(Peter McGraw is a behavioral economist, business school professor at the University of Colorado Boulder, and holds appointments in the Leeds School of Business and the Department of Psychology and Neuroscience. He is author of Solo: Building a Remarkable Life of Your Own, and host of the Solo podcast, where he explores the lives, challenges, and possibilities of single living. His work examines how institutions, markets, and culture are adapting—or failing to adapt—to the rise of singles.)
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There is a scene that lives in our collective imagination. A dying person, propped on pillows, surrounded by loved ones. Hands held. Words exchanged. The room heavy with meaning. It is the ending we are all supposed to want—the one that hospice brochures illustrate, that movies score with swelling strings, that obituaries signal with the phrase “surrounded by family.”
And then there is the other phrase: died alone.
Two words that function as a verdict. Not just a description of circumstances, but a judgment: that a life ended badly, that someone was failed, that something went wrong.
But what if it didn’t?
The Assumption Nobody Questions
The assumption that dying alone is tragic runs so deep that we rarely notice it operating. It shapes healthcare policy, hospice practice, palliative care training, media coverage, and the way we talk to each other about death. When someone dies alone, the reflex is to ask: Where was the family? Where were the neighbors? Where were the systems that were supposed to prevent this?
The question nobody asks is whether the person wanted it that way.
Sociologist Glenys Caswell asked. In her book Dying Alone: Challenging Assumptions and in a study published in the journal Mortality with her colleague Mórna O’Connor, Caswell examined older adults’ perspectives on living and dying alone. Their work challenges the conventional wisdom: For some people, the prospect of dying alone is far less frightening than the prospect of losing independence, privacy, or control.
They did not necessarily want to be managed, monitored, or surrounded. They wanted their deaths to remain congruent with their lives—in their own space, on their own terms, and perhaps in their own silence.
This was not despair. It was continuity.
Some people make deliberate choices about how to live. At the end of life, those choices should not automatically be reinterpreted as pathology.
A Distinction Worth Making
There is a critical distinction that gets lost in the cultural panic around solo death: Dying alone is not the same as dying lonely.
Japan has a word for the version we should worry about: kodokushi—lonely death. In 2025, 76,941 people in Japan were found dead alone in their homes, according to data reported from Japan’s National Police Agency. Some had been undiscovered for days or longer. These deaths raise serious concerns about aging, poverty, social isolation, and gaps in community support. They can represent genuine failures—of connection, infrastructure, and care.
But Caswell’s research points to something different. Not every person living alone is abandoned. Not every person who prefers solitude is lonely. Not every death without witnesses is a social failure.
Some people are not seeking rescue from solitude. They are seeking respect for autonomy, privacy, and continuity with the way they have lived.
Collapsing these very different experiences into a single narrative—dying alone is always bad—does a disservice to both. It obscures the suffering of people who are isolated and neglected while pathologizing the preferences of people who are intentionally solo.
The Numbers Behind the Narrative
This is not a fringe issue. In 2024, there were 38.5 million one-person households in the United States, representing 29% of all US households, according to the Census Bureau. That share was 27.6% in 2020, up from 17.6% in 1970 and 7.7% in 1940.
These are not only elderly widows and widowers. Young adults are marrying later. Divorce among adults over 50 has risen sharply since 1990. Economic independence, especially among women, has made solo living viable in a way it was not for much of modern history.
The rise of living alone is one of the most significant demographic shifts of the modern era. And yet our end-of-life infrastructure has not fully caught up.
Much of the healthcare system still works best when a spouse, adult child, or close family member is available to advocate, coordinate care, and make decisions. Advance care planning often begins with the question: “Who will speak for you?” That is an important question. But it should not be the only one.
We also need to ask: “Who do you want with you?”
And, more radically: “Do you want anyone with you?”
The entire apparatus of the “good death” was built for a world where most people lived and died inside family structures. That world is changing.
Rethinking the Good Death
The good death movement has done important work expanding our vocabulary for dying well: dignity, autonomy, presence, peace, pain management, truth-telling, the right to refuse treatment, and the right to make decisions about one’s own body.
But notice what even many progressive frameworks still assume: company.
Someone to advocate. Someone to witness. Someone to hold the hand.
For many people—probably most—the surrounded-by-family ending is exactly what they want. They should have it. No one should be forced into isolation at the end of life because of neglect, poverty, stigma, institutional failure, or lack of support.
But a genuinely pluralistic ethic of the good death has to make room for another possibility: the person who wants the door closed, the cat on the bed, the window open, and nobody else in the room.
Not as a concession to the unlovable.
Not as evidence that something went wrong.
Not as a failure of the system.
But as a legitimate ending for a life deliberately lived solo.
This is not an argument against companionship. It is an argument against compulsory companionship. It is an argument against treating family presence as the only acceptable evidence that a life was meaningful and a death was humane.
The assumption that everyone wants to be surrounded does not protect people. It erases some of them.
What Needs to Change
If we take this seriously, three things follow.
First, advance care planning should include explicit questions about accompaniment preferences. Not just who should make decisions. Not just who should be notified. Not just who should be allowed in the room. But whether the person wants anyone present at all.
This is a basic act of respect. It costs nothing.
Second, we should stop treating every solo death as a crisis to be post-mortemed. Some solo deaths are failures of care. Some are tragedies of neglect. But some may be exactly what the person wanted. Our discomfort with that possibility says more about us than about them.
Third, we need to update our cultural script. The phrase “died alone” should be a description, not a diagnosis. Whether it represents tragedy, neglect, privacy, peace, or a final act of autonomy depends entirely on the person.
The only way to know is to ask while they are still alive.
Caswell’s work gives us a better frame: Some people’s preferences around dying alone may be congruent with how they have lived. That choice deserves to be recognized as valid.
I study the rise of solo living and its effect on institutions—what I call the Solo Economy. One of the recurring themes I find is the gap between how single adults actually live and how institutions assume they live. That gap may be widest at the end of life.
We have learned to respect how people choose to live. The end of life should not be the exception.
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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.
Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.
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I really, really appreciate this article “Some people want to die alone.” With the description of lying on the bed with the cat, and looking out on a beautiful forest, I found myself agreeing competely. Or maybe out on the deck if it’s a nice day, surrounded by nature. I don’t see why the family or anyone else has to suffer this, but if it must be so, I’d like one close friend that’s comfortable with death and can notify everyone else. Thank you for normalizing this preference, to the extent possible. That said, if it’s important to them to be there, and we talk about it ahead of time, I may allow it as a kindness to them.
Thank you for sharing this perspective. I’ve known people who died while the family was “on the way.” And others who died after the rest of us finally left the room for sleep or something. I suspected some people didn’t get to say “Leave me now,” when they could have, and would have, if it seemed permissible. Even under heavy sedation a private person may want privacy for their final breath. It’s another topic we need to add into our end-of-life discussions.
As for doulas sitting with unconscious patients or patients who may barely know a doula is there, I would recommended my piers to sit.
First, because most people do want a doula, as do the families and staff. But beyond that, even the best hospice centers are way understaffed and as a doula I could see when a patient was overdue for pain or anxiety meds, or suction, and could go and get a nurse to attend to them. Otherwise they would have been in anguish for sometimes an hour or more (which shouldn’t happen but does) In that situation I’d appreciate the help. I hope to avoid that situation.
I was a hospice doula for quite a few years, and like all hospice doulas know that there is great value in the work we do. We are a comfort to many patients, their families and their caregivers. Everyone is so supportive of the role. And yet I’ve never entertained wanting someone with me when I die.
It occurred to me that that might be unusual. So in a new less support group I used to run I asked about 25 people if they would want a doula. And only a few said yes. Now that’s not a scientific study by any means, And maybe some of them were thinking they just want to be with family, but I was definitely not alone in that room.
On a side note , I really appreciated hearing Frank Ostaseski (founder of Zen hospice project) say that the concept of” no one dies alone” is a travesty. And every training session I gave stressed to make sure that the patient wants you in the room!!! (If they were able to communicate.)
If you want to get a read on people’s general resistance to this thinking, say the words,” you come into this world alone, and you leave this world alone.” OMG! People hearing this protest! To most it sounds so sad. I believe it simply comes down to our society’s inability to accept mortality. – as a doula you get a lot of time to learn to accept! And without the fear, many of us are are ‘good’ being alone.
Thank you for writing this, and bringing the subject to light!