Study: Understanding Older Adults that are Aging Alone

Preliminary Results of One of the first Empirical Academic Research Studies Aimed at Understanding Older Adults who are Aging Alone and identify as Elder Orphans*

Purpose of the Study

To explore the predictors of well-being throughout the life course and advance care planning among older adults who identify with the term elder orphan (aging along with limited support) in the US.

Participants

Over 500 members from the Elder Orphan Facebook Group answered the mixed-methods study's 89 questions. Members of the elder orphan group are more educated than most (71% have at least a bachelor's degree - compared to 32% of the general population), mostly female (98%), mostly Caucasian (97%) and proactively joined the group to discuss aging alone issues.

...

Carol Marak

Carol Marak is an Aging Alone spokesperson and advocate and founder of the Elder Orphans Facebook Group. She participated in the study as the community liaison. Carol has become the authority in the aging alone, elder orphan, and solo aging population that understands and supports the individuals facing growing older and alone challenges. She has no spouse, partner, or children to count on.

Key Statistics

  • 78% have no help with bills, financial decisions
  • 55% have no help with medical decisions
  • 70% have not identified a would-be caregiver
  • 35% have no help in a crisis
  • 45% reported being sad
  • 52% reported being lonely
  • 26% have 3 or more chronic conditions
  • 31% take 5 or more medications
  • 19% had a risk of being homeless
  • 26% fear they'll lose their home
  • 43% lack a living will or healthcare power of attorney
  • 40% reported a medium level of stress
  • 52% think they are likely to experience discrimination
  • 50% have access to reliable public transportation

Housing

Q46
If you live alone, please check all the reasons you live alone
Q47
If you live alone, how many years have you lived alone?
Q18

5% of respondents do not have secure housing

Q19

19% of respondents have been at risk of being homeless at some point in their life

Q20
If you ever have been homeless, during what time in your life?
Q21

26% of respondents fear losing their housing

Q22

4% of respondents have suffered a house foreclosure

Q23

5% of respondents have been evicted from their housing at some point in their life

Q25
Does the community where you live have the following?
Free access to computers and the Internet in public places such as the library senior centers or government buildings
85%
Senior Centers
77%
Access to reliable medical care (including mental health)
77%
Access to social services agencies
74%
Walkable streets
60%
Home and Community Based Services
53%
Reliable Public Transportation
50%
Access to community information in one central source
45%
Community information that is available in a number of different languages
41%
Community information that is delivered in person to people who may have difficulty or may not be able to leave their home
22%
Clearly displayed printed community information with large lettering
18%
Q72
What is your top choice for housing as you grow older?
Stay in my home
49%
Tiny affordable house in a village of people like you
29%
Affordable assisted living
12%
Share a home with multiple like-minded roommates
7%
Move in with family (sibling, offspring, other family member)
2%
Shared housing - Rent a room and share the home owned by someone else
1%
Q74
Community amenities: Whether living at home or in a 55+ community, what 2 amenities are most important to have nearby?
Shopping and grocery
63%
Hospital and healthcare
49%
Social connections
37%
Wellness Center with gym
14%
The arts, theater, concerts
14%
Park with outdoor activities
11%
Bus stop or metro line
11%
Work
8%
College or University
3%

Health

Q35
How would you rate your physical health?
Q36
How would you rate your mental health?
Q13

13% of those surveyed ate less than they felt they should because there wasn't enough money for food

Q16

17% of those surveyed are currently disabled

Q17

64% of those disabled do not have modified housing to meet their needs

Q27
Please indicate the current level of stress in your life:
Low
17%
Medium
41%
In general I feel that I can cope well with stress
27%
I do not cope well with stress
16%
Q28
When did you last go to your doctor for a routine wellness exam?
Within this year
64%
Last year
22%
Two years ago
5%
Three years ago
3%
Four years ago
1%
More than five years ago
5%
Never
1%
Q32
In the past year, how many trips have you made to the health facilities below?
0 1-2 3-5 6-10 11-20 20
Routine health check up 12% 69% 14% 3% 0% 1%
Chronic healthcare 43% 25% 20% 7% 3% 3%
Emergency room 71% 27% 2% 0% 0% 0%
Q33
In the past year, how many trips to a healthcare facility below were missed or delayed because you could not drive or did not have a ride?
0 1-2 3-5 6-10 11-20 20
Routine health checkup 96% 4% 0% 0% 0% 0%
Chronic healthcare 96% 3% 1% 0% 0% 0%
Emergency Room 98% 2% 0% 0% 0% 0%
Q34

47% of respondents' activities are limited because of one or more physical, mental, or emotional problems

Q37
Please indicate for each of the five statements which is closest to how you have been feeling over the last two weeks. Notice the higher numbers mean better well-being
At no time Some of the time Less than half of the time More than half of the time Most of the time All of the time
I have felt cheerful and in good spirts 3% 32% 27% 16% 18% 3%
I have felt calm and relaxed 4% 29% 30% 16% 18% 3%
I have felt active and vigorous 2% 16% 20% 22% 26% 15%
I woke up feeling fresh and rested 4% 17% 20% 20% 23% 16%
My daily life has been filled with things that interest me 8% 25% 24% 12% 25% 4%
Q41

28% of those surveyed have fallen in the past 6 months

Q42

26% of respondents have 3 or more chronic diseases

Q43

31% of those surveyed take five or more medications

Q58
In a typical week, on how many days do you do any MODERATE activities (causes small increases in breathing or heart rate) for AT LEAST 30 minutes such as brisk walking, bicycling at a regular pace, gardening, etc.?
Q59
How many hours of sleep do you typically get a night?
Q73
Which of the following are your basic health care and wellness needs at home
Chronic disease management
56%
Physical therapy and rehabilitation
30%
Activities of daily living (Bathing, grooming, meals, transportation)
30%
Home health care monitoring (check vitals)
13%
In-home visits by a physician
5%
Q86

15% of respondents do not have access to the healthcare of their choice

Q87
Has a healthcare provider informed you that you have any of the following health problems or diagnoses (currently or in the past)?
Arthritis
51%
Depression
40%
High blood pressure (hypertension)
39%
Anxiety
37%
Obesity
35%
Osteoarthritis
25%
Other (please list)
25%
Hypothyroidism
22%
Chronic heartburn/GERD
17%
Asthma
16%
Cancer
15%
Major depressive disorder
14%
Diabetes Type I or II
13%
Irritable Bowl Disease
12%
None of these health problems
11%
Heart disease and/or heart attack and/or heart bypass surgery
9%
COPD
9%
Breast Cancer
6%
Stroke
3%
Angina pectoris
1%
Dementia/AL or any other type of Dementia
0%

Transportation

Q29
What are your means of transportation?
Personal automobile
92%
Friend, relative, or neighbor
8%
Public transportation
17%
Medicaid transportation
1%
Other
4%
Q31

31% of those surveyed do not have the freedom to travel to the places they want to travel

Q77
What is your favorite form of travel?
Local destination via car
50%
Tour package like Road Scholar
23%
Take a cruise
13%
Destination train trip
8%
Walking or bike tour
6%
Q30
If you don't drive a car, why not?
Can't drive due to a medical/physical condition
26%
Can't afford a car
26%
I can access everything I need w/o car
24%
Other
14%
Can't afford gas/insurance
10%
Lost driver's license
0%

Financial

Q10
What was your total household income before taxes during the past 12 months?
Q11

23% of respondents reported experiencing at least one time when they didn't have enough money to meet their basic needs in the last 12 months

Q14
In the last 12 months, did you receive any of the following?
Social Security
47%
None/NA
42%
Food Stamps
8%
SSDI (Social Security Disability Insurance
6%
Unemployment Insurance
4%
SSI (Supplementary Security Income)
2%
Q15
Are you currently covered by any of the following health insurances?
Government insurance (that is, Medicare, Medicaid [including all state or federal Medicaid-type programs)
56%
Commercial insurance (that is, fee-for service, PPO, HMO, prepaid or similar).
38%
None or self
6%
Veteran's Administration health plans, military medical plans, or other government-reimbursed care[e.g. Indian Health Service]
2%
Q76
How will you pay for long-term care?
Savings and investments
68%
Out of pocket
47%
LTC insurance
33%
Reverse mortgage
10%
Life insurance or Life settlement
3%
N81-0
I could handle a major unexpected expense
N81-1
I am secure in my financial future
N81-2
Because of my money situation, I feel like I will never have the things I want in life
N81-3
I can enjoy life because of the way I'm managing my money
N81-4
I am just getting by financially
N81-5
I am concerned that the money I have or will save won't last
N82-0
Giving a gift for a wedding, birthday or other occasion would put a strain on my finances for the month
N82-1
I have money left over at the end of the month
N82-2
I am behind with my finances
N82-3
My finances control my life

Vulnerability

Q70

45% of respondents reported feeling sad

Q71

52% of respondents reported feeling lonely

Q57
Please indicate how safe you feel walking alone in the area near your home
Q39
In your everyday life, how likely do you think it is that you will experience discrimination (e.g. because of your race, gender, religion, sexual orientation or age)
Very Likely
21%
Likely
31%
Neither likely no unlikely
25%
Unlikely
23%
N38
While you were growing up, during your first 18 years of life:
Did a parent or other adult in the household often swear at you, insult you, put you down, or humiliate you
46%
Did you often feel that no one in your family loved you or thought you were important or special? or Your family didn't look out for each other, or support each other?
40%
Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
31%
Were your parents ever separated or divorced?
25%
Did a parent or other adult in the household often push, grab, slap, or throw something at you or ever hit you so hard that you had marks or were injured?
25%
Did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way or try to have oral, anal, or vaginal sex with you?
25%
Was anyone in the household mentally ill or did a household member attempt suicide?
23%
Was your mother or stepmother often pushed, grabbed, slapped, or had something thrown at her? or Sometimes or often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
10%
Did you often feel that you didn't have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
9%
Did a household member go to prison?
2%
Q56
Below is a list of event that can happen in an individual's life that can shape their life trajectory. Please indicate if any of these events happened to you during your midlife (40's & 50's).
Death of a parent
64%
Major financial changes (i.e. loss of a job)
57%
A major move
49%
Divorce
37%
Other
15%
Death of a spouse
15%
Death of a child
2%
Q99
During your childhood, did you ever have the following?
Obesity
40%
Did not have enough money to pay your bills
29%
Other Illness
23%
A chronic Illness
22%
Cancer
3%
Q55
Do you believe you can take care of yourself?
Q83
Listed below are a number of difficult or stressful events that sometimes happen to people. Check off each event you have experienced. Be sure to consider your entire life (childhood through adulthood) as you go through the list of events.
Transportation accident (for example, car accident, boat accident, train wreck, plane crash)
60%
Natural disaster (for example, flood, hurricane, tornado, earthquake)
48%
Other unwanted or uncomfortable sexual experience
43%
Physical assault (for example, being attacked, hit, slapped, kicked, beaten up)
32%
Life-threatening illness or injury
29%
Any other very stressful event or experience
29%
Sexual assault (rape, attempted rape, made to perform any type of sexual force or threat of harm)
26%
Serious accident at work, home, or during recreational activity
17%
Fire or explosion
16%
Exposure to sudden, violent death (for example, homicide, suicide)
12%
Exposure to toxic substance (for example, dangerous chemicals, radiation)
10%
Assault with a weapon (for example, being shot, stabbed, threatened with a knife, gun, bomb
10%
Severe human suffering
6%
Captivity (for example, being kidnapped, abducted, held hostage, prisoner of war)
3%
Serious injury, harm, or death you caused to someone else
2%
Combat or exposure to a war-zone (in the military or as a civilian)
2%
Q88
Check all that apply
I often feel like things are piling up
47%
I have a hard time getting going
44%
I often overeat
39%
I have difficulty sleeping
38%
Things are going my way
38%
I do not feel happy
33%
I feel depressed
31%
I feel tense
28%
I feel like things are going my way
28%
I am not open with my family
25%
I get sudden feelings of panic
23%
I have experienced intimate partner violence
13%
My family criticizes me
12%
I often do not feel like eating
9%
People are often unfriendly to me
6%
Q85-0
I am able to influence decisions affecting my local area
Q85-1
I am free to express my views including political and religious views
Q85-2
I am free to decide for myself how to live my life

Support

Q62

35% of respondents do not have family or friends to help them cope with life's challenges

Q60

79% of those surveyed do not have children

Q61
If you have children are you in contact with them?
Q40
People sometimes look to others for companionship, assistance, or other types of support. How often is each of the following kinds of support available to you if you need it?
None of the time A little of the time Some of the time Most of the time All of the time
Someone to give you information to help you understand a situation 7% 21% 32% 30% 12%
Someone to turn to for suggestions 8% 18% 34% 27% 14%
Someone to help you if you were confined to bed 39% 27% 18% 11% 5%
Someone to take you to the doctor if you needed it 21% 30% 21% 20% 8%
Q54

70% of those surveyed have not identified a caregiver younger than themselves in the event that they need care

Q63

55% of respondents do not have someone to help them make medical decisions

Q64

78% of those surveyed do not have someone to help with bills or financial decisions

Q65

35% of those surveyed do not have someone that can help in a crisis

Q67

81% of respondents do have a person that would call upon in an emergency situation

Q69

96% of respondents do not need help bathing, dressing, shopping and paying

Q84-0
How many relatives do you see or hear from at least once a month?
Q84-1
How many relatives do you feel at ease with that you can talk about private matters?
Q84-2
How many relatives do you feel close to such that you could call on them for help?

Technology

Q75
What technology will be most important as you age?
Social connection like Facebook and others
81%
Medical alert
49%
Online access to personal records and legal documents
45%
Home security
40%
App to access shared rides (Uber/Lyft)
36%
Telemedicine online appointments with a physician
35%
Telehealth to check health vitals like blood pressure and diabetes
22%
Q78
What type of telephone do you have?
Q79
What type of cell-phone do you have?
Calls, texts, data, and apps? (like an iPhone or Samsung Galaxy)
82%
Calls and texts?
7%
Calls, texts, and data access?
6%
One that makes calls-phone only?
3%
I do not own a cell-phone.
2%
Calls, texts, data, apps, and medical alert
1%
Q80
Do you use

Demographics

N1
Age of respondents
Q2
What is your gender?
Q3
What is your marital/relationship status?
Q7
What country were you born in?
Q89
Which region of the country do you live in?
Midwest - IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI
22%
Southeast - AL, AR, FL, GA, KY, LA, MS, NC, SC, TN, VA, WV
21%
Northeast - CT, DC, DE, MA, MD, ME, NH, NJ, NY, PA, RI, VT
21%
Southwest - AZ, NM, OK, TX
17%
West - AK, CA, CO, HI, ID, MT, NV, OR, UT, WA, WY
13%
I do not live in the US
6%
Q8
What is your highest level of education?
Q9
What is your employment status?
Retired
51%
Employed, working 40 or more hours per week
20%
Employed, working 1-39 hours per week
17%
Disabled, not able to work
6%
Not employed, looking for work
3%
Not employed, NOT looking for work
2%
Student
0%
Q24
Have you ever served on active duty in the US Armed Forces, Reserves, or National Guard?
Never served in the military
95%
On active duty in the past, but not now
4%
Only on active duty for training the Reserves or National Guard
1%
Now on active duty
0%
Q66
Are you veteran in the military?

*The preliminary results were obtained from Qualtrics. Further analysis and cleaning of data is in progress.