The fourth part of this excellent series in the NY Times examines what it's like to be alone with serious illness:

There is no way to calculate how many Americans of all ages living alone happen to be sick or disabled, but hospital discharge planners and home health care agencies say they are serving more single people without an obvious person to look after them.

The growing number of single-person households - including the never-married, divorced and widowed - is evident in census reports. In 2003, nearly 27 percent of American households consisted of one person living alone, up from 18 percent in 1970, putting a premium on friendship, a relationship without the legal status or social standing of kin. And demographers warn that the graying of the baby boom generation will swell the ranks of single-person households, with illness and disability an inevitable corollary of old age.

People living alone are among the most difficult cases, said James Bentley, a senior vice president at the American Hospital Association. Anyone who is sick or disabled, Mr. Bentley said, "needs someone to quarterback their care," both in the hospital and afterward, but people who live alone can end up being their own quarterbacks at a particularly vulnerable time.

"The patient can't be at both places at once mentally," he said, "but we don't yet have a good mechanism to address that."

Making the situation worse is the increase in short stays in hospitals, which sometimes send people home before they can manage alone. Mr. Bentley said that hospitals must develop new ways of preparing such patients for what lies ahead and that people who live alone must "think, before they are ill," what organized networks they have to call upon.

"If we wait until the baby boomers need this, there'll be so many of them it will be impossible to manage ad hoc," he said. "It's something we need to think about now, or it's going to be an absolute mess."

(Gross, "Alone in Illness, Seeking Steady Arm to Lean On", NY Times, Aug.26)