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Dementia and Cognitive Decline Create Heightened Risk for Solo Agers

Updated: Oct 17, 2023

Dementia and cognitive decline create heightened risk for solo agers.

Are you one of the 26 million Americans 50 and older who live alone? Have you thought about what will happen when your cognitive abilities start to decline? Who will look after you? Who will make sure you get the care you need?

These are important questions that you need to be asking if you’re aging without support from family or loved ones. Researchers estimate that more than 4 million of the 26 million older adults living alone suffer from dementia or cognitive impairment, putting them at risk for medication mix-ups, unsafe driving, wandering, and missing important medical appointments.

Is our nation’s health system equipped to address the needs of these people aging without family support? The answer is no, according to a new study published on August 18, 2023 in JAMA Network Open.

According to the study’s lead author, Elena Portacolone, an associate professor at the Institute for Health & Aging at the University of California, San Francisco, the study is significant because it provides, for the first time, strong evidence that it is much more difficult to care for patients with dementia who live alone, and that in the United States, patients with dementia who live alone may not receive the best possible care.

For the study, her team interviewed 76 health care providers in California, Michigan, and Texas.

Providers raised concerns about mentally impaired patients who lived alone, noting they were isolated, lacked advocates, had incomplete medical histories, required difficult interventions, and had unmet needs. Many had no emergency contacts listed and were sometimes ignored by medical professionals until a serious health episode occurred. Those living alone were most likely to be women, poorer, and without a partner.

These factors increase their risk for untreated medical conditions, self-neglect, malnutrition, and falls, the study said.

"Over 80% of long-term services and support for people is provided by friends and family, and if someone doesn't have friends and family, either living with them or in the community, they need care, especially if someone is living with dementia as the disease progresses," said Kate Wilbur, chair of the USC Leonard Davis School of Gerontology in Los Angeles, who reviewed the study’s findings. "One of the reasons people avoid care, avoid providers coming in is they don't want to have their freedom taken away, and there's a great fear of being placed in a nursing home. That is a likely outcome if someone at high risk is living alone.”

Costs are also a factor. The study estimated that only 21% of cognitively impaired adults who live alone are covered by Medicaid, leaving most of these adults ineligible for subsidized services like home-care aides. The study also noted that aides are usually provided only for a limited time after a severe medical episode.

Portacolone notes that millions and millions of dollars are spent by the government of the United States in research to delay or treat dementia. “Given the needs of older adults who live alone with dementia, it would be wise to devote resources for programs supporting older adults who live alone with dementia, as well as the professionals doing everything they can to care for this population," she said.

Countries like Germany and the Netherlands set aside government funds for long-term care of the elderly, but the United States is lagging behind. Though there are a few highly innovative programs, they are few and far between. For example, Los Angeles city enlisted meter readers and people delivering the mail to watch for signs of trouble, but that program didn’t extend to others who might be interacting with vulnerable older adults.

Individual autonomy is another consideration. While it may be tempting to assume that any older, frail person with multiple health conditions would welcome the help, that’s not always the case.

If you are growing old without the support of family or loved ones, now is the time to start preparing for your future. Takacs McGinnis Elder Care Law can help you with the planning process. For more information or to schedule a consultation, call 615.824.2571.

Source: Health Day


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