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This exploratory study examines older women's perceptions of living alone. Older adult women (N = 53) living alone were interviewed. Findings show tremendous variability in the perceptions of this sample. Whereas some women showed significant levels of loneliness and depression, many did not. Thirteen percent of the participants (n = 7) negatively perceived living alone, 49.1% (n = 26) neutrally perceived living alone, and 37.7% (n = 20) positively perceived living alone. Participants' most enjoyed aspects of living alone were being one's own boss/being independent (51%) and keeping one's own schedule (49%). Common responses for least enjoyable aspects of living alone were lack of companionship (62%), no one to help with housework (36%), and fear of falling or getting hurt (30%). Nurses should be aware that although some have perceived older adult women living alone as a vulnerable population, one cannot make assumptions based on living arrangements.
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Perceptions of Living Alone Among
Older Adult Women
Elaine M. Eshbaugh
University of Northern Iowa
This exploratory study examines older women’s perceptions of living alone. Older adult
women (N= 53) living alone were interviewed. Findings show tremendous variability in the
perceptions of this sample. Whereas some women showed significant levels of loneliness
and depression, many did not. Thirteen percent of the participants (n= 7) negatively per-
ceived living alone, 49.1% (n= 26) neutrally perceived living alone, and 37.7% (n= 20)
positively perceived living alone. Participants’ most enjoyed aspects of living alone were
being one’s own boss/being independent (51%) and keeping one’s own schedule (49%).
Common responses for least enjoyable aspects of living alone were lack of companionship
(62%), no one to help with housework (36%), and fear of falling or getting hurt (30%).
Nurses should be aware that although some have perceived older adult women living alone
as a vulnerable population, one cannot make assumptions based on living arrangements.
In recent decades, there has been a significant increase in the number of people who live
alone (Chandler, Williams, Maconachie, Collett, & Dodgeon, 2004). Living arrange-
ments have shifted toward living alone for older adults in particular (Kramarow, 1995).
At the turn of the century, only 12% of widows age 65 and older lived alone, whereas
70% resided alone in 1990 (Kramarow, 1995). Women, compared to men, are more likely
to live alone (Davis, Moritz, Neuhaus, Barclay, & Gee, 1997). It is not surprising, that un-
married women ages 80 and older are more likely to live alone than men of the same age
group (Zimmer, 2005). This difference is present mainly due to the increased life expec-
tancy of women and the tendency for women to marry men older than themselves, as the
death of a spouse is a primary reason people transition into living alone (Bureau of the
Census and National Institute on Aging, 1993; Kinsella, 1995). In addition, a growing
number of older women are experiencing divorce in later life (Nakonezny, Rodgers, &
Journal of Community Health Nursing, 25:125–137, 2008
Copyright © Taylor & Francis Group, LLC
ISSN: 0737-0016 print/1532-7655 online
DOI: 10.1080/07370010802221685
Correspondence should be addressed to Elaine M. Eshbaugh, 241 Latham Hall, University of Northern
Iowa, Cedar Falls, IA 50614–0332. E-mail:
Nussbaum, 2003; Stroup & Pollock, 1999), an occurrence that in the past was considered
Although maintaining a household with a spouse is typical for married older adults,
the living arrangements of unmarried older women (e.g., widowed, divorced) are much
more variable. Historically, older women moved in with adult children after the death of a
spouse (Macunovich, Easterlin, Schaeffer, & Crimmins, 1995). According to some (e.g.,
Costa, 1999) this significant change in the living arrangements of older women has had a
profound effect on the lives of aged women in both North America and Europe. This
change has impacted elder women’s lives in the areas of mental, physical, and financial
health. Although the demographic changes in living arrangements in this population are
substantial, it has been suggested that gerontologists have not adequately addressed the
needs of older adult women who live alone (Jenkins, 2003).
Why has the proportion of older adults, particularly older adult women, living alone
increased so substantially through the 20th century? Kramarow (1995) presents three
possibilities. First, the decline in fertility has decreased the number of available adult
children that older adults may choose with which to reside. Second, older adults in recent
decades have had increased incomes and are able to support their own residences with
less of a financial struggle than in the past. Third, it has been suggested that modern cul-
ture has changed to a more individual (vs. family) focus, and therefore living alone is
more desirable for today’s older adults than for older adults of the past who had a stronger
desire to live with family. In other words, today’s older adult values independence more
than yesterday’s older adult.
Some research suggests that elders who live alone may be vulnerable to physical and
mental health problems and therefore deserve special attention from social workers,
community nurses, and other professionals. Typically, older adults who live alone have
an increased risk of infections, falls, dehydration, and injuries (Campion, 1996). Unfor-
tunately, it is not unusual for emergency medical services to find older adults living
alone, particularly older women, helpless or even dead in their homes (Gurley, Lum,
Sande, Lo, & Katz, 1996). This is referred to by Campion (1996) as being “found down”
(p. 1738). Because older adults who live alone may not be able to summon help, this dis-
covery often is a result of a neighbor noticing they have not seen an elder for several days.
Data suggest that 3.2% of older adult men and women age 65 years and older who live
alone will be found down each year (National Center for Health Statistics, Cohen, & Van
Nostrand, 1995).
Living alone may be related to declining health for older women with severe health
impairments. Among a group of severely impaired elderly women in Baltimore, those
who lived alone had a greater deterioration of functioning when compared to those living
126 Eshbaugh
with others (Sarwari, Freedman, Langenberg, & Magaziner, 1998). Research on the older
adult population in Hong Kong has suggested that elders who live alone, compared to
those who live with others, perceive their health more negatively (Chou & Chi, 2000). El-
ders who live alone are also more likely to enter a nursing home than elders who live with
others (Steinbach, 1992; Wolinsky, Callahan, Fitzgerald, & Johnson, 1992).
There may also be psychological ramifications of living alone for this population. Ac-
cording to Dean, Kolody, Wood, and Matt (1992), living alone may play a role in the de-
velopment of depression. Mui and Burnette (1994) also report higher rates of depressed
mood among elders living alone. Furthermore, a recent study of community-dwelling in-
dividuals ages 75 years and older suggests a strong positive relationship between living
alone and loneliness (Routasalo, Savikko, Tilvis, Strandberg, & Pitkala, 2006), a finding
corroborated by other studies (e.g., Chou & Chi, 2000; Mui & Burnette, 1994). A study
of community-dwelling Chinese elders (60 years and older) suggests that life satisfaction
may be lower for older adults living alone when compared to older adults in other com-
munity living situations (Chou & Chi, 2000).
International, national, and local policy has recognized the need to decrease social isola-
tion and loneliness among older adults to improve elders’quality of life (Cattan, White,
Bond, & Learmouth, 2005). Although many of these policies target older adults living
alone, living alone is not equal to being lonely (Yeh & Lo, 2004), and some have sug-
gested that elders who live alone are not a group deserving of high-risk status (Iliffe et al.,
1992). In fact, living alone is a highly valued way of life for older adults who desire to re-
main independent (Yeh & Lo, 2004). It is not surprising that older adults who value pri-
vacy also strongly prefer their own residence (Kim & Rhee, 1997). Although some may
assume that these elders living alone are in need of special intervention services, a body
of research suggests that they may not have greater physical and mental health needs
when compared to older adults in other community living situations.
Some research on the mortality rates of those who live alone has suggested that living
alone does not negatively impact survival (Davis et al., 1997; Davis, Neuhaus, Moritz, &
Segal, 1992). In fact, some research (e.g., Zimmer, 2005) has indicated that older unmar-
ried women living alone are less limited by health factors than older unmarried women
who live with their adult children or others. In addition, a recent study of older adults liv-
ing in New Mexico (both men and women) indicated that elders living alone did not have
higher rates of health problems such as diabetes, hypertension, arthritis, emphysema, and
asthma (Tomaka, Thompson, & Palacios, 2006). When subjective ratings are used to
measure health, older adults living alone rate their health more positively than older
adults living with others (Mui & Burnette, 1994). In sum, older adult women who live
Perceptions of Living Alone 127
alone seem to be no less healthy than other older adult women, and some studies even
find that they are healthier than their counterparts who live with others.
Qualitative research has pointed to the strong meaning of home to older adult women
living alone (Swenson, 1998). The sense of self appears to be connected to the home en-
vironment, and some women feel an attachment to the home that they are committed to
maintaining for as long as possible. Homes give meaning to their lives, and maintaining a
home is key to independence (Letvak, 1995). Women may also prefer the living arrange-
ment of their own home to “keep the generations separate” (Porter, 1998, p. 401) and not
burden adult children. This symbolism and importance of the home environment may be
important for professionals working with older adult women because the home may play
a somewhat intangible role in maintaining and improving women’s physical and mental
Although authors (e.g., Findlay, 2003) have suggested that the increase in older persons
living alone should trigger concern of social isolation, there are older adult women who
live alone and are resilient from social isolation and loneliness (Letvak, 1997). Some
older adult women even see later life aloneness as an opportunity to establish creativity
and new meaning in life. There is great variability in older women’s perceptions of living
alone and the perceived advantages and disadvantages of the living arrangement. How-
ever, little research has acknowledged elder women’s perspectives on living alone (Por-
ter, 1994). In this descriptive study, a strengths approach was taken to examine the sub-
jective perceptions older adult women living alone have of their living arrangements.
Older women were divided into three groups (negative, neutral, and positive) regarding
their perception of living alone. In addition, older women’s responses to questions about
their likes and dislikes about living alone and their levels of loneliness and depression
were explored.
Participants were 53 older adult women (age 65 years and over) who lived alone in the lo-
cal community. Women were recruited through flyers posted at senior centers, physical
therapy clinics, doctors’offices, urgent care clinics, community libraries, bookstores, and
quilting stores. Interested participants were asked to call the researcher to determine their
eligibility and set up an appointment for an interview. Women ranged in age from 65
years to 93 years. All participants identified themselves as White/European-American.
128 Eshbaugh
Forty participants (75%) were widowed, nine participants (17%) were divorced, and 3
(6%) had never married. The remaining participant’s husband was in a nursing home with
end-stage Alzheimer’s disease. Among the 40 widows, the mean number of years since
being widowed was 12.1 (SD = 11.04, min = 0, max = 53). Of the 53 participants, 5 (9%)
indicated that their highest level of education was “less than high school,” 32 (60%) indi-
cated “high school diploma/GED,” and 16 (30%) indicated they had attended at least
some college. All except for three participants (94%) had worked outside the home dur-
ing their life, and five (9%) were currently working part-time (ranging from 5 to 20 hr per
week). Seventy-nine percent (n= 42) of the participants owned their own home. Exclud-
ing the never-married participants, only four (10%) women had lived alone before their
marriage. Only one of the four lived alone for longer than 6 months before marrying. The
remainder moved directly from their parent(s)’home into a residence with their husband.
Although the group overall was in good health, 29 participants (55%) indicated symp-
toms of arthritis and 7 (13%) indicated they had diabetes.
Whereas one woman preferred to be interviewed at a local restaurant, the remainder of
interviews were conducted in the participants’ home. Interviews lasted approximately 1
hr and participants were compensated with a $15 gift certificate for their time. Data col-
lection began in July of 2007 and ended in November of 2007. With the exception of
measures of depression and loneliness, the questionnaire used in this study was con-
structed by the researcher.
Perceptions of living alone.
Participants were asked the following open-ended
question: “How do you feel about living alone?” All of the responses were coded as posi-
tive, negative, or neutral by the researcher. A graduate student then coded 100% of the re-
sponses to determine interrater reliability (94%). Although many participants responded
with several advantages and disadvantages of their living arrangement, the first response
given by the participant was decided to be most important for coding purposes.
Most and least enjoyable aspects of living alone.
All participants were asked
to list the three most enjoyable and three least enjoyable aspects of living alone. Most, but
not all participants were able to provide three responses for both items.
The 10-item short-form Center for Epidemiological Studies Depres-
sion Scale (CES-D; Radloff, 1977), a self-report measure designed for the general popu-
Perceptions of Living Alone 129
lation, was used to assess depressive symptoms in participants. Respondents indicate
how many times per week they experienced each item, using a scale ranging from rare or
none of the time to most or all of the time. The internal consistency for the 20-item mea-
sure has been shown to be .85 for the general population (Radloff, 1977). Higher scores
indicate more symptoms of depression. It should be stressed that this scale measures de-
pressive symptoms and does not determine a clinical depression diagnosis. However, a
cut-off of greater than or equal to 8 has been used to indicate the presence of clinically
relevant depressive symptoms. This measure has been validated for use with older adults
(Irwin, Artin, & Oxman, 1999). Possible scores range from 0 to 30, and Cronbach’s alpha
in the present study was .80.
The UCLA Loneliness Scale, a 20-item measure, was used to measure
loneliness (Russell, Peplau, & Cutrona, 1980). The scale assesses general, or global lone-
liness, and is one of the most widely used loneliness measures. The scale uses a 4-point
system (1 = I have never felt this way,to4=I have felt this way often). Possible scores
range from 20 to 80, with higher scores indicating higher levels of loneliness. Perry
(1990) indicated ranges of 20–34 for low levels of loneliness, 35–49 for moderate levels
of loneliness, and 50 and higher for moderately high or high levels of loneliness.
Cronbach’s alpha in the present study was .84.
Other variables
Participants were also asked to provide the following ratings and
indications: their health on a scale of 1–10, their closeness to neighbors on a scale of 1–3,
how many close friends lived within 50 miles of their home, how many hrs a week they
spent volunteering, their fear of living alone and the difficulty of living alone on a scale of
1–10, their daily level of pain on a scale of 1–10, and how many days per week they typi-
cally drive. In addition, participants were asked questions about their family and marital
Perceptions of Living Alone
Thirteen percent of the participants (n= 7) had responses coded as negative, 49.1% (n=
26) had responses coded as neutral, and 37.7% (n= 20) had responses coded as positive.
Examples of negative, neutral, and positive responses are displayed in Table 1. Table 2
displays means of study variables by group (negative, neutral, and positive) and for the
sample as a whole. Because of the small sample size (and the particularly small number
of participants in the negative group), no inferential statistics were performed on this
130 Eshbaugh
data. Although caution should be applied when making conclusions based on group com-
parisons, it may be useful to look at trends in the descriptive data. The positive group was
the youngest group (M= 72.45 years; SD = 7.63), and the negative group was the oldest
(M= 82.71 years; SD = 5.31). In addition, self-rated health appeared to differ between the
three groups; the positive group’s self-rated health mean was 8.20 (SD = 2.04), whereas
the neutral (M= 7.19; SD = 2.17) and negative (M= 6.57; SD = 1.90) groups perceived
their health more negatively. Interestingly, the negative group had lived alone (M= 6.71
years; SD = 3.63) for about half of the length of time of the neutral group (14.39 years; SD
= 15.76) and the positive group (12.60 years; SD = 9.58). The negative group (M= 7.71;
SD = 2.28) also perceived the difficulty of living alone as greater than the neutral (M=
3.88; SD = 2.28) and positive (M= 2.30; SD = 1.45) groups. The negative group (M=
9.71; SD = 2.87) appeared more depressed than the neutral (M= 8.65; SD = 5.84) and
positive (M= 4.35; SD = 4.35) groups.
Perceptions of Living Alone 131
Examples of Negative, Neutral, and Positive Responses
Negative (n = 7) Neutral (n = 26) Positive (n = 20)
“I don’t like it but there’s nothing I
can do.”
“I don’t mind it.” “I enjoy it. I do what I want. I love being
so blinkin’ independent.
“I hate it.” “I get along okay. “I’m perfectly content here.”
“It’s really lonely.” “I’m used to it now. “I love it.
“I can’t stand the quiet.” “It’s better than a nursing home. “I could never live with someone else
ever again.
“It surely wouldn’t be my choice.” “It’s alright. I can handle it okay. “I didn’t think I’d like it as much as I do.
“It’s the hardest adjustment I’ve had
to make in my life.”
“It’s not easy, but being here is my
“It certainly has its advantages.”
Differences by Response Type
Negative (n = 7) Neutral (n = 26) Positive (n = 20) Total (N = 53)
Age 82.71 (5.31) 78.50 (8.18) 72.45 (7.63) 76.77 (8.37)
Length of time (yrs.) lived alone 6.71 (3.63) 14.39 (15.76) 12.60 (9.58) 12.71 (12.68)
Number of living children 5.14 (1.46) 2.19 (1.74) 4.20 (1.47) 3.33 (1.97)
Children living within 50 miles 2.85 (.89) 1.04 (1.40) 2.35 (1.87) 1.77 (1.69)
Health (1–10) 6.57 (1.90) 7.19 (2.17) 8.20 (2.04) 7.49 (2.14)
Neighbor closeness (1–3) 2.71 (.49) 2.15 (.88) 2.40 (.68) 2.32 (.78)
Friends w/in 50 miles 1.86 (2.34) 2.27 (3.82) 2.45 (2.16) 2.28 (3.07)
Volunteer hours 1.43 (2.93) 2.92 (4.68) 2.40 (4.59) 2.52 (4.41)
Fear (1–10) 2.14 (2.19) 2.08 (1.85) 2.50 (2.14) 2.25 (1.98)
Difficulty (1–10) 7.71 (2.28) 3.88 (2.76) 2.30 (1.45) 3.79 (2.82)
Pain (1–10) 4.28 (1.98) 3.38 (1.96) 3.35 (2.56) 3.49 (1.69)
Days drive 2.57 (1.51) 4.88 (2.80) 4.20 (2.42) 4.32 (2.60)
Loneliness 29.14 (3.53) 30.12 (8.54) 26.90 (6.31) 28.77 (7.30)
Depression 9.71 (2.87) 8.65 (5.84) 4.35 (2.80) 7.17 (5.02)
Most and Least Enjoyable Aspects of Living Alone
Participants were also asked about the three most and least enjoyable aspects of living
alone. Ten of the 53 participants (19%) were unable to come up with three enjoyable as-
pects, and two participants (4%) said there were no enjoyable aspects. Common re-
sponses were being one’s own boss/being independent (n= 27; 51%), keeping one’s own
schedule (n= 26; 49%/), being able to eat what one wants (n= 22; 42%), having control
of the TV/remote control (n= 20; 38%), having quiet around the home (n= 9; 17%), not
having to cook (n= 7; 13%), not having to take care of anyone (n= 6; 11%), not feeling
obligated to keep the home clean (n= 5; 9%), and having the bed to one’s self (n= 3; 6%).
Nine of the 53 participants (17%) were unable to come up with three aspects of living
alone that they did not find enjoyable, and three participants (6%) responded that there
were no aspects of living along that they did not enjoy. Common responses for least en-
joyable aspects were lack of companionship/no one to share things with/loneliness (n=
33; 62%), no one to help with housework (n=19; 36%), fear of getting hurt/falling (n=
16; 30%), no one to help make decisions (n= 9; 17%), home is too quiet (n= 9; 17%), and
home maintenance (plumbing, electrical, yard work; n = 8; 15%).
Depression and Loneliness
Actual CES-D scores ranged from 1 to 19 (possible range 0 to 40). Overall, 41.5% (n=
22) of participants had a score equal to or greater than 8 on the CES-D short form, indi-
cating depressive symptoms of clinical significance. Within the negative group, 71.4% (n
= 5) of the participants had depressive symptoms of significance. This percentage was
53.8% (n= 14) for the neutral group and 5% (n= 3) for the positive group. Actual loneli-
ness scores ranged from 20 to 45 (possible range 20 to 80). Examination of the entire
sample revealed that no participants reached moderately high levels of loneliness, and
22.6% (n= 12) indicated moderate levels of loneliness. Whereas no women in the nega-
tive group reached moderate levels of loneliness, 38.5% (n= 10) of the women in the neu-
tral group and 10% (n= 4) of the participants in the positive group indicated moderate
levels of loneliness.
This data points to the tremendous heterogeneity in older adult women’s perceptions of
living alone. Although participants lived in the same area and identified with the same
ethnic background, women’s perceptions of living alone ranged from extremely negative
to extremely positive. In addition, most women viewed living alone as neither all positive
132 Eshbaugh
nor all negative. Most (64%) were able to identify both positives and negatives to their
living arrangement.
Only seven of the 53 participants perceived living alone negatively. The vast majority
of women in this study (87%) viewed living alone either positively or neutrally. This is
not to imply that this 87% did not see negative aspects of living alone. However, when
asked how they felt about living alone, their first response was not negative. The majority
of the women in this study were living alone for the first time in their lives; most did not
live alone before marriage. The findings imply that although many women must adjust to
living alone for the first time late in life, they are able to successfully adapt to their new
living arrangement. Professionals should be encouraged by this, particularly when one
considers that several women who perceived living alone positively lost their husband to
death when they were 75 years old or older.
Which women appear to be likely to perceive living alone negatively? Although the
sample size was too small to perform inferential statistics, future researchers may want to
explore some of the trends seen in this sample. For instance, women who negatively per-
ceived living alone appeared to be older; however they also had lived alone for a shorter
period of time. It would be useful to determine whether these trends are evident in larger
data sets. Participants who negatively perceived living alone were also likely to be in
poorer self-reported health than other participants. Only longitudinal datasets with larger
samples could determine whether a person’s perception of living alone changes as their
health, age, and time living alone change.
What do older adult women enjoy about living alone? Although many mention the
value of independence, many participants also mention what could be considered small
pleasures: having control of the remote and TV, being able to eat when one wants, having
the bed to one’s self, and not having to cook. In fact, several women confided that widow-
hood brought the revelation that after 40 years of cooking, they really didn’t like to cook
at all! Of course, other women may miss having loved ones for which to cook. What do
older adult women dislike about living alone? More than half of the participants cited
having no one to share day-to-day experiences with, or lack of companionship. Although
most were not significantly lonely overall, this implies that they do sometimes experi-
ence aspects of loneliness. Women also mentioned having no one to help with housework
and home maintenance as well as fear of falling as disadvantages of living alone. Perhaps
these responses reflect the participants’ fear of having to leave their home because they
cannot keep up with home tasks or are unable to maintain physical safety. Previous re-
search (e.g., Letvak, 1997; Swenson, 1998) has suggested the importance and value of
maintaining one’s home environment for similar women.
About 40% of the participants showed clinically significant symptoms of depression.
However, this should be interpreted with caution because the measure used (CES-D)
does not diagnose depression. Although a significant majority reported clinically signifi-
cant depressive symptoms, the range of scores (1 to 19) was large. In fact, 17% of the
sample scoreda1onthemeasure. In summary, some older adult women have significant
Perceptions of Living Alone 133
depressive symptoms, but many do not. This heterogeneity emphasizes the importance of
assessing depression rather than making assumptions based on an older adult woman’s
living situation. Although participants showed varying levels of loneliness, none of the
participants indicated levels of significant loneliness reaching more than moderate. This
finding is encouraging, as this group of women seems to have maintained satisfying so-
cial networks despite living alone. Although this may not be true for all older adult
women living alone, this sample suggests that for women elders, living alone does not
necessarily equate to loneliness.
Although this exploratory study has yielded interesting and useful findings, conclu-
sions must be limited for several reasons. The small, homogeneous, convenience sample
included 53 European-American older adult women living alone. Obviously, this study
may lack generalizability. On a scale of 1 to 10, women’s responses regarding their
self-perceived health ranged from 3 to 10. However, the mean (7.49) indicated that this
was a sample in good health. This is not surprising, because women in poorer health
might be unlikely to initiate involvement in the study. Older adult women living alone
who perceive their health as very poor are certainly a population deserving of more atten-
tion. Women in our sample also averaged 2.5 hrs per week of community service work
(mostly through church). This indicates that perhaps women who wished to be involved
in the study were more active and community-minded than other women living alone.
Older adult women who live alone and are quite isolated from the community may have
not been included in our sample. In addition, this study was cross-sectional rather than
longitudinal. Data yielded a snapshot of older adult women living alone, whereas a longi-
tudinal study might tell a story that it is not possible to uncover with this methodology. It
is impossible to determine how perceptions of living alone may change across time with
cross-sectional data collection. It would be reasonable to assume that feelings about liv-
ing arrangements are dynamic rather than static, but this study cannot address this as-
sumption. For instance, some longitudinal research using small samples (e.g, Morrissey,
1998) suggests that women who live alone tend to see a change in the nature of interac-
tion (from independent to dependent) as time progresses.
How would this information be used by community nurses? Nurses should be aware that
although some have perceived older adult women living alone as a vulnerable population,
these women vary tremendously and one cannot make assumptions based on living ar-
rangements. Whereas some older adult women living alone may be in need of services
that provide social connection, many are not. Some women may be at-risk for depression,
but others are very satisfied with their lives and living situations. The only way to distin-
guish these women is to thoroughly assess them as individuals. Furthermore, similar fea-
tures of living alone may be perceived differently by different women. For instance,
134 Eshbaugh
many women mentioned that their house was “quiet.” However, some indicated this was
a positive and others indicated this was a negative. Participants also mentioned a change
in eating and cooking habits when transitioning to living alone. Yet, several women saw
being able to eat when they wanted and to only cook when they felt like it as a perk of liv-
ing alone. Others missed sitting down to a meal with a loved one. When a woman indi-
cates to community nurses that her home is quiet or that she doesn’t cook anymore, the
nurses should take the time to determine whether the woman views that as an advantage
or disadvantage of her living arrangement. This understanding will help to ensure clients’
voices are heard when suggesting programs and interventions.
Nurses should also be aware of the enjoyment that older adult women may obtain from
living alone, even if it requires an adjustment late in life. This enjoyment may make older
adult women more resistant to suggestions of a change in living arrangement, whether
that suggestion is to move in with family or to a facility (e.g, assisted living, nursing
home). A change in living situation may require giving up control of the remote and the
flexibility to eat when one wants, both of which were appreciated by the participants in
the study. Also, when providing information about resources, nurses should be aware
than many women’s dislikes about living alone pertain to not having help with house-
work and home maintenance. Perhaps providing suggestions about obtaining assistance
in these areas, particularly at a low-cost, would help women to increase their enjoyment
of living alone. Many women also indicated a fear of falling in the home. Nurses can pro-
vide information about services that alert loved ones and emergency services to a prob-
lem with the elder. Perhaps by helping women obtain resources to minimize these dis-
likes, nurses can assist elder women, particularly those who perceive living alone
positively, in remaining in their homes. As a nurse, one should recognize that even older
adult women who have never lived alone before can successfully adapt to their new living
arrangement and learn to appreciate the small pleasures of living alone.
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Perceptions of Living Alone 137
... A vida a solo em idades mais avançadas está tam-bém associada a mais comportamentos de risco (Mudražija et al., 2019) e ao aumento da mortalidade precoce (Holt-Lunstad et al., 2015). No entanto, a literatura não é consensual e alguns estudos têm defendido que viver só, em idades avançadas, não está necessariamente associado a maior risco de mortalidade (Abell & Steptoe, 2021) e pode até contribuir positivamente para a vida dos adultos mais velhos (Eshbaugh, 2008;Walker & Hiller, 2007). ...
Em países com fortes tradições familialistas, os estudos científicos associam frequentemente a vida a solo, a sentimentos de solidão, que têm consequências negativas para o bem-estar de adultos mais velhos. Nas sociedades atuais, é inegável o papel desempenhado pela internet enquanto meio de comunicação. Tendo em conta este facto, visa-se analisar o papel que desempenha a internet na relação entre a vida a solo e a solidão, nos países do Sul da Europa. O presente estudo incide sobre uma amostra de 17228 indivíduos de 50+ anos, residentes em Portugal, Espanha, Itália e Grécia que foram inquiridos na vaga 6 do projeto Survey of Health, Ageing and Retirement in Europe (SHARE). Conclui-se que os indivíduos mais velhos que vivem sós e utilizam a internet manifestam, com menos frequência, sentimentos de solidão que os seus pares (indivíduos do mesmo escalão etário). Os resultados deste estudo reforçam, pois, a importância de políticas que visem a inclusão digital.
... The theme of ownership related to ideas around control and choice. This is commensurate with much of the literature in that a sense of choice over a person's own situation or aspects of an individual's life was related to increased wellbeing (Letvak, 1997;Eshbaugh, 2008;Hammarstrom, 2011). This was evident to some degree in the experiences shared in this study, as the women valued the freedom to make their own choices and appeared to nd it challenging when choices were limited or denied such as in the case of Covid restrictions or ill health. ...
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Background and Objectives More people are living alone across the life course: in later life this can have implications for practical and psychosocial support. The Covid pandemic emphasised the importance of this when the UK government restricted movement outside of households to limit the spread of disease. This had important ramifications regarding social contact and practical support. The objectives of this study were to explore the experience of older women living alone during this time, with a focus on health and wellbeing. Research Design and Methods This study used an Interpretative Phenomenological approach. Semi-structured interviews were undertaken with seven women (aged 65+), living alone in the UK. Interviews were carried out between May and October 2020. Interpretative Phenomenological Analysis was used to analyse the transcripts. Results Findings show that life course events shaped how living alone was experienced in later life. Convergences and divergences in lived experience were identified. Three superordinate themes emerged from the Interpretative Phenomenological Analysis: Productivity, Ownership, and Interconnectedness. Discussion and Implications Findings highlight the importance of life course events in shaping the experience of later life. They also provide a better understanding of the lived experience of living alone as an older woman, increasing knowledge of this group and how living alone can affect health and wellbeing. Implications for research and practice are discussed, such as the importance of recognising the specific support needs for this group in later life, and the need for further knowledge about groups whose needs are not met by standard practice.
... However, with the development of our society and increasing preferences for individual privacy and independence, recognition of older adults on living alone is changing. Some studies have found that LWC could increase dependence, family obligations, losses of privacy, and self-determination, thus speeding up agerelated loss of physical ability (2, 28), while LA older adults have more free time and less family obligations and other constraints, which may help them to be more socially active (29). Additionally, LA has been demonstrated to be a conditioned choice of a set of critical factors among older adults: those who have higher education, financial independence or higher income, available housing, and good health status could afford to live alone (3,30). ...
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Objectives Living arrangement has been reported to have a significant influence on feelings of loneliness in older adults, but their living preferences may confound the association. This study aimed to investigate whether the associations of living arrangements with loneliness differ in community-dwelling older adults according to different living preferences. Methods In the 2008/2009 (baseline) and 2011/2012 (follow-up) waves of the Chinese Longitudinal Healthy Longevity Survey, living arrangements [living with children mainly (LWC), living with spouse only (LWS), and living alone (LA)], living preferences [preferring living with children (PreLWC) and preferring living alone/only with spouse (PreLA)], and feelings of loneliness were assessed. The effect modifications of living preferences in the associations of living arrangements with loneliness were estimated using logistic regression models, and corresponding odds ratios ( OR s) were calculated. Results Living preferences significantly modified the associations of living arrangements with loneliness at baseline ( p for interaction = 0.009 for LWS and = 0.015 for LA). Compared with LWC, LWS was protective for loneliness only in the PreLA older adults at baseline ( OR = 0.53, 95% CI = 0.45–0.64, p < 0.001), and LA was significantly associated with loneliness especially in the PreLWC older adults, compared with their PreLA counterparts (at baseline, OR s = 2.89 vs . 2.15; at follow-up, OR s = 1.68 vs . 1.51). Conclusion Living preference modifies the associations of living arrangements with loneliness, and those who prefer living with children but live alone are more likely to feel lonely. It is recommended that living preferences should be considered when managing loneliness in community-dwelling older adults.
... Eshbaugh in his -Perception of Living Alone‖ mentioned positive perception of older women living alone since they enjoyed being on their own and loved their independence. [28] Thus it becomes imperative on our part to keep involvement of aged in the name of community activity participation limited. This will bring about an all round improvement in the QOL, thereby, equally taking care of all domains. ...
... Desde el punto de vista de diferencias por sexo, las mujeres sobreviven más (24,27) por lo que son el grupo más frecuente, similar a como se encontró en este estudio. Adicionalmente se asocia a tener más síntomas depresivos como es usualmente informado en la literatura (6,8,28,29) y es un punto para intervenir. ...
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Objetivo: identificar los factores asociados a vivir solo y la magnitud de su efecto en la población adulta mayor de 60 años que residen en comunidad en la ciudad de Bogotá. Métodos: Estudio de corte transversal con análisis secundario de la encuesta Salud, Bienestar y Envejecimiento (SABE) - Bogotá 2012. Se calcularon medidas de tendencia central, las medias se compararon con la prueba t de Student, el modelo final se ajustó por edad, sexo y se calcularon las odds ratios (OR) y sus IC95% para estimar la fuerza de la asociación. Resultados: De las 2000 personas que participaron en la encuesta SABE, 252 (12,6%) vivían solas. El promedio de edad era de 71,32 años; el 64,68% eran mujeres (n=163). La escolaridad promedio fue de 6,19 años (DE 0,31). Al realizar en análisis bivariado, se encontró asociación estadísticamente significativa entre vivir solo y ser independiente para las actividades básicas e instrumentales de la vida diaria, la ausencia de demencia, tener buena autopercepción del estado de salud. En el modelo de regresión logística no tener pareja (OR 4,91 IC 95% [3,61-6,68]), ausencia de demencia (OR 2,77 IC 95% [1,94-6,16], mala autopercepción del estado nutricional (OR 1,7 IC 95% [1,24-2,33] y el sexo femenino (OR 1,37 IC 95% [1,03-1,91] se asociaron de forma significativa con la posibilidad de vivir solo en personas mayores de 60 años. Conclusiones: Este estudio encontró que vivir solo se asoció con no tener pareja, tener un buen estado cognoscitivo, ser mujer y con mala autopercepción del estado nutricional.
... Friendships have consistently been shown to be important in later life, as is the perceived ability to access support if required (Hill et al., 2009;Hank & Wagner, 2013;Magaziner & Cadigan, 1989). Social contact appeared valued for its maintenance of routine (Cederbom et al., 2014) and in those living alone, lack of companionship was a concern at times (Eshbaugh, 2008). The use of the internet to access social support has been shown to be associated with better health outcomes (Khan et al., 2018) and may help to maintain contact in those less mobile. ...
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In the United Kingdom (UK), women are more likely to live alone in later life. Social factors such as household composition have been shown to affect health and wellbeing as we age. The health and well-being of older women who live alone are of interest to researchers, care providers, health organizations, and policymakers. This article contributes to the literature by detailing a scoping review, establishing the current evidence in this field. The purpose and context of the review are given. The methodology and resulting data are described. Gaps in the literature and implications for practice and research are given.
... There is no consensus in the findings from the research on older adults that focuses on the impact of living alone on loneliness. Hence, studies claiming that older individuals living alone are more likely to experience feelings of loneliness (Jong Savikko et al., 2005;Sundström et al., 2009;Victor et al., 2002;Yeh & Lo Kai, 2004) coexist with others that identify and reinforce positive aspects of living alone (Eshbaugh, 2008;Larson et al., 1985). ...
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Living alone has been indicated as a key variable to explain loneliness in older adults. In contemporary society, where technology has become one of the main means of communication and personal interaction, has the internet influenced the relationship between living alone and loneliness? This paper aims to answer this research question by using a sample of 64,297 individuals who were surveyed in SHARE project wave 6 – in European countries with different welfare regimes (Portugal, Greece, Italy and Spain, Denmark, Sweden, Austria, Belgium, France, Germany, Switzerland, Luxemburg, Poland, Czech Republic; Slovenia, Estonia, and Croatia). The results of the regression analysis evidence the moderating role of the internet on the relationship between living alone and feelings of loneliness in individuals aged 50 and over, so that the impact of living alone on loneliness is diminished for internet users as compared to their peers who do not use the internet. The results therefore reinforce the importance of policies aimed at fostering e-inclusion as a way of reducing the loneliness of older adults.
... Approximately one half of women in this study live alone. Although some literature supports the association of living alone and negative outcomes, such as loneliness, social isolation (Pantell et al., 2013), and depression (Centers for Disease Control and Prevention, 2013), there is some evidence of great variability among individual perceptions of living alone (Eshbaugh, 2008). Regardless of the individual's perception of living alone, support for older women as a population who often live alone needs to consider safety as a priority concern. ...
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A record number of women are going through the major life transition of retirement. The purpose of the current study was to explore women's perceptions of retirement with the goals of better understanding important patterns of response regarding retirement transitioning and to inform nurses on how to assist clients who are anticipating or engaging in the retirement transition. A sample population of 170 retired women was recruited using convenience sampling from community settings within six southeastern U.S. states. Participants expressed their perceptions of retirement through written responses to open-ended questions. Content analysis revealed the following themes: Love It/Happy; Unhappy/Regrets; So Much Time, So Little (money, resources, etc.); Searching; Busy; Relief/Freedom; Giving: For Me and Thee; Adequate Resources; Creating Your Own Structure; and Positive Attitude. Careful assessment for health changes, promotion of positive coping skills, and provision of educational planning and therapeutic resources to women who are transitioning to retirement should assist women toward healthy and successful retirements. [Journal of Gerontological Nursing, 45(4), 31-39.].
... När människan blir utestängd från all gemenskap kan det innebära ett svårt lidande och kan hota personens totala existens (Eriksson, 1994). Flera studier ( Lauder et al., 2003;Alpassi & Neville, 2003;Adams, Sanders & Auth;2004;Eshbaugh, 2008) har visat att ensamhet har ett tydligt samband med uppkomst av depression. Det innebär att ensamheten inte endast orsakar livslidande utan även sjukdomslidande. ...
The number of elderly people is increasing in Sweden. Loneliness occurs specially among elderly and it can affect their quality of life. It is important to gain knowledge of elderly people´s experiences of loneliness to improve health and well-being. The aim of this study is to illuminate older people´s experiences of loneliness. A qualitative analysis method which contained three phages whole-part-whole was used to analyze the data. The data were collected through interviews with nine elderly people over 65 years old. Interviews were recorded in the tape and transcribed. From analysis it appeared three main categories with associated subcategories. Result indicated that when respondents lost their partner, the experiences of loneliness were substantial. Family, friends and social activities could prevent or reduce elderly people´s feeling of loneliness. To feel independent and undemanding was the positive experiences of loneliness. There was fearfulness among respondents of being left alone if they would become sick. It was important for elderly people to be respected as a unique human being and to feel togetherness with others.
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Duhovnost je večdimenzionalni koncept, ki usmerja človekovo življenje, se s starostjo krepi in vpliva na kakovost življenja. Z raziskavo smo želeli ugotoviti, kakšen je vpliv duhovnosti na kakovost življenja in ali molitev vpliva na preprečevanje osamljenosti starih ljudi v domačem in v institucionalnem okolju. Raziskava temelji na kvantitativni metodi, v raziskavo smo zajeli 656 starih ljudi v domačem in v institucionalnem okolju. Za pridobivanje podatkov o kakovosti življenja smo uporabili standardizirani vprašalnik Svetovne zdravstvene organizacije WHOQOL-BREF, za pridobivanje podatkov o osamljenosti pa Oldwellactive (A self-rated welness profile for the assessment of wellbeing and wellness activity in older people). Ugotovili smo, da se stari ljudje ne počutijo osamljeno in da so nekoliko bolj osamljeni v institucionalnem okolju (PV=3,71) kakor v domačem okolju (PV=3,90). Molijo tisti, ki so pogosteje osamljeni in ki niže ocenjujejo kakovost življenja. Molitev ne vpliva na preprečevanje osamljenosti. Duhovni dejavnik je za stare ljudi najpomembnejši dejavnik, ki vpliva na njihovo kakovost življenja.
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The development of an adequate assessment instrument is a necessary prerequisite for social psychological research on loneliness. Two studies provide methodological refinement in the measurement of loneliness. Study 1 presents a revised version of the self-report UCLA (University of California, Los Angeles) Loneliness Scale, designed to counter the possible effects of response bias in the original scale, and reports concurrent validity evidence for the revised measure. Study 2 demonstrates that although loneliness is correlated with measures of negative affect, social risk taking, and affiliative tendencies, it is nonetheless a distinct psychological experience.
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The Center for Epidemiological Studies Depression Scale (CES-D) has been widely used in studies of late-life depression. While the CES-D is convenient to use in most settings, it can present problems for elderly respondents who may find the response format confusing, the questions emotionally stressful, and the time to complete burdensome. A briefer 10-item version has been proposed, but there are few data on its properties as a screening instrument. The 10-item CES-D was administered in 2 studies. In study 1, a stratified sample of middle-aged depressed patients (n = 40) and comparison controls (n = 43) were administered the CES-D to determine an optimal cutoff score. In study 2, the accuracy of the CES-D optimal cutoff score was tested in a sample of adults older than 60 years (n = 68). Major depression diagnoses were derived from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, with consensus diagnoses using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Reliability statistics with the 10-item CES-D were found to be comparable to those reported for the original CES-D. Using an optimal cutoff score of 4 in study 1, the sensitivity of the 10-item CES-D was 97%; specificity, 84%; and positive predictive value, 85%. In the study 2 sample of older adults, the sensitivity of the CES-D was 100%; specificity, 93%; and positive predictive value, 38%. The 10-item CES-D has excellent properties for use as a screening instrument for the identification of major depression in older adults.
While scholars and practitioners often use the concept of "risk" in relation to older persons who live at home, there has been limited exploration of risk from the perspective of older persons themselves. During a phenomenologic study of the lived experience of seven older widows who were living alone at home, the participants articulated the risks they experienced and described the ways in which they attempted to reduce these risks. The results have meaningful implications for home care providers and policy makers.
The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
The mental health effects of living alone on elderly persons are not well known. Using multiple regression models, the authors attempted to distinguish the influence of living alone on depressive symptoms from the influence of other highly relevant variables: social support, stressors, age, sex, and marital status. The data derive from a stratified community probability sample of persons 50 years of age and older. The authors find that elderly persons who live alone have higher levels of depressive symptomatology; and this relationship is independent of the influence of expressive support from friends, face-to-face interaction with friends, undesirable life events, disability, and financial strain. The depressive influence of living alone is greater on men than women. Undesirable health events have a stronger impact on those who live alone, particularly women. Marital status influences depression indirectly through its influence on living alone. Implications of these and other findings are discussed.
This study aimed to describe the characteristics of the elderly population living alone, and to examine how living alone relates to feeling lonely. Interviews were conducted with a stratified random sample of 4,859 elderly individuals living in Kaohsiung, Taiwan. Variables collected included demographic information, living alone or not, activities of daily living (ADL), instrumental activities of daily living (IADL), Short Portable Mental Status Questionnaire (SPMSQ), chronic conditions, perceived social support, and a subjective measure of feeling lonely. Using logistic regression, it was found that factors associated with living alone included gender, marital status, occupation, source of income, religion, and IADL. Living alone was, in turn, related to decreased levels of both perceived social support and feeling lonely after adjustment for potential confounders. Managing retired life is important for adult elders, particularly for men. Lack of social support is common among the elderly community who live alone, which could well be a main reason for this group to feel lonely. As loneliness is linked to physical and mental health problems, increasing social support and facilitating friendship should be factored into life-style management for communities of elderly.
This study focuses on the economic consequences of divorce for the elderly. Family incomes of elderly white divorced men and women were compared with their married counterparts for five SES categories. Using t-tests, it was found that, for both genders, incomes for divorced persons were lower than incomes for married persons. Family incomes were regressed on a set of four control variables and a marital status variable. The marital status variable was statistically significant for the total sample for both sexes. The marital status variable was statistically significant for two SES categories for females and one for males.
The 1982-84 National Long-Term Care Channeling Demonstration data were used to construct a profile of nursing home eligible elderly who lived alone in lhe community and to compare them to peers who lived with others. Persons who lived alone were predominantly white, widowed women in their late seventies with low personal income. Compared to their counterparts, they had few- er medical conditions, less functional and cognitive impairment, and fewer perceived unmet needs in personal activities of daily living (ADLs), but more in instrumental ADLs. They also used more infor- mal supports and reported a greater number of psychological symp- toms. Implications for practice and policy are included.
This study examined the differences between Hong Kong Chinese elderly people living alone and those living with others in terms of socio-demographic characteristics, physical health indicators, social support and subjective well-being. The respondents were 1106 people aged 60 years or older from a cross-sectional sample representative of the elderly population in Hong Kong. Some 105 of these respondents lived alone; another 149 respondents who lived with others were randomly selected from the sample as a comparison group. We found that elderly persons living alone were younger and were less likely to be married. Compared to the elderly respondents living with others, they had poorer self-rated health status and a higher level of financial strain. They also reported smaller social networks of relatives, received less instrumental and emotional support, and reported more depressive symptoms and a lower level of quality of life. Service implications are discussed based upon the findings.