Sociologist Elena Portacolone was taken aback. Many of the older adults in San Francisco she visited at home for a research project were confused when she came to the door. They’d forgotten the appointment or couldn’t remember speaking to her.
It seemed clear they had some type of cognitive impairment. Yet they were living alone. Portacolone, an associate professor at the University of California at San Francisco, wondered how common this was.
Had anyone examined this group? How were they managing? When she reviewed the research literature more than a decade ago, there was little there. “I realized this is a largely invisible population,” she said. Portacolone got to work and now leads the Living Alone With Cognitive Impairment Project at UCSF.
The project estimates that at least 4.3 million people 55 or older with cognitive impairment or dementia live alone in the United States. About half have trouble with daily activities such as bathing, eating, cooking, shopping, taking medications and managing money.
Only 1 in 3 received help with at least one such activity. Compared with other older adults living by themselves, people living alone with cognitive impairment are older, more likely to be women, and disproportionately Black or Latino, with lower levels of education, wealth and homeownership. Yet only 21 percent qualify for publicly funded programs such as Medicaid that pay for aides to provide services in the home.
In a health-care system that assumes older adults .
