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Aging Alone - Old Dominion Home Care

 Could You Be An Elder Orphan?

In 2013 when I was working as an aging life care manager our business held a focus group comprised of aging adults who lived in our community.  We wanted to learn what their most pressing concerns were.  The number one fear was “how am I going to take care of myself as I grow older if I am alone?”  ” What will I do when I can no longer drive?”  “Who will take care of me when I am sick?” To address this unmet need for the growing number of elders who are aging alone, our business launched a program to fill the gap.  The term “elder orphans”, coined by specialists in geriatrics,  is relatively new  and is used to describe individuals aging and living alone with little or no support system.

A typical “elder orphan” who joined our program was Mary, a 78 year- old widow without children.  Mary lived independently in her family home, walked to the grocery store weekly, volunteered at the local museum and took the subway to concerts with her 90 year- old friend, Sylvia. Mary joined because she wanted someone she could call in case of an emergency someone who would advocate for her.  Sylvia, also widowed, with two children who lived long distance joined our program but for a different reason. Like Mary, Sylvia was very active—climbed ten flights of stairs daily to stay in shape and participated in community organizations. She has a history of heart disease and feared getting sick and being alone in a hospital waiting for one of her children to fly across the country to be at her bedside.  What both Mary and Sylvia were looking for was an advocate– someone to care about them and connect them with community resources for help when they needed.  Within a year, one-third of our practice consisted of men and women, but mostly women, just like Mary and Sylvia– who feared aging alone.

The number of Baby Boomers who are aging alone is growing.  And, there is a trend today for this generation to remain single or if married, not to have children. Research by Dr. Maria Torroella Carney, Chief of Geriatric and Palliative Medicine at North-Well Health found that 22 percent of Americans 65 years and older are aging alone and lack family or supports that can take care of them.  In addition, according to 2012 US census data, approximately 1 out of 3 Americans age 45-63 are single. Based on some research, sixty percent of nursing home residents do not have visitors!  According to Carney, “We are all at risk for becoming isolated and becoming “elder orphans.”  Even if you’re married, you can outlive your spouse.  Even if you have children, they may be unable to care for you because they have busy lives.”  Everyone is potentially an elder orphan.  The picture of living alone in a nursing home without even a visitor is heart wrenching.  Even more frightening, there are not enough nursing home beds to care for all the baby boomers who become, or are, “elder orphans.”

The lesson here is–everybody should be prepared to live as independently as possible and have a support system.  Carol Marak, an “elder orphan” herself and expert on aging, has written and shared articles on the web about her experience living alone.  In her article “Baby Boomers Aging Alone Plan,” she urges all adults to know the stages of aging:   Independence, Interdependence, Dependence, Crisis Management; and last Stage—Institutional Care.  In my experience as an aging life care manager, crisis management is too often the first stage of recognition that help is needed but the best outcomes do not usually occur when one is in crisis mode,.

For too long, our society has ignored the elderly and focused on the young.  As we know, most people want to age in place but it takes a village to make that wish come true. This applies especially to those are “elder orphans.”  But the burden should not rest solely on the individual to find their own way.   City leaders and policy makers across the country need to develop solutions to improve older people’s lives in the community.  It is encouraging to hear about innovative ventures to help elders remain independent in their homes. For example, in North Carolina there are two such efforts involving partnerships between church communities and health care systems. The New York Foundation for Senior Citizens operates a home sharing service.  It matches older people who have space in their homes with younger adults in need of affordable housing.   Another innovative idea is happening in the Village Movement. Villages typically offer transportation, home repairs, companionship for their members but there comes a time when those services are not enough, especially for those living alone.  The Arlington Neighborhood, along with several other Villages in the Washington, D.C. area, are piloting care manager services as a member benefit. The hope is that the care manager will be able to address problems before the crisis.

So, if you are over 65 and still in the ” independent stage”, look around and identify your support group—friends, family, church. Establish yourself in your community and know the resources that can help you if, and when, you can no longer drive or maintain your yard, shovel the snow or get sick.   Make sure your health care providers know your situation. Identify a health care proxy—someone you know is ethical, who will advocate for you and honor your wishes regardless of their values and beliefs. Consider joining a neighborhood village or help a young person by sharing your home.  Be proactive!  Remember, “It is always too soon, until it is too late!”

Author:  Judy Grumbly, RN, Aging Life Care Manager