are plentiful strategies that can help in such situations but we just don't see enough of them in our wealthy but sometimes callous city. The Hong Kong Housing Society has done wonderful work in demonstrating how the latest technology can make apartments almost like a therapy in themselves, with adaptations to make senior living as easy as possible. Hong Kong has never been afraid to look overseas to learn from best practice and places like Australia can show us examples of great approaches to dementia care. In fact, there are already some existing examples here of good facilities, both in day care and also residential facilities for the elderly. However, our supply of these facilities is far too small and too often what is available is accessed by those whose families understand how to navigate our bureaucratic system, rather than those with less education and sophistication whose needs may in fact be greater. What is even more galling is that, unlike many developed countries, we cannot blame a poor economy or straitened public finances for our lack of action. It is well known that our revenues are in a healthy state and surpluses have built up over the years. This is surely one of the best areas in which cash could be spent. It may be controversial to say so but personally I would prefer money to go to such services rather than to provision of a universal pension. More cash in the bank account is of little use to an elderly person whose immediate need is for specialist care in a purpose-built facility.

It seems that what is lacking is the will to take action to avoid the human misery that bedevils the lives of so many of our elderly. Very recently, however, in the light of a case in which an elderly man is alleged to have killed his chronically ill wife, the chairman of the Elderly Commission has said that he is determined to cut waiting times for elderly services by whatever means necessary. Let us hope our government and society shares this determination to get things done. Meanwhile, we all can help by being better neighbors and family members.

(HK Edition 06/09/2017 page6)