Loneliness in Old Age (Buzurgon Ki Tanhai): What Families Can Do

Loneliness in old age (buzurgon ki tanhai) rarely announces itself. It shows up as “my knees hurt”, “I don’t feel like eating”, and a television that’s on from morning to night. Families can do a great deal about it, and most of it is small, daily and free. This guide gives a contact routine, purpose tasks, the hearing and vision checks that quietly cause isolation, and the signs that loneliness has become depression and needs a doctor.

Old age in our part of the world used to come with a courtyard full of people. Now it often comes with a flat, a mobile phone the person can barely see, children in another city or country, and friends who have died or moved. The good news is that loneliness responds fast to small changes, faster than most conditions of age. This sits in our Desi Remedies series because the remedy is household-level: a routine, a role, a walk, and someone who calls.

How loneliness shows in an older person (it’s rarely “I’m lonely”)

Older people, especially men and especially those raised to never complain, don’t say they’re lonely. They say other things.

• Vague aches that move around: knees today, back tomorrow, “whole body” on Friday.
• “I’m not hungry.” Food left on the plate. Weight quietly dropping. Tea and biscuits replacing meals.
• Sleeping in the afternoon, awake at 3 am, and calling you at 6 am about nothing.
• The TV on all day for company. Or the radio, or the Quran recitation on loop, not for its content but for a voice in the room.
• Repeating the same story on every call. Not memory loss necessarily; it’s the only new thing that happened.
• Irritability, criticism of everyone, “nobody cares”, or the opposite: a bright “I’m fine, don’t worry about me” that ends the call quickly.
• Stopping the small things: not shaving, not changing clothes, not going to the mosque or the park bench they went to for 20 years.

Any of these could have a medical cause too, so a doctor’s check comes first. But once the doctor finds nothing new, look at the calendar. How many real conversations did they have this week?

Hearing and vision: the two checks that fix more loneliness than anything

This is the part families miss. A parent who has slowly lost hearing stops following dinner conversation, gets the answers wrong, feels embarrassed, and withdraws. Everyone assumes they’ve become quiet or “a bit slow”. They’re not slow. They can’t hear. The same happens with cataracts: reading stops, recognising faces at the mosque gets hard, going out feels unsafe, so they stay in. Our detailed guides on hearing loss signs families miss and early cataract signs tell you what to look for.

The action is simple. Book a hearing test and an eye check once a year from 60 onwards, and any time you notice the TV volume creeping up, “what?” more than a few times a meal, or a reluctance to go out after dark. A hearing aid or a cataract operation is, for many older people, the single biggest loneliness fix available, because it puts them back inside conversations.

A daily contact routine the family can actually keep

Good intentions fail because nobody owns them. “We’ll call more” lasts a week. A written routine with names on it lasts years. Here’s one to adapt.

1. One real conversation a day, 10 minutes minimum, assigned by day. Monday is the eldest son, Tuesday the daughter in Lahore, Wednesday a grandchild, and so on. Voice or video, not text. Put it in each person’s phone as a repeating alarm. The rule is the same slot each week, so the parent can look forward to it; anticipation is half the benefit.
2. Ask about them, not just their health, for at least 5 of the 10 minutes. “What did you eat?” is a check. “What did the neighbour say about the wedding?” is a conversation. Ask for their advice on something real: a recipe, a family decision, a dua. Being consulted is being needed.
3. One face-to-face visit a week from someone, even 30 minutes. Sit, eat something with them, let them serve you tea if that’s their pleasure. A grandchild counts. A neighbour’s child who they help with Urdu homework counts.
4. Two fixed outings a week, at set times. Fajr or Maghrib at the mosque, the park bench at 5 pm, the Friday market, the dars at a neighbour’s. Fixed times mean other regulars start expecting them, and being expected somewhere is one of the strongest pulls out of the house.
5. One purpose task with a deadline. Something a person genuinely depends on: watering the plants, teaching a grandchild Quran on video every Saturday at 4, keeping the household accounts, cutting vegetables for the evening meal, the WhatsApp reminder to the family for medicines. Not a made-up chore. A real role.

Write the routine on one page and stick it near their phone. When someone misses their day, whoever notices covers it, no fuss, and the routine continues. A missed call isn’t a failure; a missed month is.

Purpose, prayer and the people next door

Entertainment (a bigger TV, a tablet full of dramas) is company of a sort, but it doesn’t reduce loneliness much, because nobody on the screen needs them back. Purpose does. Grandchildren are the classic answer, but they grow up and move; build in roles that outlast them. Some that work in real homes: managing the kitchen store cupboard and the monthly shopping list; being the family historian with a notebook; supervising a plant corner or a few pots of pudina and mirch on the balcony; feeding the neighbourhood cats at 7 am (regulars gather); being the one who checks on the widow two doors down.

For those who pray, the mosque is a ready-made routine, five fixed appointments a day with the same faces. Encourage it, and solve the practical barriers (a cane, better glasses, a companion for the walk after dark, a chair for prayer if knees don’t allow). Dhikr and recitation at home bring real calm too, but the community part is where loneliness lifts. For women, a weekly dars, a Quran circle, or simply the neighbour’s veranda at 4 pm does the same job.

And neighbours. In our culture they’re already half family; use that. Tell the neighbour, plainly, “Ammi is alone in the day, would you mind sitting with her for chai on Tuesdays?” Most people are glad to be asked. Offer the same in return for their elders.

Depression in the elderly: when tanhai has become something that needs a doctor

Loneliness and depression overlap, but depression is an illness, it’s common after 65, and it responds to treatment. The trouble is it looks different in older people. Instead of saying they feel sad, they present with the body: constant tiredness, unexplained aches, poor appetite and weight loss, waking early, slowness, poor concentration that gets mistaken for early dementia, and losing interest in things that used to matter. Sometimes irritability instead of sadness. Sometimes a repeated “I’ve lived long enough” or “I’m a burden”.

The rule: if the signs above are there most days for 2 weeks or more, see a doctor, and go with them. Say the words “we think it might be depression” so the visit doesn’t stay stuck on the knees. The doctor will also check the physical things that copy depression in the elderly: thyroid, anaemia, vitamin B12, sugar, kidney function, the side effects of existing medicines, and early memory change. Talking therapy works at any age, and older people often do very well with it; whether any medicine is added is the doctor’s call, and no family member should ever start, stop or adjust one, including “calming” syrups from a relative’s cupboard. A parent’s daily structure matters here too; our daily routine for elderly parents gives a full timetable that supports mood as well as body.

Buzurgon ki tanhai: questions families ask