It was only when Gay Ellis fell ill with ME four years ago that she realised how lucky she was. The 67-year-old had moved into a small cottage in a pretty cluster of buildings in Dorset, where half the properties were privately owned, and half social housing. It wasn't just a new home she acquired, but a "second family".
"One neighbour came in every day and gave me news of the outside world," she says. "There is something important about knowing I can go out and knock on any door here.'"
Ellis lives in a converted holiday home, with throws over sofas and rugs on the stone floor. The lounge has a round, wooden table – just big enough for three. Beyond this is a snug kitchen tucked under the stairs. The other homes range from one-bedroom units to three-bedroom houses, many around the central green, still cheery in winter with pots of trailing plants. Ellis scoops up a neighbour's cat as we head inside the stone farmhouse where residents meet for group activities. In one of the large, dark kitchens a couple of friends are having lunch and call out greetings. In the large dining room, where the neighbours have a joint twice-weekly meal, the fireplace is hung with a chain of smiling photographs of all the inhabitants. The set-up is known as co-housing.
Tall and elegant, with her long, grey hair, swept back from her face, Ellis outlines, over a bowl of homemade vegetable soup, the benefits of her new life: "This is an intentional community, so you don't feel guilty about imposing on other people. I can call on anyone and people are always popping in."
She tells the story of her 75-year-old neighbour, Caroline, who died last year. When Caroline was in a hospice, several residents offered to care for her. "Before she came here," says Ellis, who has a picture of her friend on her bookshelf and another in the meditation room, "she nursed her 90-year-old mum for three years. She always said she never wanted that for her children. Maybe she thought if she was in a community the burden would not entirely rest on them – and that's how it worked."
Although The Threshold Centre, as the community is called, is open to all ages (the youngest resident they have had, was two) and most residents like the green and spiritual aspect of the centre, co-housing is being touted as an antidote to the chronic loneliness many people face in old age. Groups have sprung up across the country: 12 are established, and another 32 are in development, three of which hope to create homes exclusively for older people. Co-housing, says Professor William Lauder at the University of Stirling, who has studied the health effects of loneliness, is an "absolutely perfect" solution to what has become "one of the most important and least-addressed public health issues".
Many experts now believe we could be facing a loneliness epidemic. The figures are startling. Laura Ferguson from the Campaign to End Loneliness says the number of people who describe themselves as sometimes lonely has shot up by 20%, while "10% of everyone over 65 is chronically lonely".
According to the Department of Health, five million older people say their main companion is the TV set, and almost one in five older people are in contact with family friends and neighbours less than once a week. In response, the government has announced plans to "map" loneliness in older people by asking local authorities to identify in which areas people are suffering most acutely.
Psychologist John Cacioppo, at the University of Chicago, is a leading researcher into loneliness. He defines it as a "debilitating psychological condition characterised by a deep sense of emptiness, worthlessness, lack of control and personal threat". He believes loneliness is partly hereditary – and an important evolutionary tool. "This pain served to prompt us to renew the connections we need to ensure survival and promote social trust, cohesiveness, and collective action," he says. In fact, Cacioppo believes, loneliness is an indicator of our society's health, allowing us to measure how well we are integrated. If this is the case, we should be seriously concerned.
A flurry of research has demonstrated that lonely people face serious health risks. Some reports have even suggested that being lonely is comparable to smoking 15 cigarettes a day; others that it can increase the risk of dementia. Lauder agrees: "My research has shown that those who are lonely are more likely to smoke and be obese," he says. "US researchers have shown that those who are lonely are less likely to take regular exercise. If you are lonely you are more likely to have a heart attack, and if you experience a heart attack when you are lonely, you are less likely to survive it. You are double or triple as likely to die. But although there is more research, this hasn't translated into policy."
One reason for this may be because loneliness is such a complex issue. For a start, it is subjective, and not necessarily linked to physical isolation: "You could have 10 relatives who live near you," says Lauder, "but you could still be lonely."
To help effectively, charities must distinguish between emotional loneliness – when you miss one person, a partner or friend after a bereavement, for instance – and social loneliness, when you no longer feel part of the group, says Ferguson. Cacioppo makes further divisions into situational loneliness – when circumstances such as family or health problems stop you feeling connected to others – and chronic loneliness, when feelings of loneliness "become uncoupled from the situations that aroused them".
For David Etherington, 90, it was losing mobility and independence that hit him hardest; sitting in the cramped, silent lounge of his sheltered accommodation in Weybridge, brightened only with photographs of his wife, daughter and granddaughter, and the postcards of cats and kittens pinned to the walls, he says the loneliness came as a shock.
A soldier in the parachute regiment during the war, Etherington worked all his life, from his first job as a lorry driver to collecting glasses in a local pub when he was almost 80. He loved working and after he gave it up was still active and happy, going to the pub and football matches with friends.
It was a stroke, three years ago, that left him unable to walk without a frame – and almost overnight brought isolation. After he was released from hospital he found himself trapped in his small, institutional flat, at the end of a long bleak corridor of similar homes. All his ordinary pursuits – from drinking in the pub to watching football matches – became impossible to navigate when he couldn't walk on his own, and by then his close friends in the sheltered accommodation had passed away. "All my old friends have gradually died," he tells me, his voice cracking.
The worst blow was when he was told he could not even step into the communal garden, in case he fell over – and all the casual, personal interactions that make up our days, disappeared. "Before the stroke I would walk down to the shops, but afterwards I never went anywhere," he says sadly.
His daughter visits every Saturday and phones him every night but his days still seem endless, he says. "It grows on you and in the end you don't want to do anything. I would walk down the corridor, but if I didn't see anyone it was a waste of time. I go to bed as soon as it's dark – even in the winter. You just pray for sleep to come."
Etherington, whose wife died 40 years ago, is now helped by the charity Friends of the Elderly, whose befriending service set him up with a weekly visitor and a weekly visit to a nearby day centre. Having a cup of tea with someone and getting out of the house has helped enormously, he says. But the tears are not far from the surface and even this respite cannot stop Etherington from feeling that he is overlooked, no longer part of the world.
Disability and ill health have long been recognised as triggers for loneliness but the fragmentation of society – the decline of the nuclear family, the way we move around for work, the fact that fewer families live with older relatives, and of course, the increasing numbers of people living alone – clearly adds to the problem.
Iris Nichol, for instance, moved from her home in Newcastle to live next door to her daughter in a village in Northumberland 10 years ago. She is 80 and sees her daughter, a headmistress, every day and has close relationships with her other children, she also visits a day centre run by the age positive charity, WRVS. But because her daughter works long hours, it can be a solitary existence, as she often does not see anyone else. "People are different today," she says. "They keep themselves to themselves. If you ask them to help, they are always willing, but I have been more or less incapacitated for the last few years and not one has asked me if I am all right.
"I grew up in a little mining village in County Durham. We lived in an enclave of people who worked for the same boss, but nowadays it is only retired people here. I sit where I can see out the window to the focal point of the village, and most days I see no one at all. There's no movement, apart from a cat."
Iris says it was the local bus service being cut that compounded her feeling of isolation, because she could no longer get around on her own to visit the shops or go to a cafe. She tells me that the day before we talk she did not see anyone until her daughter came home at 9pm, then poignantly corrects herself: "The postman always gives me a wave."
David McCullough, chief executive of WRVS says it is a problem he has heard many times. The charity started to research loneliness after the people it supports said it was the thing that made the most difference in their lives, over financial or even health worries.
Despite the scale of the problem, few people are willing to admit to feeling lonely – Nichol, for instance, won't use the word of herself but says her problem is "more a lack of company". Loneliness is still stigmatised, says Cacioppo and "those who are afflicted by it tend to deny it, ignore it, or tough it out". When Esther Rantzen broke the taboo and wrote about her own feelings of loneliness, she said she was amazed at the avalanche of letters from people in similar situations, and by those, she says, who told her how brave she was to be honest about it.
In response she decided to set up a 24/7 helpline and telephone befriending service. A pilot scheme, dubbed The Silverline, began in November, taking calls over Christmas throughout the north-west. "Some people had not spoken to anyone else on Christmas Day or Boxing Day, but despite this they said there were others worse off than them," said Rantzen. "There is this overwhelming feeling among older people that they don't want to be a burden."
Sophie Andrews, who helps to run the helpline, says the trained volunteers took 300 calls in the first few weeks and half of the callers had asked to join the befriending service. "I spoke to a lady with terminal cancer who was very isolated," she says. "Her phone was cut off to outgoing calls, so our weekly incoming call was the only one she was going to get. She had run into financial problems and her heating had been cut off. With her consent we managed to involve social services and get emergency fuel payment through."
Another caller expressed the common complaint of being married and surrounded by family, but still feeling alone. "Her partner had dementia and she didn't want to be a burden on the family, so she just felt trapped. That's something a lot of people have described. People can be happy living alone, but equally you can be in a house full of people and be lonely."
Others have called after losing their partners. "Many of the men we talk to who are widowed have lost that social connection because all their social networks were managed by their wives, so they feel they have lost contact with the outside world."
A similar project in Ireland, Senior Helpline, has been running for more than a decade and received more than 15,000 calls last year. "Underpinning an awful lot of our calls are those who are living in emotional loneliness, or geographic isolation, or both," says Anne Dempsey from the charity. "Some people call us every day and know our volunteers on a first-name basis. We know about their lives. For many the situation won't change – but we keep them company. Older people are living longer – we have added years to our lives, now the challenge is to add life to the years."
Experts warn that loneliness is far from each individual's problem – the ill health it causes can be expensive for the NHS, not to mention the associated mental health problems, such as depression. Loneliness can be catching, too: as one lonely person gets caught in a cycle of negative thoughts, they can push away their friends and family, making them, in turn, feel lonelier.
Maria Brenton, from the Older Women's Co-Housing network, thinks that what older people need is not to be pitied, but a chance to prevent themselves being caught in such situations. She has been trying to set up a housing project for women aged 50-plus in High Barnet, north London, along the lines of the Threshold Centre in Dorset. "My generation looks with horror at sheltered housing and care homes; I have run my life as I want to for 67 years, and I don't see why I should stop."
To get involved in volunteering or to to find charities and organisations that can help you try:
Contact the Elderly 0800 716 543 or go to www.contact-the-elderly.org.uk, Age UK ageuk.org.uk (0800 169 6565), WRVS wrvs.org.uk (0845 600 5885), Friends of the Elderly fote.org.uk (020 7730 8263) and thesilverline.org.uk (north-west only) (0800 328 8888)
