Evaluating the Feasibility, Acceptability, and Utility of the Home Alone Intervention: A Mixed Methods Pilot Study

Loneliness and social isolation are associated with significant negative impacts on physical and mental health. Living alone increases one's risk for loneliness and social isolation. Many older adults live alone, including individuals with mild cognitive impairment (MCI) and subjective memory decline. Living alone with a diagnosis of MCI or subjective memory decline adds greater complexity, stress, and difficulty in navigating daily life due to loneliness, social isolation, and negative mental and physical health outcomes. Despite these concerns, there is a dearth of support interventions for older adults who live alone with memory decline. Home Alone is a new support program created for this unique population of older adults in continuing to live independently and safely while engaging in social and meaningful activities. This pilot study evaluated the feasibility of the novel Home Alone support program.

Home Alone is a seven-session psychosocial and psychoeducational intervention that provides one-on-one, tailored coaching in person or via telehealth. Home Alone focuses on promoting home safety strategies and modifications and encouraging personally meaningful activity and social engagement through behavioral activation-based tasks. Fifteen older adults who live alone and have MCI or subjective memory decline enrolled in the 3-month feasibility study to evaluate the initial program and inform its refinement. Mixed methods data were collected from 1- and 3-month follow-up surveys. Additional qualitative data on participants' experiences of the Home Alone intervention were collected at post-intervention interviews.

Results demonstrated preliminary feasibility, utility, and acceptance of Home Alone. Qualitative analyses of participant interviews identified useful aspects of the intervention, including home safety, meaningful activity, and socialization, as well as recommendations for program refinement.

The Home Alone program was well-received and viewed as valuable by participants. Participant feedback and recommendations were incorporated to further improve the intervention. The refined Home Alone intervention is now being evaluated in a larger pilot trial. Trial Registration: ClinicalTrials.gov identifier: NCT05746390.