Protecting independence: Why living alone matters for older patients

For nurses, a seemingly simple question –  “Do you live alone?” – can be a valuable tool in assessing an older patient’s health and social needs. Research indicates that living alone can correlate with an increased need for healthcare support.⁴ By asking this question, nurses can identify patients who may benefit from additional resources to help them remain safe and well within their community.

Why living alone matters

Research indicates that older adults who live alone face greater health risks, including increased emergency department admissions and unscheduled hospitalisations.^5,6

Those who live alone also tend to have a heavier burden of comorbidities,⁷ experience delayed hospital arrival after a stroke,⁸ and are at risk of a “long lie” after a fall, which is associated with serious clinical outcomes such as hospital admission and the need for long-term care.⁹

Despite its health risks, living alone remains important for older adults who value independence and wish to stay in their own homes for as long as possible.¹⁰

Independence: a goal worth protecting

Research highlights that maintaining independence – including having control over their own time and staying connected – is essential for older adults living at home.¹⁰ New Zealand policy has long supported “ageing in place”, encouraging seniors to remain in their own homes for as long as possible.¹¹

In planning for this, health concerns inform preparedness: interviews with community-dwelling seniors show that “preparedness” – establishing support systems before a crisis occurs – is a key strategy they use to safeguard their independence.¹²

The role of personal medical alarms

Personal Emergency Response Systems (PERS), such as a St John Medical Alarm, can play a vital role in preparedness, offering older adults faster access to assistance and increased confidence in their safety.¹³

Research highlights their cost-effectiveness, showing reductions in ambulance attendances and emergency department transportation for older individuals living in the community.¹⁴ Older adults with extensive medical histories – many of whom live alone – are precisely the patients nurses and other healthcare professionals strive to keep safe and supported.

What you can do

A simple question – “Do you live alone?” – can help identify potential risks to your patient’s independence. Consider incorporating it into routine assessments, flu clinics, or other health and wellbeing reviews.

If the answer is yes, referring patients for a St John Medical Alarm can provide reassurance for both them and their whānau, ensuring 24/7 access to help at the press of a button – supporting the independence they value.

You can easily arrange a free trial of a St John Medical Alarm. Simply complete a referral through your Practice Management System (Healthlink or ERMS) or online at stjohnalarms.org.nz/hcp.

For more information visit stjohnalarms.org.nz/hcp

References

1. Stats NZ. (2024). 2023 Census population, dwelling, and housing highlights.
2. Stats NZ. (2015). Growth of one-person and two-person households driven by ageing population.
3. Stats NZ. (2024). How we live – a look at families and households from the 2023 Census [press release].
4. Kharicha, K., Iliffe, S., Harari, D., Swift, C., Gillmann, G., & Stuck, A. E. (2007). Health risk appraisal in older people 1: are older people living alone an “at-risk” group? British Journal of General Practice, 57(537), 271-6.
5. Pimouguet, C., Rizzuto, D., Lagergren, M., Fratiglioni, L., & Xu, W. (2016). Living alone and unplanned hospitalizations among older adults: a population-based longitudinal study. European Journal of Public Health, 27(2), 251-6.
6. Barrenetxea, J., Tan, K. B., Tong, R., Chua, K., Feng, Q., Koh, W-P., & Chen, C. (2021). Emergency hospital admissions among older adults living alone in the community. BMC Health Services Research, 21(1), 1192.
7. Abey‑Nesbit, R., Jamieson, H. A., Bergler, H. U., Kerse, N., Pickering, J. W., & Teh, R. (2023). Chronic health conditions and mortality among older adults with complex care needs in Aotearoa New Zealand. BMC Geriatrics, 23(1), 318.
8. Reeves, M. J., Prager, M., Fang. J., Stamplecoski, M., & Kapral, M. K. (2014). Impact of living alone on the care and outcomes of patients with acute stroke. Stroke, 45(10), 3083-5.
9. Fleming, J., & Brayne, C. (2008). Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. BMJ, 337, a2227.
10. van Leeuwen, K. M., van Loon, M. S., van Nes, F. A., Bosmans, J. E., de Vet, H. C. W., Ket, J. C. F., Widdershoven, G., & Ostelo, R. (2019). What does quality of life mean to older adults? A thematic synthesis. PLoS ONE, 14(3), e0213263.
11. Davey, J. (2006). “Ageing in Place”: The views of older homeowners on maintenance, renovation and adaptation. Social Policy Journal of New Zealand, 27, 128-41.
12. Tuohy, R., & Stephens, C. (2016). Older adults’ meanings of preparedness: a New Zealand perspective. Ageing & Society, 36(3), 613-30.
13. Stokke, R. (2016). The Personal Emergency Response System as a technology innovation in Primary Health Care Services: An integrative review. Journal Of Medical Internet Research, 18(7), e187.
14. Wang, Y., Srikanth, V., Snowdon, D. A., Ellmers, S., Beare, R., Moran, C., Richardson, D., Lotz, P., & Andrew, N. E. (2021). Quantifying the economic benefit of the personal alarm and emergency response system in Australia: a cost analysis of the reduction in ambulance attendances. Australian Health Review, 45(1), 51-8.