Website intended for a NZ health professional readership
Many older adults want to live independently for as long as possible, preferably in their own home.1 Increasingly, however, older adults are living alone, which can come with challenges. This includes being able to access help should they experience an acute medical event.
Older patients living alone are likely to have a higher level of healthcare need.13
The proportion of older adults living alone is increasing, largely due to population ageing.2,3 Just over ten years ago 44% of New Zealanders living alone were aged 65 years or older.4 As the population continues to age, the number of New Zealanders projected to live alone is expected to increase by 48% to 580,000 people by 2038, with 90% of this growth occurring among adults aged 60 years or older.2
Older adults living alone at home, either with or without comorbidities, are more likely to require emergency hospitalisation compared with older adults living with others.5
In one study, people living alone at home at the time of a stroke had delayed hospital arrival, received less thrombolytic therapy, and were less likely to return home compared with those who lived with others.6 Another study found that nearly 80% of falls in older adults living in the community occurred when the person was alone and that 13% had a “long lie” (on the floor for ≥1 hr), which is associated with serious clinical outcomes including hospital admission and subsequent need for long-term care.7
Furthermore, older adults who live alone can experience functional decline, which jeopardises their ability to live independently, following hospitalisation for an acute medical event.8
Interventions that enable ageing in place while avoiding hospital admissions can help to support older adults living alone at home. Technology-based solutions, including use of a personal medical alarm, are a potential resource to facilitate older adults to live independently while providing health-related quality of life,9 especially for those with ongoing health conditions.10
Typical users of a personal medical alarm are older adults with an extensive medical history and who are often living alone.11 Research into the benefits of personal medical alarms for older adults includes accessing help faster and confidence to maintain an active life.
Based on the findings of a cost analysis of emergency alarm activations due to falls or other acute medical events among older adults, triage-based personal medical alarms were advocated as a low-cost and effective intervention to support older adults who live alone.12
Older patients living alone are likely to have a higher level of healthcare need.13
It may be that practice data can be used to identify older patients who are living alone, as GPs are in the unique position to identify those who could benefit from additional support.14
It could also be that in the screening of older patients’ health risk appraisal, or checking on their well-being and social function, it can be helpful to enquire about their living situation (e.g., “Do you live alone?”). Those who live by themselves could benefit from a St John Medical Alarm to support their ability to continue to live independently.
Your older patients living alone at home, especially those at risk of a future medical event, can feel reassured knowing that they can access help 24/7 in an emergency with a St John Medical Alarm.
Referral is as easy as clicking a link in your Practice Management System (via Healthlink or ERMS). Access to a FREE trial is available to all patients.
For additional information visit: stjohnalarms.org.nz/hcp
1. van Leeuwen KM, et al. What does quality of life mean to older adults? A thematic synthesis. PLoS One. 2019;14(3):e0213263.
2. Statistics NZ. Growth of one-person and two-person households driven by ageing population. 2015. Wellington: Statistics New Zealand.
3. Molinksy J. The number of people living alone in their 80s and 90s is set to soar. Joint Center for Housing Studies of Harvard University. 2020. Cambridge, MA: Harvard University.
4. Statistics NZ. Two’s a crowd: Living alone in New Zealand. 2016. Wellington: Statistics New Zealand.
5. Barrenetxea J, et al. Emergency hospital admissions among older adults living alone in the community. BMC Health Serv Res. 2021;21(1):1192.
6. Reeves MJ, et al. Impact of living alone on the care and outcomes of patients with acute stroke. Stroke. 2014;45(10):3083-5.
7. Fleming J, et al. Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. BMJ 2008;337:a2227.
8. Mahoney JE, et al. Problems of older adults living alone after hospitalization. Gen Intern Med. 2000;15(9):611-9.
9. Ollevier A, et al. How can technology support ageing in place in healthy older adults? A systematic review. Public Health Rev. 2020;41(1):26.
10. Agboola S, et al. Healthcare utilization in older patients using personal emergency response systems: an analysis of electronic health records and medical alert data. BMC Health Serv Res. 2017;17(1):282.
11. Stokke R. The Personal Emergency Response System as a technology innovation in Primary Health Care services: An integrative review. J Med Internet Res. 2016;18(7):e187.
12. Wang Y, et al. Quantifying the economic benefit of the personal alarm and emergency response system in Australia: a cost analysis of the reduction in ambulance attendances. Aust Health Rev. 2021;45(1):51-8.
13. Kharicha K, et al. Health risk appraisal in older people 1: are older people living alone an ‘at-risk’ group? Br J Gen Pract. 2007;57(537):271-6.
14. Dreyer K, et al. The association between living alone and health care utilisation in older adults: a retrospective cohort study of electronic health records from a London general practice. BMC Geriatr. 2018;18(1):269.
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