Her job had taken her all over the world. After she retired, she made it a point to drive herself to visit her friends. As the years kept moving, and as her body failed to keep pace, just going down two floors to sit by the garden in front of her building became the highlight of her day, every day.

Sitting there, with a stray dog to keep her company, she would call her six friends one by one. Just to discuss the weather and the day’s headlines and to ask how things were at the other end. Occasionally, much to her frustration her mobile would misbehave, until someone found the time to show her what she was doing wrong. When a friend was willing to talk longer, she would be thrilled and would thank them profusely for listening to her.

She would always keep some chocolates with her. She would give it to random people—the watchman, a maid on her way home or even the driver of a cab returning after dropping someone. Their smile and “thanks” were worth more than the little she spent on each chocolate.

Then one day she had a fall. Or others said she did. She could not remember what exactly happened. Just that she was no longer able to walk or even stand without help. They cared for her despite multiple admissions to the hospital. For her, the biggest pain was she could no longer go down.

Everyone tried to persuade her it did not matter. For her, nothing else did.
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She was alone, more alone than before.

Rajni was a responsible homemaker, devoted to caring for her husband, her children, and other members of her family. Then the elder ones passed away and the children were all comfortably settled elsewhere. She felt she was not needed by anyone anymore. The one who cared for many lives thus far yearned for a reason to care for her own.

That’s when she approached a professional, to help her find a purpose beyond being just alive.

The counsellor began by congratulating her for seeking help instead of drowning in self-pity and loneliness. Their conversations helped Rajni recollect how she had dealt with difficult situations in life. Together, they listed all she could do to help and earn, including some things Rajni had always wanted to do.
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When we get old, we plan for our financial security, we prepare our Will, and we even draw up a bucket list. Prerna Shah, the psychotherapist who helped Rajni observes: “We rarely discuss or even think about a situation of being the lone survivor …. If there are open discussions about how the survivor (could be anyone) could utilize his/her alone time meaningfully or how the person can have activities that would help regular interaction with other people, would it not be easier for the survivor to pick up the ropes of life, as they restart their life alone?”

It is part of palliative care to ease pain and make the final journey as comfortable as possible. Simultaneously, it also helps the family members and caregivers cope with grief before and after the end. However, there is no predicting how long it would take for the person closest to the departed soul (very often the spouse) to get back to what is called normalcy.

According to senior palliative care physician, Dr Pradeep Kulkarni, the shock of loss has an immediate effect on both men and women in the family. “However, contrary to common belief, I have observed that women recover faster than men.”
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He cites the example of a friend who lost both his wife and his parents in quick succession. “He remained in touch with me for a whole year through daily messages. Then he found a job in a distant city and the messages slowly stopped.”

Preparing for loneliness after the life mate’s death can be tougher for those who are low in education and income because they are rarely told the truth until it is too late to mitigate the shock.

Dr Parth Sharma, physician, researcher, and writer recently interacted with the wife of a patient who was in the terminal stage of oral cancer. They just had each other for family. “For me," Dr Sharma said, "this interaction was more as a researcher for my paper on oral cancer. However, I soon learnt that the treating oncologist had not informed them how serious his condition was and how little time they had together.”

While Dr Sharma was hesitant to crush whatever hope they were clinging to, the couple were busy planning how they would repay him for his help and kindness. Maybe she could start selling vegetables and fruits and thus start earning?

“I gently told them not to think so far into the future and to focus on today. I urged her to try and fulfil his wishes, like maybe when he wants to eat something special,” Dr Parth remembered.

“Five days after he passed away, she called me up. She was hesitant maybe because she thought her husband had already passed away, so why bother the doctor. I assured her that she was welcome to call me, whenever she wanted.”
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Dr Parth regrets that we look down upon people who “complain.” Yes, everyone is busy in his or her own way. Perhaps, those who are in a position to comfort and ease loneliness could just listen to the complaints, without being judgmental? Could that be the starting point for a positive resolution?

The loss of a dear one is only one of the factors that can trigger loneliness. According to the Loneliness Statistics Worldwide 2024, 43% of the people in India feel “lonely always, often or some of the times” (third from the top in the list of 28 countries) while only 27% “never or hardly” feel lonely (third from the bottom)—the global average being 33% and 37%, respectively.
  
Perhaps, in this age of disasters and conflicts (natural and manmade), it would be too much to expect India to have a Minister for Loneliness like the UK did in 2018. One can imagine the pressure on the healthcare system if more and more people visited doctors just to have someone to talk to.

Is that the reason why senior citizens now constitute a lucrative market for old age homes? And why we need more associations of youngsters who provide companionship to senior citizens in multiple ways—dropping in to play games with them, singing songs, taking them to the bank or accompanying them to their favorite restaurant?

Unlike Covid, the source of the pandemic of loneliness is within us. So is the remedy, if we can spare a moment of empathy to open up and reach out, often just by listening.
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Or simply by helping someone go down to the garden safely, so that she could be truly alive again.

There was a time when our ancestors had designed death rituals to let the consciousness exit the body and move on to a different state. In this intermediate state, there is awareness (though not in the “living” sense) but the consciousness requires guidance.

In his new book, Does the moon exist?, Dr Abhijit Dam prefers to call dying as “transference of consciousness.” He regrets that today most deaths happen in hospitals, surrounded by “death-prolonging machinery.” This alien setting is very confusing and frightening to the transitioning consciousness. It is more comforting if this happens in the peaceful, familiar setting of home in the presence of loved ones.

When you read this book, you might find it difficult to believe that Dr Dam was once immersed in intensive care, busy trying to kill death. After a decade he realized that rather than saving lives, he was prolonging the process of dying.

It would be even more difficult to accept that he was a staunch atheist for long until a life event made him seek refuge in God. He also realized his “stuttering inadequacy in handling religious and spiritual issues” raised by his patients. He undertook a one-year course in Advanced Vedanta from Chinmaya Mission and then I completed a six-month course in Contemplative and End-of-life Care conducted by the Naropa University, USA. He went on to find the hospice Kosish in 2005.

More recently, Dr Dam has developed a “culturally appropriate death doula course for India”. Death doulas assist a person during the process of dying. “They help in restoring sacredness to the dying process in a culturally and religiously appropriate manner.” The course, named Farishtey marries the “modern principles of quantum physics and the ancient wisdom of Vedanta”. This book provides the rationale for that marriage.

The book (which Dr Dam often calls his “dissertation”) is a difficult read. Especially because most of us do not want to read about death! Unless one is facing it or has had to be (or is) responsible for looking after someone on the verge of departure. If you are brave enough to look life in the eye, this book will tell you why the end is not really the final end. Given that the bodily end is a certainty (just as the moon is surely there, whether you look at it or not) this book could well prepare one for a peaceful transfer.
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After all you are not just your body, are you?