“I used to have no problem walking up the slope in front of my house, to go to the community center on top of the hill.
But now, this slope has become too much for
me, and I’ve lost touch with other members of the activity group at the center.”
This initial change then accelerates the
process of giving up trying something and losing mental energy to live.
I recently hear more and more stories like
this, a vicious cycle older people face
as they start having difficulty going out even in their neighborhoods, or the “last
mile.”
When we talk about barriers to going out,
we have mainly focused on transportation issues, such as older people giving up
their driver’s licenses and local bus companies cutting back on their services.
To address these challenges, various
measures have been taken such as community bus services. In some neighborhood
groups, members give rides using their own cars to help older people go out.
But what I’ve been hearing lately is that a
growing number of people are having difficulty going out, even within walking
distance of their houses, although they are not certified as needing care or
support in the public long-term care system.
Just the other day, I had a chance to speak
with a person at an apartment residents association, who told me that more
people are now having difficulty even getting to a meeting point when the
association organizes an outing program.
But you know what? Many of these people
saying “I can’t go” can actually walk. Indeed, they do go to hospital several
times a month.
Hip pain sure could make it difficult to
walk, but the real barrier could well be mental, a lack of motivation.
My mother, in her 80s, is no exception. She
used to love going out and wouldn’t come home until the evening. Since the
COVID-19 pandemic, however, she has rarely left home.
She does move around the house, but when it
comes to going out, she often cancels the plan at the last minute.
Not long ago, her grandchild had a recital
at a place only a 10-minute walk from her house, and we planned to go there
together. But just as we left the front door, my mother turned back to the
living room saying, “I’m coming down with a cold.”
It wasn’t her first time to cancel a plan
like this, and going through this over and over makes not only herself but her
family members, who have made plans with her, feel beyond disappointed and
rather depressed.
“I have no problem getting exercise because
I move around doing housework at home,” she insists. But the biggest problem
since she stopped going out is a lack of
opportunities to feel something like “a sense of usefulness” as she no
longer spends time with people other than her own family.
What I mean by “something like a sense of usefulness”
is that non-family members can appreciate something really small in her, which
the family living with her may not notice.
For example, she may have a friend who is
feeling down because of family caregiving stress. She may say to the friend, “I
understand how you feel, you’ll be alright!” and receive “Thank you” in return.
Even such a small communication can make a difference.
As I watched my mother refusing to leave
home, I remembered a story about a person who had set up a bench at the
entrance of his mother’s house. She was in her 90s and rarely left home.
His mother would sit on the bench all day
from the morning, knitting something, waving at kindergarteners passing by, and
chatting and laughing with her neighbors. According to the son, her face has
brightened up since the bench arrived.
If people face a mental barrier at the “last
mile,” the barrier to leaving their houses and walking around the neighborhood,
maybe we can bring something to create connections to their front doors…
It can be a bench, but it can be something
else like potted flowers so that they can enjoy growing them in front of their
houses and sharing them with neighbors. Maybe, having such a small thing can help
start something wonderful…. My “creative” mind never stopped working even in
the New Year’s break.
Shino Sawaoka
Associate Professor,
Dept. of Health Management,
Tokai University
zt1864@tokai.ac.jp
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