Living Alone, Socially Isolated or Lonely—What are We Measuring?

Excerpt

Many older adults live alone. For example, in the United States, over 45 % of women over the age of 75 years live alone.1 Much attention has been placed on older adults who are living alone, because of the recent studies that have shown that both loneliness and social isolation are associated with poor health outcomes.1 ^– 4 These studies have also suggested that living alone is not necessarily indicative of having poor social support or of feeling lonely. While it may be reasonable to believe that living alone is a good proxy for these types of social measures, there is increasing recognition that the measures of social well-being are complex concepts and go beyond simply describing the situational facts of a person’s life. In actuality, social isolation and loneliness are complex self-perceptions that may not be fully captured by whether or not someone lives alone. This demands that as clinicians, we must dig deeper into a patient’s personal perspective. For example, measures of loneliness go beyond just asking about whether a person has social contacts, but also ask about the subjective feeling of feeling left out, isolated or not belonging.5 Accordingly, this raises the question of whether we should consider living alone as a risk factor for poor health outcomes and if this risk is adequately measured by asking if a patient lives alone, or if we must concomitantly include composite measures of social isolation and loneliness. …