Harvard Health Letter

Steps to stay independent when you live alone

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Safety, socializing, and helpful services enhance your ability to stay at home longer.

Living alone in our older years can be a challenge and a risk. There's no one in the house to call paramedics if you get hurt, and there's no one sitting at the dinner table for conversation or companionship. Isolation can lead to a decline in thinking skills and to an increased risk for depression.

While there are many tools to help you reduce the risks of living alone, implementing them may be easier said than done. "The misconception is that any acceptance of help is somehow the beginning of a slippery slope into dependence and losing control of your life," says Barbara Moscowitz, a geriatric social worker at Harvard-affiliated Massachusetts General Hospital. "We need to reframe what will help us remain independent and accept the tools to help us. Make a choice to enhance your ability to live alone. See assets and positives, not signs of weakness."

Safety first

One of the most important tools when living alone is a safety alert button, a waterproof device you wear as a pendant or on your wrist that alerts 911 at the touch of a button. "This device must stay on your body 24 hours a day," says Moscowitz. "It won't do any good on your nightstand if you've fallen in the shower." Prices range from $25 to $50 per month, depending on the system. Look for a service that allows you to pay month-to-month and has no start-up fees.

Moscowitz also recommends having an emergency supply kit to help you through bad weather, electricity outages, or times when you just can't get to a store. "Imagine that you'll need three days' worth of supplies, including food and water. Keep those supplies in a pantry, so you'll have them if you need them," she says. And to avoid running out of medications, always refill prescriptions when you have a week supply remaining.

Social connection

Being in contact with others is as vital and important as your health care. Moscowitz says it doesn't have to be a formal date or event. It can be going to the mailroom, picking up mail, and chatting with a neighbor for five minutes. But, she stresses, "You must talk to someone at least daily, and get out of your house at least once a week. Any less could have a negative impact on your health and well-being."

Start by arranging a daily phone call with a family member or friend, even if you're the one who calls. "It stimulates your social juices, validates your existence, and also acts as a safety check," says Moscowitz. For activity, reach out to friends and family, a church or synagogue, a senior center, or a volunteering opportunity. All of these offer social connections that will be meaningful and add richness to your life. But even the simple of act of doing errands and seeing others in person provides a benefit.

Services

When you're no longer able to drive or manage once-routine activities such as housecleaning or shopping, it's time to turn to convenience services. Take advantage of grocery stores, pharmacies, and restaurants that deliver to your neighborhood. Ask a senior center, church, or even local bus service about free or affordable rides to take you to the store or the doctor. You can also hire errand services.

And when the activities of daily living—such as bathing, dressing, taking medication, and cooking—become too difficult, you can hire private-duty care. This usually comes in two forms: a companion or a health aide. Both are able to offer homemaker services, such as light housework, cooking, shopping, overseeing medication routines, and transportation. The difference is that a licensed worker, such as a home health aide, will also be trained in body mechanics and able to provide hands-on physical care such as help bathing, eating, brushing teeth, and using the bathroom.

These services can be expensive, but keep in mind that moving to assisted living can also be costly. Weigh the benefits of making the investment for services at your own home against moving to a senior living environment. "But don't make the mistake of thinking you don't need any help," says Moscowitz. "That may land you in a facility faster than you expected, without giving you the control over where and when you want to make the move to the next chapter."