More Americans Age At Home, Alone

At least three times a night during much of the long, harsh northern winter, Aldea Campbell gets out of bed, steps into her slippers, and descends a flight of frighteningly steep, narrow wooden stairs to the cellar to fill her wood-burning stove. She’s 82, a widow, and has lived in her 102-year-old house near the Canadian border for almost six decades.

Aldea Campbell, 82, who lives alone in her 102-year-old 
house in Stockholm, Maine, descends narrow stairs to fill 
her wood-burning stove several times a night during 
the winter. Photo: Jason Paige Smith/WSJ

She burns wood because she can’t afford enough oil to get through the cold months. When her arthritis is bad, she gingerly maneuvers the steps sideways to keep from falling. But still, she slipped on the stairs twice last year, once badly hurting her tailbone. “It happened so fast,” she said.

Such predicaments are increasingly common in Maine: the grayest, most rural state in the U.S., with housing among the oldest in the nation. Maine has another distinction: it is among the first states to experience challenges from a growing number of seniors who are “aging in place”—remaining independent rather than relocating to nursing homes or moving in with grown children.

Wellman Pryor, 89, on the back porch of his home in 

Fort Fairfield, with his dog, Maxx. Mr. Pryor, a retired 

commercial float plane pilot, has had three surgeries that 

make it hard for him to keep up with repairs on this 

home. Photo: Jason Paige Smith/WSJ

More elderly across the nation are aging at home for a variety of reasons: they prefer to and are healthy enough to stay; they can’t afford other options such as assisted living; and states in some cases have imposed policies to limit nursing home stays paid for by Medicaid, which is a major funder of long-term institutional health care for older Americans.

But aging in place is proving difficult in places where the population is growing older, supportive services are scarce, houses are in disrepair and younger people who can assist have moved away. As a result, elderly people who live at home are having to rely more on neighbors—who sometimes are elderly, too—and local nonprofits and public agencies are starting to feel the strain from increasing requests for help.

“It’s a huge issue—it couldn’t be bigger,” said Lenard Kaye, director of the University of Maine Center on Aging. “Ninety-nine percent of older adults say they want to stay right where they are until they’ve taken their last breath, but that doesn’t mean they are continuing to remain safe and remain well.”

Medicaid, a network of aging services under the federal Older Americans Act and state and community programs have long provided some assistance to elderly people who want to remain independent. But in general, people who choose to age at home “have always been on their own,” said Donna Wagner, dean of the New Mexico State University College of Health and Social Services and a researcher on aging. “I don’t think we’ve had a clear contract with the elderly,” she said.

Public and private entities are increasingly trying to offer more services but demand is outstripping supply because the population is aging, she said. In some poorer areas, services can be hard to find at all, she said. “This philosophy of remaining independent with the help of community-based services has been a little oversold,” said Ms. Wagner. “Lots of people have a hard time doing it.”

Maine, Pennsylvania, Kentucky and New York are among states now boosting programs that help the elderly live at home, while churches and communities are also implementing more initiatives.

Participants in a youth mission trip organized by Saint 

Anne and Saint Catherine of Alexandria parishes in 

Massachusetts work on the roof of Karen Hill’s home in 

Caribou, Maine, this summer. The mission group helps 

repair homes of the elderly in Northern Maine. 

Photo: Jason Paige Smith/WSJ

There were 26.8 million households headed by someone 65 and older in 2013, up 24% from 10 years earlier, according to the U.S. Census. Households headed by a person 75 and older grew 13% to 12.2 million. Meanwhile, the number of older people living in institutions or with relatives has declined. Living alone has supplanted living with relatives as the most common scenario for women 75 and over, according to the Census’s official blog in July, describing a “gray revolution in living arrangements.”

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