Old age and solitude are creating a human problem for our health system. This is manifested in the incidence of social cases in Mater Dei, our general hospital. It is much deeper than that.
The lack of beds relative to demand in St Luke's Hospital used to be attributed in part to the number of patients who did not really require medical treatment, only care and attention. It was planned that Mater Dei Hospital would be different. Social cases would not be allowed. That was important because the new hospital, while boasting state-of-the-art facilities, is a number of beds short of the old one.
Yet, still not far down the road in Mater Dei's existence, there are already some 80 social cases embedded in it. This newspaper highlighted one such case (February 6). A senior citizen who had led an independent albeit solitary existence suffered a fracture which keeps him from walking. He needs assistance but cannot get it at home. For one reason or another relatives are not able to give it adequately.
Ironically, this is symptomatic of a not-so-serious situation. At least this person had been independent before his fracture. Hundreds, if not thousands more are barely that. Old age is in many regards a blessing, the time to enjoy serenity after a long and demanding life. It can be anything but that.
Old age brings loss. Partners who lived a lifetime together inevitably find themselves alone. Their deep grief, their tremendous disruption of a life used to sharing is not infrequently accompanied by solitude.
Offspring have married or otherwise left. The surviving partner has to fend for himself/herself. Even where there are caring children who make it a point to visit, or invite, to help out as much as they can, most of the time passed in one's house and especially the night is marked by solitude. Alone does necessarily mean loneliness. Still, it is generally the case that in such circumstances loneliness reigns.
It is worse when some hospital patients cannot be sent home after being cured and rehabilitated. In most such cases they cannot look after themselves. And their children, even when they care deeply - as most do - may not be in a position to help out. Nowadays it is the case that many married couples are both in employment, apart from having to look after their own household.
It is not that they reject the Maltese concept of the extended family. Very often they do not have enough time to practise it. This social problem will worsen over the years. There will increasingly be proportionally more senior citizens than there are now. And more couples will be both in employment. It is a problem that requires more attention than has been given so far.
That is not to say that nothing has been done. The Church blazed the way with old people's homes. The state took up the challenge many years ago and governments across the political spectrum did their best. Today the administration is experimenting with public private partnerships, after a period helping qualifying individuals to pay their fees in private retirement homes. The private sector has been very active, and is building more homes.
Private homes offer good service, for a charge which is beyond the reach of most people. Some families pool resources to fund their surviving (or sometimes both) parents in private homes.
All of that, admirable though it might be, is not enough. The private sector will continue to respond to the demand. It is the state which has to rethink its role. It should not encourage unnecessary dependency. Yet it cannot ignore the terrible effect of solitude in the final years, even among those who can lead an independent life of sorts.
Fresh thinking and more resources are required. Not simply to cater for those who cannot make do alone. But to make the final years easier to bear through living in models where senior citizens can still feel part of a community. Where dignity and mutual support can counter the terrible effects of solitude.