Richard, bereavement volunteer, writes:

I’ve recently taken early retirement from a job as a human resources manager, and I decided to volunteer for a bereavement support charity. I’ve just finished my volunteer training, and Mary is one of my first clients. I’ll be discussing her in my supervision group, and I’ve written this account of our first meeting as a basis for discussion.

Mary, 77, was referred by her GP. Her husband Ken died suddenly two years ago this month. She has been visiting her GP very frequently since then. The GP has diagnosed depression, and has prescribed antidepressants but felt that she would also benefit from some bereavement support. The GP acknowledges that she has some physical health problems (arthritis, high blood pressure) but she seems disproportionately anxious about these, and generally seems to have lost her confidence. She is anxious about going out alone, and as a result is becoming socially isolated, and also physically unfit; she’s gained a lot of weight, which is making her health problems worse.

When I visited Mary at home, she was very welcoming and eager to talk. She insisted on making me a cup of tea with home-made cake, saying that baking is one of the few things she still enjoys these days, but that it makes her sad when there is no one there to eat the cakes with her. That led her into talking about how hard she finds it living alone for the first time in her life, and how much she misses Ken. They were childhood sweethearts who went to the same primary school, and she can’t remember a time when she didn’t know him. She quickly became tearful as she talked about him, and then apologised, saying she felt she should be getting over his death by now, but she just seems to miss him more as time goes on. She had felt things were improving a bit up until about a month ago; she was finding she could concentrate better on reading and television programmes, and even enjoy them sometimes, but now she feels she’s taken a step back again, and she just can’t pull herself together. Sometimes she finds it hard even to get out of bed in the mornings. Is there something wrong with her, she wonders?

I didn’t know what to say, and felt very incompetent and inadequate. I’ve dealt with people in Mary’s situation in my previous work, but that was different. For one thing, they were younger, and I had a different role then; if they needed counselling I’d refer them on, and if they needed extra compassionate leave or a phased return to work, I’d fix that for them. It was a new experience for me to just listen to Mary’s sadness and anxiety without having any solutions to offer. I found myself wanting to reassure her that there wasn’t anything wrong with her, but I realised that I knew very little about her so far, and I needed to keep on listening to get a fuller picture. She carried on talking about her health. She’s been suffering increasingly with osteoarthritis over the last ten years or so, with pain in her back and legs. The doctor says she doesn’t need hip or knee replacement yet, and is always trying to persuade her to get more exercise. She can walk as far as the local shops, but doesn’t like using a stick because it makes her feel like an old woman, and without it she feels she might fall, so she doesn’t really like going out on her own at all now. She did have a nasty fall soon after Ken died; she was having trouble with her blood pressure then, and the doctor was trying to get her medication level right. To start with the dose was too high, and she felt faint, and fell as she was walking to the shop to get her newspaper. So now she gets it delivered, and Tracey helps her with the rest of the shopping, either getting it for her or going with her to the shops.

I asked if Tracey was her daughter, and she said no, Tracey, now 30, was one of the children she fostered. Her daughter was in Australia. She has two grandchildren there too; she showed me their photographs which were on either side of the mantelpiece. She became tearful again as she told me that she hadn’t seen them since her daughter and son-in-law emigrated four years ago. She and Ken were planning a visit when he died, but she doesn’t feel she can make the trip on her own. Her daughter came over for funeral but didn’t bring the grandchildren. I asked her how she keeps in touch with them, and she said they have a weekly phone call. Her daughter keeps suggesting Skype, but she doesn’t have a computer, and wouldn’t know how to use it even if she did.

She showed me another photograph in pride of place on the mantelpiece, which was reprinted from the local paper, and showed her and Ken receiving an award from the mayor for their long service as foster carers. She became much more animated as she talked to me about this; she’s obviously very proud of what they achieved together. They started fostering when their daughter was seven. They’d been trying for another baby, but then Mary realised she was entering an early menopause. This was a very difficult time. She came from a large family, the youngest of five, and had always assumed that she would have a large family of her own. To begin with, they fostered younger children, but as their daughter grew older and eventually left home, they began to foster adolescents, and were much in demand because they were able to cope well with problems that most other foster carers found too challenging. She told me that Ken was involved in the local athletics club, and several of the young people responded well to channelling their energy into athletics with him. She was involved in the social and organisational side of the club, and they both continued this right up till Ken’s death. They also took part in fundraising for several charities, and she told me how well-known Ken was in the local community and how much he is missed. I asked if she was still involved in any of these activities, and she looked surprised and said no, those were things they did together, and she couldn’t imagine doing any of them on her own. The fostering, too, was something they did as a couple. ‘We were a team. I couldn’t have done it without him’.

She went on to talk more about Ken, and how he built up his car repair business from small beginnings into a very successful and respected local enterprise. He’d been apprenticed to the previous owner of the business when he left school at 15, and he took it over when his boss retired. At that time, it wasn’t doing very well; his boss had been depressed and had lost his grip on things, letting people down and letting the bills and invoices get into a muddle. But customers trusted Ken, and he soon began to pull things together again, taking on two new apprentices and beginning to expand the business. By the time he retired he was employing a dozen people, and was chair of the Rotary Club. He was able to sell the business for a sum that enabled them to have a comfortable and happy retirement, with lots of holidays abroad and weekends caravanning.

I asked if she’d worked at all, apart from the foster caring, and she said not really, apart from bits of shop work. She’d never got any qualifications. She became thoughtful for a moment, and then said, ‘It’s one of the few regrets in my life. When I look at what Tracey’s been able to achieve after leaving school with nothing, like I did, I think perhaps I could have done that too, and been a social worker, or perhaps a teacher or a nurse. But we got married when I was only 19, and I just thought we’d have lots of children...’. She looked sad, and there was silence for a while, then she went on, ‘But the fostering has been great; I’ve learned so much. Never a dull moment. And of course I helped Ken out a bit with the business too, and that was interesting, learning how to do bookkeeping, VAT and all that’.

She paused again, and then went back to talking about Tracey, and how proud she was of what she’d achieved. She pointed out Tracey’s graduation photograph on the wall, and told me how she’d gone back to college to do an access course so that she could study for a degree in social work, and how much she’d loved the course. ‘And I’m sure she’s a brilliant social worker. She’s got that gift for putting herself in other people’s shoes. I don’t know what I’d do without her now. But I’m worried about her; I think maybe she’s finding work stressful at the moment, but I can’t get her to talk about it. I think she doesn’t want to worry me. I hope everything’s all right between her and Rob. I’m not seeing as much of him as I used to’.

I wondered if she had any other support from family or friends, and I asked her about this. ‘I don’t have any family left now’, she said, and started to cry. I felt that I’d said the wrong thing, and didn’t know what to say next. But after a few moments she went on to talk about her siblings; two sisters have both died within the last five years, one brother died young, and the other, her only surviving sibling, suffers from dementia and is in residential care. She was particularly close to her oldest sister, who was unmarried and lived close by, and she clearly misses her a lot. She has several nephews and nieces, but doesn’t often see them, as none of them have settled in the area. University education and careers have taken them further away, and increased housing costs in London mean that renting or buying property locally isn’t a realistic option.

She went on to talk about how things have changed since she was young; she’s always lived in this area, but it seems a different place now. The local industries where her parents and siblings worked have mostly closed down, and so has the cinema where they all used to go on Saturday mornings, and most of the local pubs. And the local shops are mostly charity shops and cafes now; if you want to buy clothes or do a big food shop you have to go to a huge shopping mall half an hour’s bus ride away. By this time, I’d been with Mary for well over an hour. It was difficult to bring my visit to an end, as she was clearly enjoying talking to me, and from what I had gathered she has become quite socially isolated since Ken’s death, and loneliness is a problem for her. She wanted to know when I would visit her again. She said that she finds the weekends particularly lonely: it’s when everyone else seems to be going out with their families and enjoying themselves. She asked if I could come next Saturday, and as I wasn’t doing anything else, I agreed.