How Living Alone Heightens Risks for People in Cognitive Decline

A new study has found that patients suffering from cognitive decline who live alone encounter higher levels of risk than those who have live-in family or aides.

Research conducted at the University of San Francisco determined that the American healthcare system is ill-equipped to deal with the increasing number of people suffering from cognitive impairment. This has particularly affected those suffering from decline who live alone, without family or the privilege of home care assistants. According to the study, it can have as great of an effect as economic conditions such as low income, lack of education, and institutional racism.

Lead author Elena Portacolone and her team interviewed 76 healthcare providers, including doctors, social workers, nurses, case workers, and home care professionals. They’ve worked at various institutions in California, Michigan, and Texas.

Some of those interviewed reported that they’d seen patients missing critical information from medical documents, unsure what to write with no one to guide them. Often, they listed no emergency contacts either. The healthcare providers reported that in most cases these patients were ignored until a serious matter, such as missing medication or an injury, required medical intervention. Living alone also led to poor hygiene and nutrition, as well as a higher risk of falls.

“An estimated 79 percent of people with cognitive decline have an income that is not low enough to make them eligible for Medicaid subsidized home care aides,” Portacolone noted in the study. This often results in patients being discharged from the hospital with no care plan in place. 

Only those who make less than $20,121 annually can qualify for Medicaid-supported home care assistants in California, the study noted as an example, and often those come with a limitation on benefits and duration. Portocolone also pointed out that aides trained in Medicaid home care often don’t possess the necessary range of skills to care for those in cognitive decline.

The number of patients suffering from cognitive decline is only expected to increase, due to longer life expectancies and a lack of any treatment to reverse dementia. Researchers have recommended a plan to fund the treatment through an expanded Medicare and Medicaid system, which would make considerations for changing family dynamics and seniors who will be living alone.