These days, living with two knee replacements, chronic obstructive pulmonary disease and other ailments, she can no longer drive and sits at home alone a lot. She says even people from her church don’t come to see her much.
“Since I’ve gotten 84, it’s gotten tough,” Pugh-Myers said in her South Durham home.
Like Pugh-Myers, roughly three out of 10 North Carolinians older than 65 live alone, as do 12 million people nationally. As the state’s over-65 population reaches a million, the percentage and raw numbers of older people living alone will also increase, the result of the flood of baby boomers, many of whom have divorced, never married or will outlive spouses.
Researchers at the Washington, D.C.-based AARP Foundation have pinpointed social isolation as a factor, along with housing, income and hunger, that can lead to catastrophe for older people. Stacks of medical studies tie living alone to increased rates of physical and mental illness, another indication that rising Medicare costs will be even tougher to contain.
Keys to Successful Aging
Faced with the alternative of long-term care, most older people prefer to live alone, but it’s not easy and there are emotional and physical risks. The keys to successful “aging in community” involve support from family and sometimes government, advocacy in health care, keeping up mobility, access to transportation and social involvement.
For example, Pugh-Myers has a background in health care and help from family and government-paid caregivers to protect her from some of the worst consequences of living alone.
“I stay alone so far,” she said. “It’s a tough life, but God’s good. I’ve got two or three friends. When I was working, I had a whole lot of friends.”
Daniel Rodriquez, 87, in North Raleigh, has family members living nearby who check on him daily, and family in his native Puerto Rico he talks with regularly.
Martha Driver, 85, of Garner, also has supportive family and a deep religious faith.
Professionals who work with older people say they need to have strong advocates for them in dealing with health care and other vital matters. Or, like Clydie Pugh-Myers, an older person can speak up for herself, as she felt compelled to do during a recent hospital visit.
“I said, ‘What kind of antibiotic am I on? I’ve been on that long enough – I would change that,’” she said. “Everything I told them to do, they did it, and I got better.”
Conditions can turn grim for older people in a society where people are living longer, husbands usually die before wives, relatives aren’t always nearby and social services are shrinking relative to the growing number of aging baby boomers.
“They have no children. Their siblings have died,” said Alan Winstead, executive director of Meals on Wheels of Wake County. “And they are alone.”
Sequestration Cuts 12,000 Senior Meals
Myers, Driver and Rodriquez each get visits from Meals on Wheels or in-home caregivers, part of a set of state, local and federal services that are mostly maxed out and face static or decreasing funding. Federal sequestration cuts have trimmed $1.9 million this year from North Carolina counties’ ability to offer this help. Meals on Wheels of Wake County, for example, will serve 12,000 fewer meals this year because of sequestration cuts.
The budget proposed by Gov. Pat McCrory, a Republican, calls for no increase for such services, despite waiting lists of more than 13,000 people statewide.
Daniel Rodriquez is one of the more fortunate solo seniors, practicing what experts call “aging in community.” He lives alone in North Raleigh and no longer drives, but remains close to family, with one daughter in the same apartment complex. Rodriquez spent his career as a plant manager in New England, then came to North Carolina after his adult children moved here.
“My daughter comes every day,” Rodriquez said. “I’ve got another one in Wake Forest; she comes every Saturday.”
For daughter Lydia Menzel, 57, the weekly trip from Wake Forest is a Saturday reward as well as a chance to fix food and prepare medication for Rodriquez.
“I’m finding it to be a blessing,” Menzel said. “It’s great every week.”
For exercise, Rodriquez takes his dog, constant companion Tess, out for a walk three or four times a day.
“Since my wife died, I’ve been with the feelings that I would like God to take care of me,” Rodriquez said. “It’s a lot different. It’s kind of tough.”
Rodriquez has a colorful life to reflect on – he spent his teen years in Puerto Rico, then moved to New York City in the 1940s. Before he started climbing the ladder to success in manufacturing, he got a job making brushes for 75 cents a day.
“I used to have a good time,” he said of his days working and partying in lower Manhattan, then raising a family. “Now I am suffering myself a little. Sometimes I think I am getting my daughters to work a little bit too much.
“I ask God to let me be with him and stop this type of life.”
A New Normal
Martha Driver, 85, worked for BellSouth until she was 65, then stayed on past the typical retirement date because the company needed her. Many of today’s older seniors have rich lives to remember, but may lack the resources, ability or will get out of the house to shop or see friends and family.
“I haven’t been able to go to church in a little over a year,” driver said. “I did real well until the last year and a half. I had double pneumonia and had side effects from that. It seems like I don’t have the same energy I did.”
There are ways that older people living alone often require changes in lifelong habits, acceptance of new ways of doing things and higher levels of dependence.
“If you don’t stay active, you start losing your ability to be active,” said Winstead, with Meals on Wheels. The agency serves thousands of residents daily, both with home visits and at senior centers or other sites where dozens of seniors can dine and talk together.
“If you’re going to a congregate meal site, you get to do a few activities with your new friends,” Winstead said. “It’s very simple if you’re at your apartment to say, ‘Nah, I don’t feel like it.’”
Duke University’s Dan Blazer, a nationally renowned geriatric psychiatrist, said the proximity of other people, particularly a spouse, is typically a sign that an older person will be healthier, physically and emotionally.
“Often you need somebody there to say, ‘Did you take your pills tonight?’” he said. “When a spouse dies, with men especially, their mortality increases in the year after their spouse’s death.”
He added, “When you lose somebody really close to you, like a spouse, not only do you miss the person emotionally, there are routines that you go through, like what you do in the morning. When that other person is gone, that routine is gone and that can be very disruptive.”
More Lives May Spin Out of Control
Changes in social services and the mental health system mean that more people living alone may see their lives spin out of control, said Craig Burrus, Wake County’s program manager of senior and adult services .
“It’s on the increase and likely to continue based on the state of the mental health system and the dwindling of services and personal interaction with the people that need help,” Burrus said.
Among other county functions, Burrus oversees adult protective services, the staffers who get called in when an adult can clearly no longer maintain an independent life.
If the person is living in a seniors-only complex such as Capital Towers in North Raleigh, management can alert the county that the tenant’s situation is desperate.
“They happen to go into somebody’s apartment to do a routine check and it’s a mess with feces all over the place,” Burrus said.
With the increase of solo seniors, the importance of remaining engaged will also grow, whether through senior centers, adult day cares, informal gathering places or churches.
Blazer pointed to telemedicine as a means to bridge gaps between people living at home alone and medical professionals. A physical therapist could, for example, monitor via Skype the progress a patient is making as he learns to use a walker or crutches in a home setting. But the up-close personal visit remains best, whether for professional or personal contacts.
“The most advantaged people can escape isolation – they go into retirement communities,” Blazer said, referring to places such as the Forest at Duke, where residents can start in independent cottages and wind up in skilled-nursing care.
Making the Rounds
Healthier or more mobile acquaintances can help isolated folks by actively encouraging those living alone – especially with memory or hearing problems – to get out and make their customary rounds.
Hazel Logan, 84, works with the senior ministry at Martin Street Baptist Church in Raleigh. Many members of the congregation from the World War II generation, Logan said, keep active and reach out to members living alone who can no longer make it to church.
But they also have an active ministry to younger people in the historically African-American neighborhood around the East Raleigh church.
“We grew together, we had children together and now we are old together,” Logan said of her peer group. “We were satisfied with the church membership, but that is not altogether what church is about. We are focusing now on what’s outside the walls.”