Elder Orphans living alone need to avoid social isolation

By Carol Marak, Aging Advocate and Senior Care Contributor (original at Huffington Post)

Seniors living alone and socially isolated are Elder Orphans. The deeper my age propels into my senior years, long-term care planning cannot delay. This is the first of a series on how I plan to avoid the problems of elder orphans. Like most over 60 years of age, we haven’t planned well, and adults like me who live without a spouse or children cannot afford to put it off. Even my parents delayed making arrangements. But they had four children they could rely on for care. I don’t, nor does my sister or many of my friends. But since I work with aging experts at SeniorCare.com, there’s no excuse to let the loose ends dangle.

The matters that need attention in retirement and I plan to address in the blog series

• Healthcare challenges
• Keep physically fit and mentally healthy
• Eating right and taking medications
• Am I investing properly?
• Am I saving enough money?
• When should I begin taking Social Security?
• How to afford health care in retirement
• Outliving my money
• How to enjoy retirement
• Long-term care needs
• Does aging-in-place make sense?

A few months back, my personal concerns with elder care nudged my curiosity and I wrote, “Who will care for us, the aging, childless and single people?” Since the topic affects me intimately, I’ve made it my mission to research the “elder orphan or adult orphan” concerns and to share my findings. Over the next 12 months. I will write about what I learn and what my plan will be.

Elder orphans research

The other day, I spoke with Dr. Maria Torroella Carney, chief of geriatric and palliative medicine at North Shore-LIJ Health System, about her research on the topic. (I believe she coined the term, elder orphan, but I could be wrong.) Carney’s study discovered close to 22 percent of Americans 65 years and older are in danger of becoming, or already are, an elder orphan. As of 2012, there were 43 million people over 65 in the U.S., up from 35 million in 2002. There will be many of us, and as my plan unfolds, I hope to motivate you — to make one also.

How I discovered Dr. Carney and the research was serendipitous. Anna Medaris Miller interviewed us in “No Spouse, No Kids, No Caregiver: How to Prepare to Age Alone, for The U.S. News, and World Report. In the article, Carney warns, “The risk of finding yourself without a support system may be on the rise since the family gives the care.” And that struck a chord in me.

It’s not news to me, but the geriatrician has me thinking about my elder years. I have enough sense to know that if there’s no solid plan in place, then the chances are good that I may not have the opportunity to live life out as I hope. Carney cites a patient who came to her hospital (Mr. HB) a 76-year-old New York man, a prototypical elder orphan. HB arrived at the hospital with cuts on his wrist, bedsores, dehydration, malnutrition, and depression. The man lived alone and hadn’t been in contact with any relatives in over a year. His treatment was complicated and in the end, he landed in a nursing home. And I know that’s not how I want to end up.

The penalties of not having a plan can be extensive. According to Carney, older adults have a higher risk of having trouble with daily tasks, experience cognitive decline, develop coronary heart disease and even die. The risks increase for people living alone and socially isolated. They have higher incidences of medical complications, mental illness, mobility issues and health care access problems. This is not good news for us, the single without children.

Who are elder orphans? 

• We are the socially and physically isolated aged living in local communities
• We live without a family member or a designated surrogate
• We have a higher vulnerability to losing the decision-making capacity
• We use only a few community resources and are lonely
• We have a high risk of losing independence and safety
• We aren’t acknowledged (as a group) that will need more attention and care

In the 2012 U.S. Census, the data shows close to 33 percent of Americans age 45 to 63 are single and positioned to become orphans. Even an AARP (2013) report found:

• 11.6 percent of women ages 80 to 84 were childless in 2010
• By 2030, the number will reach 16 percent

Other alarming facts found by AARP

• In 2010, the caregiver support ratio was seven helpers for every person over 80. [A similar ratio refers to the number of workers contributing to the economy and tax base versus those who are retired.]
• By 2030, the rate will decline to four to one
• By 2050, the number of caregivers falls to three to one
• Health risks associated with aging orphans (Carney’s new research)

Carney’s research found:

• Loneliness is a predictor of functional decline (loss of ability to complete ADLs and IADLs), cognitive decline, coronary heart disease, and mortality
• Social Isolation is linked with medical complications, poor psychosocial well-being, mental illness, restricted mobility, and poorer functional capabilities. People in social isolation typically lack adequate long-term commitment from a healthcare proxy
• Low Social Support and Interaction is linked with increased mortality, low affect, and arousal, reduced cognitive and social skills and altered neuropsychological functioning

What needs to happen?

The geriatrician says, “The medical and social community must actively screen for elder orphans before they lose function or admitted to a healthcare facility.”

• We also need to think about the issues like who will care for us, our housing arrangements, estate planning and whom to put in charge of our financial matters.
• It’s crucial that the people you care about and who care about you, know what you want.
• Since I’m going to be an elder orphan, I need to make sure that I’m ready financially, to build a community of friends and connections, and to help them when they need it.

Plan for the future now

That’s the goal. Over the next 12 months, I will share with you — what I learn and what I decide to do. Since I will age alone, my plans and exploration of them will be done while I am still financially, mentally and physically capable. At the moment it’s hazy, but I hope to have a clearer direction by the end of 2016. Stayed tuned. And feel free to add your tips and advice, especially if you have no spouse or children. Let me know how you plan to care for yourself.

About the Author

Carol Marak, Aging Advocate and Editor at Seniorcare.com is an experienced family caregiver and writes about aging issues, senior care concerns, and the family’s role throughout the journey. Carol earned a Fundamentals of Gerontology Certificate from the USC Davis School of Gerontology and is passionate about ending society’s barriers that obstruct aging with dignity. Her work appears in senior health outlets. Follow her on Twitter at @Carebuzz and @SeniorCareQuest.