Sociologist Elena Portacolone was surprised when she visited older adults in San Francisco for a research project. Many of them were confused and seemed to have cognitive impairments, yet they were living alone. This led her to wonder how common this situation was and how these individuals were managing.
Portacolone discovered that there was little research on this topic, making this population largely invisible. As a result, she started the Living Alone With Cognitive Impairment Project at UCSF. The project estimates that at least 4.3 million people aged 55 or older with cognitive impairment or dementia live alone in the United States. Many of them struggle with daily activities, but only a third receive help.
These older adults living alone with cognitive impairment are usually older, more likely to be women, and disproportionately Black or Latino. They have lower levels of education, wealth, and homeownership. However, only 21% qualify for publicly funded programs like Medicaid that provide support services in the home.
Without family caregivers to assist them, these seniors are at risk of falling through the cracks in the healthcare system. As their memory and thinking decline, they may face challenges with managing bills, maintaining their homes, or even communicating effectively. This can lead to social isolation, malnutrition, self-neglect, and vulnerability to scams.
Portacolone and other researchers have been following older adults with cognitive impairment who live alone. Many express concerns about trust, forgetfulness, finding help, and hiding their memory issues. People like Kathleen Healy, David West, and Denise Baker shared their experiences of living alone with dementia and the challenges they face in maintaining their independence.
These individuals highlighted the importance of community support, hired help, and planning for the future. They emphasized the need for healthcare providers to ask about living situations to identify those who may need additional assistance. By raising awareness and providing resources for older adults living alone with dementia, we can better support this vulnerable population.