Elderly alone: when the care of gratitude is difficult or impossible, what shall we do?

Aggiornamento: 4 giu 2020

Donatella Bramanti, Full Professor of Sociology of Cultural and Communicative Processes, Faculty of Educational Sciences - Catholic University of the Sacred Heart, Member of the Board of the Centre for Studies and Research on the Family

Relational poverty, referred to a family, can be interpreted both as the lack of present and active relations in a specific family group, as the scarcity of the network of relations in which the family is included, and as a deficit of quality of the relations themselves, whether they are internal or external.

The intertwining of such conditions frequently stands at the origin of that solitude of the elderly.

Although nowadays in Italy life expectancy makes the co-existence of various generations inside one family possible and the Italian families have a strong tendency to allow elderly to stay at home as long as they can, this does not happen for many of them.

To understand closely the solitude and isolation in which the elderly can find themselves, it is useful to see the results of a research carried out by us (Rovati, Bramanti, 2018) on the users of an innovative service promoted by the Municipality of Milan from 2008, which was created with the explicit aim of contrasting the serious forms of isolation and solitude of families, especially of elderly.

The service, called Custodia Sociale (Social Care), promoted a new type of operator, the social keeper, with the task of being a sentinel of the discomfort and an activator of interventions in case of necessity.

In this text we share a short and emblematic story, to understand closely the relational poverty that can affect the elderly who live in the big urban areas of our country and the concrete support that a service of proximity can offer.

Giovanna, a lady who loves cats

Giovanna is an old woman; she is 81 and she lives alone. She used to manage a shop in the city centre before she started suffering from various pathologies: the most serious one is diabetes, which forced her to have her foot amputated. Furthermore, she suffered from a lung cancer, for which she also had to undergo an invasive surgery. Due to these serious illnesses and to loneliness, she suffered from depression, to such an extent that she contemplated suicide various times; she felt abandoned and isolated because of shame, once she went to live in social housing. Giovanna had a sister, who died, and a brother who also died recently, therefore she was left alone, except for some friends in the neighbourhood. Giovanna cannot walk, but she can drive the bike. Giovanna loves cats, she is a cat person, she owns some cats that keep her company. “She lives for these cats” - tells us her keeper - “she feeds them”, she even allows stray cats to enter her house.
She lives in a medium-sized flat, the walls are dirty, they have not been painted in a very long time, the furniture of the living room where the interview takes place is old, the bedroom is clean while there's more mess and dirt in the dining room: the lady's cats walk on the furniture and on the sofa; the window of the dining room has a hole that opens onto the small balcony, that overlooks the street, from where the stray cats can get in and out. Some cats have amputated limbs; the cat that goes on the table during the interview even lost one eye as a result of a hooligan stunt.

The first visit of the social keeper to the lady’s house was “kind of a shock”: on that occasion, she had been sent by the social worker to accompany her to the hospital for a quite delicate intervention to a foot. The social keeper did not know the way and the location of the ward where they had to go, while Giovanna was very expert and able to orient herself well in the hospital. That was the occasion on which the social keeper and Giovanna were able to establish a bond, precisely by starting both from a condition of deficit.

Giovanna is a person who loves to read books, but she is very lonely, therefore she is involved in “moments of socialisation at the Santa Lucia oratory, where people plays bingo, knits, eats cake and organises parties”. The social keeper takes care of accompanying her to the frequent health visits and collaborates to the periodic blood tests at home. The test is carried out by a professional nurse who leaves the vial with the blood sample at home, and the social keeper takes care of bringing it to the hospital and of carrying out the acceptance every time; the pharmacy collaborates as well to the process, and it receives via fax the results from the hospital.

Giovanna requested an aid for the rent, the social keeper carried out the aid request and they are now waiting for the response.

The woman is monitored by the social keeper every week, with a visit at home and then by phone, every Saturday.

Since Giovanna cannot go out when it is cold or too hot, she has some problems with grocery shopping: the social keeper activated the municipal service of at-home meals. It has also been requested an aid to the solidarity fund because Giovanna was not able to pay the rent.

This summer, her refrigerator broke and the social keeper was able to give her one that was donated by an Institution that is in charge of residential care for elderly and that recently reformed its kitchens. Not only did the keeper make the request, but she also contributed to the transportation at home with the help of her son and of another operator of the institution.

The relationship between Giovanna and the social keeper appears to be very strong, they are very affectionate with each other, although the keeper reprimands the elderly with regard to what she should do and the successive commitments she should make. The operator tells that “it’s like we are a part of their family [...] we become familiar, there is a family-like relation, she is calm, always smiling, always happy and content”, “ it is not an effort for us to carry out the telephone monitoring to make her feel that she has someone, sometimes we argue on our point of view, but always in a polite manner”.

Giovanna declares: “I am very happy to have a person like her next to me, I could not ask for anything better, she is a good person”.

For her part, the social keeper underlines that she likes her job: “It is wonderful for me, you get to help people and see improvements. For example, I had some difficulties with users who have not been talking to their children for years, but we were able to connect them with their relatives, through our insistence”.

From this story we understand well that in extreme situations it is possible to create “artificial” relations that progressively manage to become real and have a deep effect on the person who provides the service, the operator, and the person who receives it, the recipient.

The relations exchange allowed many persons to restart and to rethink about their future, even if it is unsure and fragile. The precious thing is that the exchange and the material and instrumental aids (the money for rent, the refrigerator) acquire a meaning inside a relationship that becomes meaningful. For the keepers, this means a precious confirmation of their own professional role identity, of which they appear to be aware.

The orientation of action that aims at promoting the natural coping networks is still faint and it requires some more competences by the social keeper: however, it must be noted a natural predisposition of these persons to assume a perspective of this kind. In many cases it is possible to understand, maybe between the lines, that a work was made for an actual network of natural coping, close to the subject, able to catalyse itself for a common interest or a perceived good.