If your parent or other loved one has spent the majority of their life living independently, it makes perfect sense that they would want to continue to do that into their senior years. And, they would be in good company. According to AARP, nearly 90% of seniors over age 65 wish to remain in their own home for as long as possible.
That may all be well and good if they have a spouse, family member or significant other with whom they can share their home. However, should that person be taken from them and living independently means living completely alone and isolated, the resulting situation is far from ideal.
According to the U.S. Census Bureau, some 28% of people age 65 or older lived alone as of 2010. That equated to 12.5 million people. Of those more than 5 million were determined to need assistance with long-term care to perform activities of daily living. What’s more, of the 60-70% of seniors with dementia living in the community, 25% live completely alone.
That’s millions and millions of seniors who are at risk every day. Among the dangers are:
Poor health, the loss of a spouse or other companion, strain in family relations and lower incomes are all primary causes—whether alone or in combination. What’s more important, however, is that isolation, in turn, leads to loneliness. And loneliness leads to an often invisible, damaging impact on a senior’s physical, mental and emotional well-being.
What is the impact of loneliness on health?
- One study concluded that loneliness results in a 64% increased chance of developing dementia
- Another concluded that its impact is equivalent to smoking 15 cigarettes a day
- A third study concluded that it increases the likelihood of mortality by 26%
- And a fourth study indicated a direct relationship between loneliness in older adults and increases in systolic blood pressure over a 4-year period
While you may be aware of the classic symptoms of depression, you may not know that it may actually appear quite differently in seniors. In fact, many seniors suffering from depression can honestly claim to not actually feel sad at all. Instead, they may complain of a lack of energy, low motivation or have physical complaints without an underlying cause—which makes depression in seniors all the more difficult to recognize and treat.
Unfortunately, depression is estimated to affect some 6 million Americans over age 65, making it all too common. That doesn’t mean that it’s considered to be a normal part of aging. In fact, The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem.
Most importantly, 80% of those seniors could completely recover with proper diagnosis and treatment. If left untreated, the impact of depression in seniors has an even greater impact on physical health, as well.
Left untreated, depression can:
- Worsen symptoms of other illnesses such a heart disease
- Suppress the immune system, raising the risk of infection
- Reduces the ability to rehabilitate
- Lead to disability
- Lead to premature death
- Result in suicide
Combine aging and alone with one or more chronic diseases, impaired vision and the occasional (or more) lapses in memory and you have a prescription for disaster.
On the average, adults between the ages of 65 and 69 take some 14 prescriptions a year. And those aged 80 to 84 take an average of 18 prescriptions a year.
Of those medications, a Health and Human Services study found that as many as 55% of seniors take their medications incorrectly. There is also a growing body of evidence that popular over-the-counter herbal supplements may have toxic effects in combination with prescription medications. As a result, approximately 200,000 seniors are hospitalized annually due to adverse drug reactions.
The most common and potentially dangerous medication mistakes are:
- Taking the wrong dosage of a medication
- Taking the medication at the wrong time, missing a dose or forgetting whether the medication has been taken and taking an additional dose
- Confusing one medication with another
- Poor or even dangerous medication interactions with one another
- Food and drug interactions
- Taking the medication through the wrong route of administration
- Modifying medications by cutting it in half or smashing it to make it easier to swallow
- Storing the medication incorrectly
- Obtaining different prescriptions from different doctors and different pharmacies resulting in neither physician or pharmacy being aware of all medications that are being taken
- Not making your physician or pharmacist aware of any herbal supplements you may be taking in combination with prescription drugs
Granted, someone living with you may not automatically decrease your risk of medication errors. But if you are sharing your life with someone who can go along on doctor’s visits, be aware of what is being treated, assist in reading labels and be present should there be a bad reaction, the chances of a much better outcome are increased substantially.
There’s an old truism that it’s easier to cook for two than one. Unfortunately, when it’s just one, it’s just as true that it’s even easier to not cook at all. That’s due to a number of different physiological, psychological, financial and environmental factors related to aging that come into play when there’s no one else around:
- Taste buds decrease as we age, as does our taste for salty or sweet. As a result, the food we once enjoyed may now taste bitter or sour
- The loss of smell as we age makes food less appealing
- Poor dental health or difficulty swallowing can lead to greater difficulty eating
- Chronic illnesses such as diabetes, hypertension, congestive heart failure, and coronary artery disease are treated with dietary restrictions and medication that may change the taste of food and reduce the appetite
- Due to chronic medical conditions, some seniors may not be able to fully meet their nutritional needs with food alone
- Gastrointestinal changes such as esophageal reflux, constipation or gas may cause seniors to avoid fruits and vegetables
- Due to changes in the hypothalamus and kidney function as we age, seniors often fail to realize that they are thirsty and are less able to conserve fluid, resulting in dehydration
- Declines in functional status (both physical and cognitive) affect a person’s ability to shop for food and to prepare meals
- Depression can contribute to a lack of interest in food
- Alcoholism due to loneliness may interfere with the digestion and absorption of nutrients, while nutrients may also be lacking if alcohol is substituted for food
- Dementia may result in the lack of desire to eat or forgetting about it completely
- Limited income might mean choosing between medicine, housing, and food
- Urban residents who purchase groceries at small neighborhood stores must pay between 3 and 37 percent more than suburbanites buying the same items at grocery stores
- Lack of transportation may reduce access to food
- Fear of falling can prevent regular trips to the grocery store or the use of a hot stove or oven
- Residents of lower-income and rural areas may be living in “food deserts,” where healthy food such as fresh fruit and vegetables are not readily available
- A weakened immune system, which increases the risk of infection and illness
- Poor wound healing
- Depression or lack of energy
- Memory issues
- Increased muscle weakness and decreased bone mass, which can contribute to a higher risk of falls and fractures
- A higher risk of hospitalization for a longer period of time
- An increased risk of death
Greater Risk From Falls
Between age, chronic illness, poor nutrition, mismanagement of medication and no one around to ensure a parent doesn’t have any tripping hazards, the stage is automatically set for seniors who are living alone to be at risk for falls. And, should a fall or other emergency occur, there’s no one else around to help.
According to the CDC, 2.5 million people ages 65 and older visit the emergency department (ED) because of falls—more than any other age group. In fact, according to the National Council on Aging, an older adult is treated in an emergency room for a fall every 11 seconds. And one senior dies from a fall every 19 minutes.
The first fall, unfortunately, is only a precursor to more falls or even death. According to The American Journal of Emergency Medicine, “More than one-third of older adult ED fall patients had an ED revisit or died within 1 year,” making falls the leading cause of both injury deaths and emergency department visits for trauma.
While pets can make great companions and reduce loneliness, also please be aware that they are the direct cause of falls that result in more than 80,000 visits a year to the hospital.
Greater Chance of Missing Symptoms
Keeping track of physical symptoms, mental health and nutrition become all the more critically important as we age. And, when a parent lives with someone else, they can see things that your parent can’t.
According to a 2012 study, adults ages 52 and better have a much higher risk of mortality if they live alone. This is believed to be due in larger part to a reduced social network with fewer people available to notice any change or decline in the senior’s health.
Elder Abuse or Fraud
Think your parent is too smart to be at risk for abuse or fraud? Think again. A recent report notes that one in eighteen “cognitively intact” adults fall prey to financial fraud or abuse every year. That adds up to some $36.5 billion each year. And, if your parent is living alone, the chances are even greater they’ll become a victim without a second set of eyes on any dubious relationships or transactions.
The report further noted that:
- Small losses may indicate a vulnerability for larger ones. A senior who lost as little as $20 to scammers might be expected to lose up to $2,000.
- A senior who receives just one telemarketing call a day is three times as likely to experience a financial loss as another senior who only receives none.
- It is currently believed that 954,000 seniors are skipping meals as a result of financial fraud.
What’s worse, this is only the fraud that has been reported. According to the National Adult Protective Services Association, it’s estimated that just 1 in 44 elder abuse cases is ever reported. Isolation, embarrassment, and unwillingness to report suspicions about a loved one can contribute to this lack of reporting.
The risks of living alone get greater as we get older. However, there are two important things you can do to reduce or even eliminate them. Pay attention to the warning signs. And make sure that any journey along the gray mile in taken with the company of a watchful spouse, other family members, good friend or caregiver.