Special Issues for Those Who Are Aging Alone

By Anna M. Rappaport, Society of Actuaries and WISER Board Member

When older individuals need help, family support is very important. But some people have no available family members. These individuals aging alone, also known as elder orphans, are aged, community-dwelling individuals who are socially and/or physically isolated, without an available family member or caregiver. These individuals face unique challenges.

The Situation Today

People who are single and have no children or other available family member are at great risk of being alone. Some people with family will not have support because the family members are not willing or able to help. It is estimated that 22% of Americans 65 and older are at risk of aging alone or becoming “elder orphans.”[1]

Planning for Care

These individuals have a continuum of support needs, changing with their age and health.

Support includes help with various tasks, activities of daily living, managing finances and decision-making.

Some help is short-term and not intensive. It may include tasks such as providing transportation, help with smaller home maintenance and housework, assistance with shopping, doctor visits, etc. Other people require intensive help daily and even around the clock and may require such help for a long time.[2] Friends and neighbors may offer some support, but they are unlikely to offer intensive help over a long period of time.

Many people who are aging alone have been accustomed to being independent and they manage well on their own until they decline.  It can be difficult for them to anticipate when they will need help and the importance of providing for future support.  My observation is that they are more likely to plan for the early stages of retirement, but they may have little awareness of late-in-life issues.  They often have not cared for others during the later stages of decline and to have experienced the challenges as others needed major help. People with more family are more likely to have been a caregiver.

Finding Care

These isolated individuals also face differing economic and community situations. Some may be well-off and able to hire caregivers as they age, while others will struggle. Age friendly communities are likely to offer informal support.  Specialized housing that provides a community and support services offers formal support and maybe informal support as well.

Identifying “Elder Orphans”

Another issue is that providers who care for elder orphans in their offices, a hospital or the emergency room may not recognize the situation or identify the special risks related to working with individuals aging alone who have not implemented a support system.

It is estimated that the number of people living alone with limited or no family support will increase in the future.[3] People aging in the coming years are in cohorts that had fewer children, were less likely to marry and married later than today’s elderly. Divorce has also been on the rise.

Some individuals aging alone have designated people to make decisions for them when they can no longer make them, but others have not chosen anyone, or they may have chosen someone but not set up the appropriate paperwork. It is particularly troublesome when individuals without designated decision-makers develop dementia. At that point, the courts may be asked to appoint guardians.

Ways to Prepare

If you or someone you know is aging alone, you should be aware of several areas you may need to problem solve:

  • You will probably need more financial resources than those who have family to provide needed help
  • As your abilities decline, your needs will increase.
  • Everyone needs contacts and sources of social engagement at all stages of retirement.
  • For some things, you may be able to manage with the help of friends and neighbors.
  • If you experience significant cognitive or physical decline, you will need both physical help and someone who can help manage your money. This may exceed what friends and neighbors can provide.
  • Long-term care insurance can be particularly valuable to individuals aging alone.
  • Widows can be in a worse position than individuals who have been single for a long time. Some widows who were caregivers for a long period before widowhood were consumed by caregiving and lost many of their relationships. Individuals who were single for a long time may have a better social and support network.
  • When an individual aging alone anticipates a need for or currently needs help, there are often good reasons for moving into senior housing that embeds an appropriate amount of help.
    • Moving to senior housing gets help with specific situations. It does not remove the need to have a financial and health care power of attorney, help paying bills, help with going to the doctor, a health advocate, etc.
  • Failure to select appropriate decision-making help leaves the individual vulnerable to having a court-appointed guardian if they are unable to make decisions and to function.
  • Building a support network before help is needed is very important. Age-friendly communities offer a good environment for creating opportunities to meet people and for supporting networks.

While the issues facing individuals aging alone are well-known, it can be hard to find solutions to those problems. The Society of Actuaries Research Institute’s Late-in-Life Decision Guide offers a general framework for decisions in four areas and some ideas with regard to late-in-life decisions.

 

[1] DePaulo, Bella. Elder Orphans: A Real Problem or a New Way to Scare Singles. Psychology Today, Oct. 4, 2016, https://www.psychologytoday.com/us/blog/living-single/201610/elder-orphans-real-problem-or-new-way-scare-singles. The article cites research conducted by Dr. Maria Torroella Carney.

[2] Merrill Lynch. 2018. The Journey of Caregiving: Honor, Responsibility and Financial Complexity, Life Stage series, in partnership with Age Wave. http://agewave.com/what-we-do/landmark-research-and-consulting/research-studies/the-journey-of-caregiving/. This report provides some examples of the journey.

[3] Carney, et al. Elder Orphans Hiding in Plain Sight.

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