Living alone in later life: Understanding independence, adaptation, and well-being in the face of impairment using the National Health and Aging Trends Study
Date
2023-12
Authors
Nemmers, Natasha Lina
Major Professor
Advisor
Lee, Jeongeun
Martin, Peter
Russell, Daniel
Gilligan, Megan
Shelley, Mack
Committee Member
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Abstract
This dissertation investigated the multifaceted implications of solo living in later life, particularly focusing on the adaptation strategies to maintain independence and psychological well-being amidst impairments. Three research studies were conducting using data from the National Health and Aging Trends Study (NHATS). In Study 1, latent profile analysis uncovered three distinct disablement profiles among solitary dwellers: Unimpaired, Poly-Impaired, and Sensory Impaired. The Poly-Impaired group, marked by pervasive impairment and limitations across domains, exhibits reduced activity engagement, heightened dependence on assistance, and a racial-ethnic minority demographic skew. Meanwhile, participants in the Sensory Impaired group were linked to advanced age, lower educational attainment, Hispanic ethnicity, reduced social activity, heightened dependence on assistance, and poorer mental health outcomes. The Unimpaired profile, the largest group, showcased facets of optimal aging. Study 2 compared older adults living alone and living with others on the propensity to relocate to long-term care between 2011 and 2019. Functional disabilities (i.e., self-care and mobility difficulty) and environmental compensatory strategies (i.e., mobility device utilization, bathroom modifications, and human help were also assessed. The findings disclosed a notable trend: individuals living alone, especially with greater disabilities, had a significantly higher likelihood of relocating to long-term care. Contrary to expectations, the use of compensatory strategies increased the odds of moving, and these effects were amplified among solo living adults. In Study 3, a latent growth curve mediation model was employed to comprehend the relationships between cognitive impairment, activity engagement, and well-being over five time points. The results revealed that higher initial activity levels and increasing engagement were associated with improved well-being at baseline and over time. The mediating role of baseline activity was evident in the link between cognitive impairment and initial well-being, although the mediating effects were marginal with regards to changes over time. Collectively, these three papers expand our understanding of the intricacies associated with solo living in later life. The findings underscore the importance of tailored interventions, early assessments, and the need to increase awareness of available age-related resources to fortify independence and well-being within this unique context.
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Type
dissertation