Living Alone

In the USA, about one third of the nearly 30 million community-dwelling elderly live alone; four fifths of those living alone are women. Of the oldest old (>= 85 years), one half of those living in the community live alone. Men are more likely to die before their wives, and widowed or divorced men are more likely to remarry than are widowed or divorced women.

The elderly who live alone are more likely to be poor, especially with advancing age. Many report feelings of loneliness (60% of those > 75) and social isolation. In those with health problems or sensory deficits, new or worsening symptoms may go unnoticed. Many have problems complying with prescribed treatment regimens. Because of physical limitations and because eating is a social activity, some elderly persons who live alone do not prepare full, balanced meals, making malnutrition a concern.

Despite these problems, almost 90% of those living alone express a keen desire to maintain their independence. Many fear being too dependent on others and, despite the loneliness, want to continue to live alone. To help them maintain their independence, physicians should encourage them and social workers should help them to engage in regular physical activity and social interactions.

Coordination and delivery of services during convalescence are difficult for those living alone. Physicians should ensure that home care is available and recommend additional services as appropriate. A passive or individually activated emergency response device may reassure a patient that help can be obtained if needed.