Opening Up

A Q&A with Dr. Chao Fang on loneliness, the elderly, and aging.

Mockingbird / 3.16.22

This interview appears in the Age Issue of The Mockingbird magazine.

With more elderly people alive today than ever before, there are also more books, memoirs, and testimonies telling what it’s like to age. Some promise that even into very old age, you can “flourish” and learn new skills and enjoy a better-than-ever sex life. In The Guardian, Krishnamoorty Dasu, at age 90, maintains that “To a large extent, age is a state of mind.” As Walt Whitman once wrote, with typical breathlessness, “Do you know that Old Age may come after you with … grace, force, fascination?”

Writing in The New Yorker at 71, the essayist Arthur Krystal isn’t buying it. For most of us, he says, “getting old just means that we have to work harder at staying young.” It’s high time for a reality check, he says. “The body—tired, aching, shrinking—now quite often embarrasses us… Life, [some people] insist, doesn’t necessarily get worse after seventy or eighty. But it does, you know.”

In his 1979 book The View in Winter, Ronald Blythe carves a middle path between extreme optimism and pessimism: “Old age is full of death and full of life,” he writes. “It is a tolerable achievement and it is a disaster. It transcends desire and it taunts it. It is long enough and it is far from being long enough.”

In short, the aging process seems as varied as the people undergoing it. If our aim is to understand the variety of experience, it is imperative that we listen. As Paul Zahl says in Peace in the Last Third of Life, an elderly person “probably has a lot to say and almost no one to whom to say it.” In an appendix to the same book, Mary Zahl writes that “most conversations are simply people taking turns talking”; by contrast, good listening enables “graceful healing.”

Which is what makes the research of Dr. Chao Fang so luminous. Dr. Fang researches loneliness in Bath, England, with a particular focus on the emotional landscape in retirement communities. For the Bath Loneliness Project, he and his colleague, the psychologist Dr. Sam Carr, conducted more than 130 hours of interviews with older people. The project, undertaken between 2019 and 2021, is a qualitative exploration of loneliness and aging, at the heart of which is, well, a heart. Its basis is compassion: simply allowing the elderly person to express how he or she feels.

Turns out that such a practice has an immense impact. As Carr and Fang concluded in The Conversation online, listening is “mutually beneficial and help[s] older people to feel that the lives they have lived counted for something.” Regardless of whether their testimony is optimistic or pessimistic, regretful or peaceful, an opportunity to share it proves to be an immense gift. To find out more about his research, we contacted Dr. Fang over email.

Why did you start researching the experiences of older people?

I was drawn into aging research when I realized my own grandmother was aging. Being an expat (a Chinese who has lived in Japan and England for more than ten years), I’ve missed many important moments, both pleasant and distressing, in my grandma’s life. Every time I talk to her, I always feel the profound power of aging—how it has impacted her physical appearance, cognitive activeness, social mobility and, more fundamentally, the sense of who she is. Having lost the opportunity to “age with” my grandma, I decided to learn more about what aging means to older people and their loved ones, and subsequently how they can be better supported.

And as the concept of “active independent living” has become increasingly popular in Western countries, I’ve become more interested in retirement communities. Despite living where resources and support are more concentrated, many older residents, it seems, still face loneliness and isolation in retirement communities; this pain of being separated from others and society can be hidden and often hard to articulate.

I was simply keen to learn about the lived experience of aging and its multifaceted, pervasive impact on older people’s everyday lives. Growing older does not necessarily mean being lonely and distressed, but the Bath Loneliness Project afforded me a precious opportunity to listen to older people’s rich life stories and their concerns about how their lived lives may be lost alongside their aging.

Can you tell us about your research?

Between 2019 and 2021, my colleagues and I conducted a large qualitative study involving 80 long-lived individuals from eight retirement villages across England and Australia. We were fortunate to talk to a greatly diverse group of community residing older people with an age range between 55–93, in varied social and health conditions. Many residents thrived and remained independent and active as long as possible, while many were also faced with varied challenges alongside aging, like bereavement, bodily deterioration, and isolation.

How did you get people to open up about their experiences, vulnerabilities, and histories?

I talked to many older people as a younger person who was genuinely interested in their stories. By adopting an empathetic and non-judgmental approach, I became what we called a “safe stranger” in the interviews. Many participants were able to feel comfortable while opening up about their experiences, which included not only joys but also sadness, regrets, and many other distresses.

It is often thought that people may feel reluctant to convey their emotions, especially those associated with vulnerabilities. However, it is also true that recollecting their stories can help them better make sense of their experiences. Quite a few older people thanked me at the end of our interview, for giving them an enjoyable but rare opportunity to freely share their lives and feelings.

Would you share a distinctive story from the interviews?

One of the most memorable stories was from a gentleman, widowed and in his 70s. Having spent over four decades with his late wife, he had sadly lost her to cancer. Not only was his daily life drastically disrupted by his conjugal loss, but his social connections were also largely shattered by losing the only “sociable” person in the house-hold. As a result, he had to spend a lot of time alone in his bereavement. He said, “She died about four years ago; just over four years ago, yes. Then it was just me and the dogs and the fish. Yes … take what comes. I shall be unhappy when these dogs start dying, very.”

While experiencing the pain of loneliness, this gentleman also kept a “stiff upper lip,” lacking as he did the emotional language to convey his feelings and further seek support. Such a mentality was quite prevalent among the older people in our study, often as a result of certain cultural and familial circumstances, such as war, military service, and family hardship.

This story profoundly showed me the importance of not only understanding older people’s complex challenges, but of also providing accessible tools to help them articulate their pain and needs.

What are your suggestions for people suffering from loneliness or loss? How can we care or show compassion to the lonely or bereaved?

I think that developing a “compassionate community” would be an ideal way to support older people who are lonely and/or bereaved. The concept of “compassionate community” originally derives from a community-based model for supporting terminally ill patients. This model advocates a literacy of understanding, empathy, and support for not only patients and their close others, but also those in local communities and the wider society.

Similarly, a compassionate literacy for loneliness and bereavement is also needed when supporting older people. Indeed, this would not be an easy task, since fostering a culture requires multi-faceted, ongoing investments. However, education can be an avenue to develop such literacy in communities—providing resources and support mechanisms to help older people become aware of their loneliness and bereavement, as well as enabling others in family and communities to be more knowledgeable and supportive to older people’s needs.

In our own lives, we can simply be an interested listener and have a chat with our older neighbors. This helps them share their lives and further feel valued.

Your research indicated that many elderly individuals value connections to the younger generations. How, in your opinion, could we foster more of those connections?

There are many ways. One excellent example is an award-winning British TV show called Old People’s Home for 4 Year Olds, in which kindergarten-age children make friends with older people living in retirement villages. I was so impressed to see the natural, beautiful bonds that can grow between two generations of “strangers.” I truly believe in the benefits and potential of fostering intergenerational bonds for older people.

There is no fixed way to do this. Bonds can be developed with-in family, in local communities, or even across the globe through the internet. Fundamental in this initiative is to provide both older and younger generations with accessible platforms to engage with each other. For example, we can let children spend more time with their grandparents, promote befriending programs between older people and school pupils in local areas, and encourage older people to teach their language and culture to international students.

What are some of the benefits and drawbacks of retirement communities?

Moving to a retirement living may involve compromises and risks. It’s often challenging to adapt to a new living environment, since older people may have to leave behind their already established social networks, their long lived-in family house, and the many cherished memories there.

Living in a retirement community may also lead to conflicts with fellow residents. Although residents in retirement communities are often seen as homogenous, they are actually an extremely diverse group consisting of people in a wide age range and from varied socio-cultural backgrounds. As such, people with different and even competing needs and values may find retirement-living unsatisfying.

However, many people we talked to found benefits in (re)gaining social connections, accessing more concentrated support, and “future-proofing.” According to our research, one potential solution for conflicts in retirement communities is to enable residents to “age together”; by sharing their lives while growing older, older residents are more likely to foster a sense of community and security.

You’ve studied in the UK, China, Japan, and Australia. Does loneliness look differently in different cultures?

In a broad sense, I think loneliness is a universal experience, facing not only those older, but also everyone in all age groups.

As we have found in the Loneliness Project, humans are inherently lonely; we’re all fundamentally driven by the so-called “separation anxiety” to seek meaningful human interactions. However, as people start to lose these meaningful human connections and resources to fulfill their lives, loneliness may become more prevalent in old age. So regardless of the cultural background, I would say aging could expose people to increased risks of loneliness.

On the other hand, loneliness is also profoundly shaped by culture. For example, in Western contexts, many older people see living alone as a way of being “independent” and “successful,” while in more family-centred cultures such as China, living away from adult children is often seen as “lonely,” “isolated,” and more fundamentally bad. So in order to further support older people’s needs, it’s important for us to understand their unique socio-cultural backgrounds.

What would you say to people who are afraid of aging?

As we all know, humans tend to be afraid of things unknown to them; this is the same when facing the process of aging. Central to our fears of aging is the fact that life is irreversible, and growing older always remains uncertain. As clearly evidenced in our research, many people chose to move into retirement communities to “future-proof” uncertainties and risks.

In any case, it’s key for people who are afraid of aging to start making sense of aging—and to understand that aging does not necessarily mean deterioration and isolation but may also bring fulfillment and joys.

If you are afraid or at least worried about aging, why not try to talk to older people you know, to understand their experiences? In so doing, you may be able to better envisage your own aging and subsequently face and prepare for it.

Why do you think your Loneliness Project was such an important endeavor for today’s world?

Loneliness is becoming increasingly prevalent in our society; some people even call it a modern epidemic that can undermine people’s health and wellbeing in varied ways. I hope the evidence we’ve provided can help practitioners, policymakers, and the general public better understand the complex experiences that older people face.

More particularly, by highlighting the deeply painful nature of loneliness in old age, I genuinely wish that our Project will help propagate a loneliness literacy for older people, so they will feel more comfortable sharing their pain with others in their every-day lives.

Illustration provided by Ricardo Tomás

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