Dr. Suzanne Salamon remembers Ellen as a “tiny, shriveled-up little lady” who, nearing 90, could barely hear anymore. She didn’t have major health problems, but the nuisances and niggling issues of aging were inexorably adding up. And Ellen lived alone, with no family even to check on her.
The latter fact worried Dr. Salamon most. She found herself occasionally fretting about Ellen and her well-being, so she called a local senior center to help the woman periodically. “They were wonderful and took her where she needed to go, which gave me peace of mind,” recalls Dr. Salamon, clinical chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center.
Ellen is a prime example of a phenomenon called solo aging. Defined by AARP as people 50 and older who aren’t married, don’t have living children, and live alone, solo-agers account for steadily growing numbers of older adults in the United States, especially women.
But many of these folks have no idea who will care for them if they become unable to care for themselves. “It’s a concern, because some people are living by themselves without any attachment to the world,” Dr. Salamon says. “They can get lost if they don’t have anybody.”
Provocative proportions
The statistics surrounding solo aging are illuminating. About 8% of adults 55 and older have no biological children and no spouse or partner, according to the U.S. Census Bureau. Women living alone make up the largest proportion — 16% — of non-family households.
A few factors are fueling this trend, including longer life spans — especially among women. “People also aren’t getting married as often as they used to,” Dr. Salamon says.
Beyond that, millions more older Americans who live alone don’t reside anywhere near adult children or other family members such as siblings — or they have strained relationships that stop them from seeking support. About 11% of solo-agers have at least one living child but are estranged from them, according to a 2023 AARP survey of nearly 1,100 solo-agers.
The poll revealed that only a quarter have someone they can count on to help them clean, cook, grocery shop, or handle other household tasks if needed. Fewer than two in five said they knew someone who would help manage their ongoing care. And some just let the void persist: four in five haven’t planned for ongoing living assistance, and only 41% have a living will or advance treatment directive. “They decide not to think about it,” Dr. Salamon says.
Pros and cons
But there can be perks to growing older in your own company. According to the AARP survey, the top three descriptions solo-agers provided of living alone were all positive: 55% said they felt independent, 41% were satisfied, and 30% were happy. The best thing about living alone is the freedom, respondents said.
“I don’t think solo-agers would necessarily say it’s a negative thing,” Dr. Salamon says. “Most are not necessarily unhappy with the way they live.”
The cons, however, form a longer list. Without others bolstering their independence, many solo-agers can be vulnerable to deteriorating physical and mental health, Dr. Salamon says.
The AARP survey highlighted what solo-agers worry about: 78% are concerned about losing their independence; 60% about not being able to stay in their current home; 51% about being moved somewhere against their will; and 50% about needing help with daily activities.
Unmonitored, older adults often uphold habits and living patterns that can chip away at their strength, such as eating scant or unbalanced meals or being extremely sedentary. Issues such as high blood pressure — and even ministrokes — may pass unnoticed. And those who develop cognitive impairments can become a danger to themselves and others.
“They may leave the stove on while cooking. They may break a bone and no one knows,” Dr. Salamon says. “Maybe they notice they don’t walk as well as they used to, so they’re afraid to go out. There are lots of health implications.”
Build your support system
Solo-agers who want to successfully remain independent often build themselves “a little just-in-case community,” says Dr. Suzanne Salamon, clinical chief of gerontology at Beth Israel Deaconess Medical Center.
But it takes time, intention, and effort to assemble a group of people who are willing to jump in and help. She suggests these strategies:
Set up a buddy system. Choose a neighbor or friend and agree to call each other once a day.
Stay in regular touch with loved ones. Ask friends or extended family members to check in with you on a set schedule, “even for a minute,” Dr. Salamon says. Or if it’s routine for them to hear from you, they’ll notice sooner if you don’t touch base.
Combat isolation. Join a community group or take a class to build your social network. Even chatting with the mail carrier, lawn care contractors, or maintenance people can create a web of people who are invested in your well-being and may notice if something is amiss.
Tap senior programs. Many communities offer a Council on Aging or senior center staffed by social workers and others whose mission, at least in part, is to take care of older adults living by themselves. “They may go once a month to check on them or call them to make sure they’re okay,” Dr. Salamon says. Some offer help with shopping or errands.
Filling the gap
In the absence of a partner or children, who can solo-agers turn to if illness or infirmity strikes? Many count on a patchwork that includes siblings, neighbors, friends, grown nieces or nephews, church or synagogue members, community groups, and paid help, according to a study published March 1, 2023, in the Journal of Applied Gerontology.
Siblings may be the best resource since they’re family and may feel a tug of love and responsibility. “Often a sibling will take over for someone who can no longer take care of themselves,” Dr. Salamon says. “It can become the responsibility or the burden, however they choose to look at it.”
Non-family members can also fill the gap, but may not be as emotionally invested in your welfare as a relative, she points out. Relying on neighbors can work well as long as they regularly look out for you.
“I tell people who have older neighbors to be on the lookout — not to assume that people who are aging are just as vibrant as they were. We’re periodically called by a friend who’s noticed something or a neighbor who’s seen the mail piling up or other little signs that things are amiss,” she says. If you don’t see the lights on, or if you see no activity around the house, knock on the door. If you don’t get an answer, call the police.”
Hiring someone to help you — either an aide or a geriatric care manager — is the optimal choice if you can afford it, Dr. Salamon says. “They take people to doctor’s visits, go shopping for them, and touch base regularly with them,” she says. “They basically manage their lives. Sometimes they’re expensive, but if you can afford it, they provide a lot of relief.”
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