Photo: Mrs. Delarta, shown in photo, a 74-year-old Puerto Rican woman, is among the many older Chicago Latinas who feel living alone has its positive sides, but often feels lonely. (Marcela Cartagena/La Raza)
Part 1 of 2 articles.
“The secret to having a good old age is nothing less than making an honest pact with loneliness.” --Gabriel García Márquez
CHICAGO--Millions of adults in the United States ages 65 or older live alone. Although that is positive for many, experts at the Gerontological Society of America [www.geron.org] (GSA) Annual Scientific Meeting last fall indicated that seniors living alone and socially isolated can lead to detrimental health consequences worse than smoking and hypertension.
“The consequences of living alone and isolated include higher mortality levels, sleep deprivation, cognitive deficiency and just about any health problem you can imagine,” said Harry Taylor, a
Meet Ms. Olga
The first time I meet Ms. Olga (who asked not to include her last name) through a hospice program where I volunteer, I see an old woman whose teeth and hair are almost all gone. Her small and tired eyes are sunken in deep dark circles, and her lips are severely chapped.
Ms. Olga lives in a gloomy room where there is not a single plant or picture, much less a flower. The lamp on her nightstand doesn’t work, and the daylight rarely enters the room because the window blinds are always shut.
I visit her once a week and every time I enter her room, located in a Chicago healthcare facility for seniors, I always see the same scene: She is lying on her bed in a fetal position, watching gossip shows on Telemundo on a tiny television.
Ms. Olga suffers from severe arthritis in her knees and Parkinson’s disease, which keeps her from being able to move her legs or even be in a wheelchair. (Her last name is kept confidential as per her hospice program's request.)
But despite her medical condition, I get the feeling that her loneliness is crueler. Her family had abandoned her. A couple of nurses and I are the only people in this world with whom she can talk. In essence, I’m the only person she can converse with because she doesn’t speak English and the nurses who care for her don’t speak Spanish.
“Sometimes my mouth gets so dry because I never speak to anyone,” she tells me.
Ms. Olga laments her physical pain, but more often tells me with teary eyes that her son doesn’t visit her anymore. She narrates incoherent stories and I begin to suspect she has early signs of Alzheimer’s. Although she is age 78, strangely she believes she is 48.
Curiously, she always remembers my name when I greet her. And when it is time for me to leave, she never fails to say, “Thank you so much for coming to see me. You are my only friend. Come back soon, por favor.”
There are millions of cases like Ms. Olga’s: elderly people who live and are left alone, whether they are in their own homes or rehabilitation nursing facilities. But there are also millions of others in good health, who end up living alone for many reasons: they want to be independent; they have lost their partners; their children and relatives move away, among other circumstances. Whatever the case, elders living alone in this country can be a complex problem.
In April, Ms. Olga died in the nursing home facility where she was living shortly after this article was written.
--Marcela Cartagena
doctoral candidate at Washington University in St. Louis, who presented the findings at the GSA conference.
He added that older adults who are socially integrated have stronger mental health, feel more satisfied with their lives and are less prone to suffer from depression. “We know that if someone lives in an environment surrounded by people who love you, care for you and support you, those things do wonders to your health,” Taylor said.
For Latinos, Familismo Is Essential
Older adults in the U.S. will double by 2040, said Steven Wallace, who directs the national coordinating office of the Resource Centers for Minority Aging Research at University of California, Los Angeles.
Poverty among ethnic elders is a key concern: National Institute of Aging shows that 21 percent of Latinos 65-plus live in poverty compared to 17.7 percent of black seniors and 7.4 percent of whites.
Social isolation can especially affect older Hispanics. Strong ties with family members are essential in Latino culture, a tendency sociologists call familismo, a system where family is the number one priority.
“The connection among family members is extremely important because it gives them a sense of harmony and happiness, even when there are conflicts among them,” said Elise Hernández, of the University of Michigan, who also presented her findings at the conference.
“However,” she said, “familismo could diminish among the new generations born in the United States because they find themselves submerged in a culture where work and success takes priority over family. This could create pressure and confusion in new generations.”
‘Elder Orphans’
A recent New York study presented at American Geriatrics Society 2015 conference found that more than one-in-five older Americans are at risk of living the rest of their lives completely alone. Lead researcher by María Torroella Carney, MD, chief of geriatrics at Long Island Jewish Medical Center and North Shore University Hospital, calls them “elder orphans.”
She observed, “We have a sense that this will be a growing population as society ages and life expectancy increases, and our government and society need to prepare how to advocate for this population,” she said in a press statement.
Carney emphasized that because this population is hidden right before us, “Our goal is to highlight that this is a vulnerable population that’s likely to increase, and we need to determine what community, social services, emergency-response and educational resources can help them.”
Also, Stephen Golant, a social geographer at the University of Florida, Gainesville, noted that 85 percent of older adults say they want to age in their own homes and communities.
“People are most attached to their homes, belongings, neighborhoods,” said Golant, author of Aging in the Right Place (Health Professions Press, 2015). Older adults who live on their own may also experience a myriad of issues such as feeling of loneliness, malnutrition, finances, transportation, and falling with no one around to help them. “Many feel like their lives are out of control, and they get into an emotional battlefield because they start to feel incompetent,” he said.
Golant explained that Hispanics, including many who are middle class, are especially at risk because they have less money and can’t afford the high cost of eldercare.
Factors for Being Alone
Elena Portacolone of the University of California, Berkeley, listed several factors causing many seniors to end up alone. Among them are “the death of a partner, the desire not to be a burden, distance from the family of origin, lack of a kin, attachment to a location,” she said.
Portacolone continued that some people have “negative experiences with romantic partners, adult children, friends, [which] also can contribute to their decision. Some have their spouses in a nursing home because they could not afford private care.” She added that one of her main findings “is that most of these persons were living a precarious life.”
Also, though, Portacolone said her research show that many older adults enjoy the freedom associated with living alone: “It is a sign of independence, a deeply rooted value in the United States. For some it is an important achievement, it allows the expression of one’s preferences, but it can also bring out hardships.”
The lack of financial freedom can also affect the experience of living alone when older adults don’t own their own home and don’t have enough money to pay rent leaving them no choice but to move into single-room-occupancy hotels in poor inner-city neighborhoods.
“This is the case for minorities especially, some of these rooms do not have a bath or toilets because bathrooms are down the hall, and space is so compressed that there is barely room for a mattress,” Portacolone said.
Along with other researchers, Portacolone has pointed to other issues that elders living alone can face, such as the loss of their driver’s license. That can trigger issues with transportation compounded by ageism, low income, grief from losing of a partner, boredom and a feeling of low self-esteem.
Those Portacolone interviewed for her research often brought up the issue of loneliness before she asked. She recalled one woman who would sometimes go outside to watch the sunset near her apartment complex with a view to the San Francisco Bay Bridge. She said she hoped to meet somebody else from the apartment complex, but no one ever came.
U.S. Long-Term Care Incomplete
A primary issue is that the U.S. long-term care system is incomplete and depends mostly on families. Medicare covers only brief continuing care following a hospital stay, and those without very limited private long-term care insurance much pay down their savings until they can qualify for Medicaid, a poverty program.
“The goal would be to allow these people to live and stay in their homes until they die, which is something that is not happening in the U.S.," Portacolone said. “In Denmark, for example, older adults don’t have to have Medicaid to receive home care aid. The problem is not that we are living alone, the problem is that there are no services that help us to live alone at an older age.”
Marcela Cartagena wrote this article in Spanish for La Raza in Chicago, as well as this English translation, with support from the Journalists in Aging Fellowships, a program of New America Media and the Gerontological Society of America, sponsored by the Silver Century Foundation.This series, translated into English by the author, is adapted from her three-part La Raza
series. Read the original stories in Spanish: Part 1, Part 2 and Part 3.