It’ s a population whose numbers far exceed those living in nursing homes— about 1.2 million— and yet it receives much less attention from policymakers, legislators and academics who study aging.
Consider some eye-opening statistics about completely homebound seniors from a study published in 2020 in JAMA Internal Medicine: Nearly 40 % have five or more chronic medical conditions, such as heart or lung disease. Almost 30 % are believed to have“ probable dementia.” Seventy-seven percent have difficulty with at least one daily task such as bathing or dressing. Almost 40 % live by themselves.
Homebound seniors often slip through health system cracks
STORY BY KFF HEALTH NEWS
Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern.
“ What’ s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’ s Visiting Doctors Program.
“ I don’ t know,” she answered, so softly it was hard to hear.“ Going from here to the bathroom or the door, I get really winded. I don’ t know when it’ s going to be my last breath.”
Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’ s fallen several times and dropped to 85 pounds, a dangerously low weight.
And she lives alone, without any help— a highly perilous situation.
Across the country, about 2 million adults 65 and older are completely or mostly homebound, while an additional 5.5 million seniors can get out only with significant difficulty or assistance.
That“ on my own” status magnifies these individuals’ already considerable vulnerability, something that became acutely obvious during the Covid-19 outbreak, when the number of sick and disabled seniors confined to their homes doubled.
“ People who are homebound, like other individuals who are seriously ill, rely on other people for so much,” said Katherine Ornstein, director of the Center for Equity in Aging at the Johns Hopkins School of Nursing.“ If they don’ t have someone there with them, they’ re at risk of not having food, not having access to health care, not living in a safe environment.”
Research has shown that older homebound adults are less likely to receive regular primary care than other seniors. They’ re also more likely to end up in the hospital with medical crises that might have been prevented if someone had been checking on them.
To better understand the experiences of these seniors, I accompanied Gliatto on some home visits in New York City. Mount Sinai’ s Visiting Doctors Program, established in 1995, is one of the oldest in the nation. Only 12 % of older U. S. adults who rarely or never leave home
CONTINUED ON PG 8
6 SENIOR RESOURCE GUIDE 2025