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Of Shrunken Leaves and Bowed Down Trees: Loneliness and Depression in Old Age

Submitted by on October 26, 2016 – 12:06 AM 2 Comments

71fbd30d02f956c62f89363ab65ef743“Do you know that a simple phone call will make them happy? A simple hello can make them smile? You cannot do a kindness too soon, for you never know how soon it will be too late.”



The above quotation captures a very profound message, for all those of us struggling with strained parental relationships, losing our loved ones to a mutual silence. It’s also a simple message: reach out to those in the evening of their lives; you never know how much time they have left.


Old age may be called a double-edged sword: for all the experience and wisdom one gains, often there also sets in a sense of insecurity and despair, particularly in those older adults whose family members have scattered few and far.


Naturally the population of the elderly continues to grow. By 2050, more than 1 in 5 people will be 60 years or older. Pakistan is one of the most populous countries globally. According to the 2006 WHO data sheet, Pakistan had a population of 166 million in the reported year. About 4% of the total population consists of elderly people in Pakistan. Moreover, according to a cross-sectional study by Holy Family Hospital Rawalpindi (HFH), about 28.71 % elderly were depressed and lonely.


Many personal problems may be associated with aging: family changes, retirement, changes in income, widowhood and awareness of one’s own mortality, declining reserves of physical strength, and a shrinking social world.


Family is why we come unto in this world. For many of us, it is the primary source of affection and support. With time, family dynamics and structure evolve. The parents, our caretakers by default, eventually become the ones needing care. For those not having a strong support system, retirement from jobs can take its toll on their social security, and sense of self worth.   Widowhood is another factor which requires tough adjustment. Women are most affected, as they tend to live longer than men.


Loss of a life partner plays a major role in bringing about depression and loneliness in the elderly. The demise of a spouse or friend forces one to confront the prospect of one’s own mortality. In addition, one of the most significant factors that lead to loss of independence is declining physical health which eventually causes changes in appearance and slow responses.


Adaptation to these changes and adjustments involves fulfillment of psychosocial needs of older individuals. For that, close relationships with family members are invaluable. Simply being surrounded by their loved ones can bring the sunshine back into the evening of their lives.


Saint Vincent, a home for aged people which was established in 1960 by Cardinal Joseph (late) is one of the oldest old age homes in Karachi. When we, a group of geriatrics students, visited the place, we received a warm welcome from the residents. We talked, exchanged stories, built a connection with our moist-eyed hosts. As a lady named Maryville told us, home is not a place, it is a feeling. She had truly found a home there. And as we saw what wonders the time, attention and compassion of strangers can do, I believed her. I believed that you can find family anywhere.


“Wrinkles should not indicate growing age, it should merely indicate where the smiles have been.”

–Mark Twain


Abrar Hussain Azad, Sadaf Hasan, & Iram BiBi. 2015. “Prevalence and Predictors of Depression amongst Elderly .” Journal of Islamabad Medical & Dental College, 4(2), 77-80.

Munir, Sarah. 2013. For the elderly, a sanctuary lies on the edge of Drigh Road . Blog, Karachi: The Express Tribune.

Qidwai, Waris. 2009. “Ageing Population: Status, Challenges and Opportunities for Health Care Providers in Pakistan .” Journal of the College of Physicians and Surgeons Pakistan 399-400



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  • Moiz Mehmood Galmani

    A good point to raise. Well done.

  • Tania Stanwood

    Loneliness can be debilitating. It can lead us into a life of isolation. Four Seasons of Loneliness a book by J.W. Freiberg. He writes of 4 different people who deal with both. It’s interesting how far this goes with people at times.