Older Adults Living Alone

In the United States as of 2020, about 28% (14.7 million) of community-dwelling older adults lived alone, including 21% of older men and 34% of older women. The percentage of people living alone increases with age (ie, among women ≥ 75 years, about 44% 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. About 69% of older men were married compared with 47% of older women and, in 2021, 31% of older women were widows (1). However, in 2021, about 60% of community-dwelling people age ≥ 65 lived with their spouse or partner (2).

Older adults who live alone are more likely to be poor, especially with advancing age. Many report feelings of loneliness, and 25% of those ≥ 65 are considered to be socially isolated (3). In those with health problems or sensory deficits, new or worsening symptoms may be unnoticed. Many have difficulty complying with prescribed treatment regimens. Because they have physical limitations and because eating is a social activity, some older people who live alone do not prepare full, balanced meals, making undernutrition a concern.

Despite these problems, most older people 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 to engage in regular physical activity and social interactions and should provide social work referrals to help them do so.

Coordination and delivery of services during convalescence are difficult for patients 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 patients that help can be obtained if needed.

Since the onset of the COVID-19 pandemic, many community-based mental health and social care providers have increased capacity for technology-enabled outreach and service.