At age 66, South Carolina doctor Paul Rousseau has decided to retire after decades of caring for the suffering of seriously ill or dying people. It was a difficult and emotionally charged transition.
“I didn’t know what I was going to do, where I was going to go,” he told me, describing a period of crisis that began in 2017.
Seeking a change of location, Rousseau moved to the mountains of North Carolina, the beginning of an extended period of wandering. Soon, a feeling of emptiness enveloped him. He had no friends or hobbies – his work as a doctor was all-consuming. Former colleagues did not come into contact, nor reached out.
His wife had died after a painful illness a decade earlier. Rousseau was estranged from one adult daughter and in only occasional contact with another. His isolation was reinforced as his three dogs, his most trusted companions, died.
Rousseau was completely alone—without friends, family, or professional identity—and was overcome by a sense of loss.
“I was a somewhat distinguished physician with a 60-page resume,” Rousseau, now 73, wrote in the Journal of the American Geriatrics Society in May. “Now, I’m a ‘nobody’, a retired, forgotten old man whiling away the days.”
In some ways, older men living alone are at a disadvantage compared to older women in similar circumstances. Research shows that men tend to have fewer friends than women and are less willing to make new friends. Often, they hesitate to ask for help.
“Men have a harder time connecting and communicating,” said Robert Waldinger, a psychiatrist who directs the Harvard Study of Adult Development, which has traced the arc of hundreds of men’s lives over more than eight decades. The men in the study who did the worst, Waldinger said, “didn’t have friendships and things they were interested in — and they couldn’t find them.” He advises men to invest in their “social competence” in addition to their physical fitness to ensure they have satisfying social interactions.
Slightly more than 1 in 5 men ages 65 to 74 live alone, according to 2022 Census Bureau data. That rises to nearly 1 in 4 for those age 75 and older. Almost 40% of these men are divorced, 31% are widowed and 21% have never married.
This is a significant change from 2000, when only 1 in 6 older men lived alone. Longer lifespans for men and rising divorce rates are contributing to the trend. Information on this group – which is dwarfed by the number of women living alone – is hard to come by because it has not been studied in depth. But psychologists and psychiatrists say these older men can be quite vulnerable.
When men are widowed, their health and well-being tend to decline more than women’s.
“Older men tend to ruminate, get into our heads with worries and fears, and feel more alone and isolated,” said Jed Diamond, 80, a therapist and author of “Surviving Male Menopause” and “The Irritable Male Syndrome”. .”
Add in the decline of political institutions where men gathered—think the Elks or the Shriners—and the reduced ability of older people to participate in athletic activities, and the result is a lack of stimulation and a loss of sense of belonging.
Depression can follow, fueling excessive alcohol use, accidents or, in the most extreme cases, suicide. Of all age groups in the United States, men over 75 have the highest suicide rate by far.
For this column, I spoke at length with several seniors who live alone. All but two (who were divorced) were widows. Their experiences are not representative of all men who live alone. But again, they are revealing.
The first person I called was Art Koff, 88, of Chicago, a longtime marketing executive I had known for many years. When I reached out in January, I learned that Koff’s wife, Norma, had died the previous year, leaving him grief-stricken. With no interest in food and incessant solitude, Koff lost 45 pounds.
“I’ve had a long and wonderful life and I have a lot of family and a lot of friends who are wonderful,” Koff told me. But now, he said, “nothing interests me anymore.”
“I’m not happy living this life,” he said.
Nine days later, I learned that Koff had died. His nephew, Alexander Koff, said he had passed out and passed out within a day. The death certificate listed the cause as “end-stage protein calorie malnutrition.”
The transition from being married to being single can be profoundly disorienting for older men. Lodovico Balducci, 80, was married to his wife, Claudia, for 52 years before she died in October 2023. Balducci, a renowned physician known as the “patriarch of geriatric oncology,” wrote about his emotional reaction in the Journal of the American Geriatrics Society, likening Claudia’s death to “mutilation.”
“I find myself talking to her all the time, most of the time in my head,” Balducci told me in a phone conversation. When I asked him who he confides in, he admitted, “Maybe I don’t have close friends.”
Disoriented and disorganized since Claudia died, he said his “anxiety has exploded.”
We spoke at the end of February. Two weeks later, Balducci moved from Tampa to New Orleans to be near his son and daughter-in-law and their two teenagers.
“I plan to help as much as possible with my grandchildren,” she said. “Life must go on.”
Vern Ostrander, a carpenter in the small town of Willitch, California, about 140 miles north of San Francisco, was thoughtful when I spoke with him, also in late February. His second wife, Cindy Morninglight, died four years ago after a long battle with cancer.
“Here I am, almost 80 years old — by myself,” Ostrander said. “Who would have guessed?”
When Ostrander isn’t painting watercolors, composing music or playing guitar, “I get into this lonely state and cry a lot,” he told me. “I don’t ignore these feelings. I let myself feel them. It’s like therapy.”
Ostrander has lived in Willits for nearly 50 years and is part of a group of men and a group of couples who have been meeting for 20 years. He is in remarkably good health and in close contact with his three grown children, who live within driving distance.
“The hard part about living alone is missing Cindy,” he told me. “The good part is the freedom to do whatever I want. My goal is to live another 20 to 30 years and become a better artist and meet my children when they grow up.”
Rev. Johnny Walker, 76, lives in a low-income apartment building in an economically challenged neighborhood on Chicago’s West Side. Twice divorced, he has been single for five years. He also has close family ties. At least one of his many children and grandchildren checks in on him every day.
Walker says he had a life-changing religious conversion in 1993. Since then, he’s depended on his faith and his church for a sense of meaning and community.
“It’s not hard to be alone,” Walker said when I asked if he was lonely. “I accept Christ into my life and He said He would never leave us or forsake us. When I wake up in the morning, it’s a new blessing. I just thank God for bringing me this far.”
Waldinger recommended that men “make an effort every day to connect with people. Find what you love — golf, gardening, bird watching, pickleball, working on a political campaign — and pursue it,” he said. “Put yourself in a situation where you see the same people over and over again. Because that’s the most natural way conversations happen and friendships start to develop.”
Rousseau, the retired South Carolina physician, said he doesn’t think too much about the future. After feeling lost for several years, he moved across the country to Jackson, Wyoming, in the summer of 2023. He embraced solitude, choosing an extremely isolated place to live—a 150-square-foot cabin without running water or a bathroom, surrounded by 25,000 acres of public and private land.
“Yes, I’m still lonely, but the nature and beauty here has completely changed me and focused me on what’s really important,” he told me, describing a feeling of redemption in his loneliness.
Rousseau realizes that the death of his parents and a very close childhood friend left him with a sense of loss that he kept at bay for most of his life. Now, he said, instead of denying his vulnerability, he tries to live with it. “There’s only so long you can put off dealing with all the things you’re trying to escape from.”
It’s not the life he envisioned, but it’s the one that suits him, Rousseau said. He stays busy with volunteer activities – cleaning tanks and tours at Jackson’s fish hatchery, serving as a part-time park ranger and maintaining trails in nearby national forests. These activities brought him into contact with other people, mostly strangers, only intermittently.
What will happen to him when this lifestyle is no longer possible?
“I wish I had an answer, but I don’t,” Rousseau said. “I don’t see my daughters taking care of me. As for someone else, I don’t think there is anyone else who will help me.”
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