Aging alone 

Ann Allen described her life as full. She grew up with her childhood friends, married, had children and, in her senior years, continued to live in her hometown where her sisters also live. But at 75, the St. Louis native found herself living alone like a growing number of older residents in the region.

Allen died this spring — alone in her senior living apartment — weeks after speaking to The St. Louis American. While The American has no information linking Allen’s solitude to her death, her story underscores the risks facing a growing number of older adults.

In a recent analysis of newly compiled U.S. Census data by The New York Times, St. Louis emerged as the “loneliest city,” driven by a dramatic rise in single-person households. Nearly half of all households in St. Louis, 48%, are occupied by just one person, the highest share among U.S. cities with at least 50,000 households. Living alone does not necessarily mean someone is lonely, but it can increase the risk of social isolation, especially among older adults.

Declining marriage rates, more affordable housing costs and a growing population of seniors aging alone have all contributed to the solo-living trend in the metro area. But behind the numbers lies a deeper and more complex story about connection, community and health, especially among older adults. Nearly 20% of St. Louis County’s population is over 65, according to the U.S. Census.

“When someone retires, their social network naturally narrows,” said Michele Prevedel, coordinator of Visit-a-Bit, a program that connects volunteers with older adults living alone across the St. Louis region. “If they stop driving, that narrows it even more. A lot of people stay in their homes, and over time, that isolation grows.”

And that isolation can lead to loneliness.

“Loneliness starts as an emotion, but it can domino into the physical,” Prevedel said. “It doesn’t just affect how people feel. It can impact heart health, brain function, sleep and even immunity.”

The World Health Organization has linked loneliness to an estimated 871,000 deaths annually. That’s more than 100 deaths every hour.

Allen said she filled her days with reading and watching television, cooking and baking, and she was excited about sharing her recipe for the chicken cordon bleu she had made a few days earlier. She also sought ways to stay connected, even as her social circle shrank.

Between her food prep and housekeeping routine, she admitted that aging had presented some challenges. Her husband, a Vietnam veteran, died in 2004. Her children, now adults, live in California and Colorado. Time normally spent with her sisters became limited because of mobility issues. And two of her closest childhood friends moved to Kansas City and Dallas within the past several years.

In 2022, she lost both her legs as a result of a rare condition, antiphospholipid syndrome, an autoimmune disorder that can cause blood clots, and had been getting around using a wheelchair since.

“I was totally independent, and then everything changed,” said Allen, referring to life as a double amputee. “I have outlived my friends –– my childhood friends, my high school friends. I only have two left.”

“When your social group and your family group are the same age as you, and they die off or they move away, you’ve lost community,” she said.

Allen and her friends and family usually spoke by phone, and she had occasional visits from her sister, who would bring fresh produce. But Allen longed for that physical connection she had grown accustomed to. So, she took action and signed up for a local program that gave her opportunities to socialize.

Visit-a-Bit offers meaningful connections for older adults through volunteer support, weekly tele-bingo games and peer-to-peer connections.

Allen’s death is bringing attention to issues surrounding aging and living alone.

The Centers for Disease Control and Prevention draws a critical distinction between social isolation and loneliness. Social isolation refers to the absence of relationships or regular contact with others, while loneliness is the emotional experience of feeling disconnected. Both carry serious risks.

CDC research shows prolonged isolation is linked to higher risks of heart disease, stroke, depression and dementia –– all contributors or related to cardiovascular disease, the No. 1 killer of Black Americans.

Prevedel said programs like Visit-a-Bit, which is operated through SSM Health Visiting Nurses Association, are helping to bridge the gap between healthcare and community support.

“We pair people based on hobbies, interests and social needs. So, the connection is genuine, and we’re seeing meaningful connections that truly improve quality of life,” she said. “It’s about reaching people who are homebound who may not have technology, transportation or a support system.”

Darla King participated in the Visit-a-Bit program as Allen’s volunteer connection and built a friendship with her over the past four years.

“It’s a joy to go see her,” King said in an earlier interview. “We’re kindred spirits. We just have that respect for each other that makes everything easy.”

King, a correspondence specialist for U.S. Bank, relocated to the St. Louis region 19 years ago from California to take care of her ailing father, who is in his late 80s. She understands the impact that having family and friends around can have on older adults.

“When I’m with Ms. Ann, it’s like time stands still. We just talk and talk,” she said. “Sometimes I bring lunch. I always bring her flowers.”

King, who has adult children and now lives alone, said the connection shows not only the impact she had on Allen, but also how much she gained from the experience.

“She has enlightened my life the same way I have enlightened hers,” she said. “She’s the sunshine that you didn’t know you needed.”

Allen said before her passing that her quality of life would not be the same without King.

The relationship made her wish she had built a broader, more layered community –– friendships across generations that could have sustained her through her latter stage of life.

“Reassess your friendship base,” she said. “If I had thought about it, I would have had tiers of friends. People younger than me, people older than me. People I could still tap into.”

Both women agreed that those kinds of relationships take work.

“The seeds that you plant, you will see the flowers grow. If you plant no seeds, you have no harvest,” King said. “I choose to give of myself in a way that makes someone else’s life better because someone did that for me.”

Over the years, King’s weekly visits turned into monthly visits as life became busier, but the two continued to cook and dine together.

Her April visit got pushed back due to a business trip to Kentucky. When King returned, she learned Allen had died.

“She was such a vibrant woman who was looking forward to doing so much. We just talked about how she wanted to go horseback riding,” King said tearfully recalling one of her last conversations with her friend.

Allen knew it was going to take some work, but she wanted to explore further physical therapy to get her prosthetics adjusted to jump back into the saddle for equestrian classes offered to people with limited physical capabilities.

Allen, who would have turned 76 in October, said it was “seldom” that she felt lonely, “but there are times I feel alone.”

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