Is Home Always Better? What the Studies Say About Loneliness

At home, who do you talk to on a Tuesday?

By Neil Solomon · 3 min read

I believe that loneliness in a facility might have shortened my father's life. It is a belief and not a fact. The studies below do not settle it either way.

Here is what they say.

Picture a woman named Rosemary, 74. She lives alone in the house where she raised her children. Her daughter has asked her to think about an assisted living community near her. Rosemary read that loneliness is bad for health, so she decided to stay home.

A friend asked her, "At home, who do you talk to on a Tuesday?"

Rosemary thought. "The mail carrier."

"I'm not saying move," the friend said. "I'm asking who."

The largest review of the research on this brought together studies that followed people over time. Holt-Lunstad and colleagues published it in 2015, covering studies up to early 2014.

An odds ratio of 1.29 means that, on average, people in that group had 29% higher odds of dying in the study period than people with more connection. The authors found no difference between measured isolation and felt loneliness. The effect was stronger in groups with an average age under 65. These are observations of groups. The review shows an association, and it does not prove that loneliness causes death. It also did not compare care settings.

The third row matters here. Living alone is on the list, and home is where many people live alone.

Studies of the question we usually ask are thinner. A 2017 Cochrane review looked at home or foster-home alternatives to institutions for people who needed daily help. It found 10 studies with 16,377 people, and only one was a randomized trial. The certainty was low or very low for deaths, hospital stays, function and quality of life. The reviewers concluded that there was insufficient evidence to recommend home-based alternatives. That is a finding about the evidence, and it points in neither direction.

A 2020 review of 28 studies looked at nursing home residents who had to move, for example when a home closed. It found that people who knew about the move and were prepared for it tended to have better health and well-being. The summary gives no effect on death, and a closure is a different situation from a move a family chooses together.

The studies do not tell us that one place is better for everyone. A care home can be a loving and right place for some. A person with friends down the hall and visitors who come on schedule could have more company there than at home.