Living Without Family: 5 Stages of Self Care Seniors Should Know
Preparing for the Rest of Your Life as an “Elder Orphan”
We all want to live the rest of our lives in a comfortable and safe place we call our own. We value our space as much as we value our independence. Our fixation with self-reliance has taught us that we can do everything alone.
As more and more Americans have chosen to live a single and childless life to focus on their careers and personal life goals, the question “How can I take care of myself as I grow older?” will be inevitable. Eventually, the changes in our physical and mental capabilities may leave us at a loss once the boomer years start. Will I still be able to rely on my willpower alone to battle the high risks of immobility and dependence that comes with aging? How will I achieve the kind of retirement I planned for if I age alone?
It can’t be denied that the number of Boomers who are aging alone is growing. Experts on geriatrics call them “elder orphans”- baby boomers without adult children, spouse, relatives or other support groups to rely on for assistance, company and help during senior years.
According to Dr. Maria Torroella Carney, Chief of geriatric and palliative medicine at NorthWell Health, the populations of “elder orphans” increases as baby boomers retire every year. More boomers may find themselves without a support system “because the majority of care provided as we get older is provided by family”.
In Carney’s pioneer research, she found that 22 percent of Americans 65 years and above are aging alone and lacking family or support that would take care of them. A majority of them are women. In the updated 2015 U.S. census, the percentage of older people living alone increased to 42.8 percent.
Who is an “Elder Orphan?”
Older adults aging alone may find themselves isolated and are more likely to find it difficult to accomplish daily tasks and increase their risk of cognitive decline, cardiovascular diseases, and early death.
To clearly describe what a “typical elder orphan” looks like, Carney presented the case of Mr. HB, a 76-year old man from New York who she met at the hospital she worked at. Mr. HB was confined in the hospital for various predicaments. He was dehydrated, malnourished, bedsores, depressed and had cuts on his wrists. For years, he had been living isolated from the world. His relatives haven’t contacted him for more than a year. The hospital couldn’t handle his treatments so he was passed on to a nursing home to wait the rest of his life.
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Who are at Greater Risk of Becoming an “Elder Orphan?”
According to research and articles on “elder orphans”, everybody is at risk of becoming one. But the demographics that are at risk the most are the following:
- Older adults who are isolated
- Older adults estranged from siblings and family
- Single older adults with no children
- Single older adults with estranged children
- Childless couples
- Married couples with estranged children
- Single older adults with no or limited social circles and support group
- Older women without support
In other words, neither having children or being married will make us safe from becoming “elder orphans”. It’s dependent on how we build our relationships and ties with people who may be reliable support systems for us in the future.
According to Carney, “We are all at risk for becoming isolated and becoming elder orphans.” Even if you’re married, you can outlive your husband or wife. Even if you have children, they may be unable to care for you because of their own busy lives.
“Everybody has to prepare to live as independently as possible,” said Carney.
Common Issues and Concerns of “Elder Orphans”
Unlike other older adults with solid support systems, “elder orphans” are more vulnerable to negative effects of aging such as:
- Being lonely. Aging alone can make older adults feel lonely may be at risk of losing their ability to perform everyday tasks, have a higher risk of acquiring cognitive illnesses, cardiovascular disease and increased rate of mortality.
- Being Socially Isolated. Older adults who are aging alone and refraining from social activities and connections can lead to medical complications, depression, and a decrease in function and mobility. They’re also more likely to have limited support in times of need and emergencies.
- Being Abused. Elder orphans are more vulnerable to abuse, physically, emotionally and financially. Since they do not have family support and are dependent on advocacy groups, some people may take advantage of their weakness and their isolation to steal their belongings and manipulate them.
- Lacking Legal Support. Some older adults have adult children who may help arrange finances and legal issues for them. But for elder orphans, there is little to no mechanism or support systems in place that would take care of legal and financial affairs for them or would ensure that they are not being duped when their capabilities and cognition declines.
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How to Plan the Stages in Your “Elder Orphan” Life
Carol Marak, an “elder orphan” and an expert on aging, have been chronicling her experience living alone and sharing it in her articles published across the web. In one of her articles “Baby Boomers Aging Alone Plan, she was able to suggest the first step in her aging alone plan – knowing the stages of aging.
For those who are getting nearer and nearer towards the boomer ages, here are the stages of aging you need to consider so you can plan better for your future alone:
First Stage. Independence.
In the first stage, you are generally self-reliant and sufficient. You still have the ability to manage simple health problems, chronic ailments and disabilities. You can rely on your own capabilities and do not need help from your loved ones.
This is the right time to “assess your place and community” to know whether they will be reliable and supportive to you once the aging process takes a toll on you. In your years of independence, you should already be looking out closely for your health and the kind of care you may eventually need in the future. Where would you live the rest of your life? Consider options such as long-term care, assisted living, or an affordable nursing home. Plan your finances to cover your future. Put effort in preparing documents like your will and testament or a power of attorney. Find ways to self-advocate.
Second Stage. Interdependence
This is the stage in your older adult life when you are in need of help with basic tasks such as cleaning, doing house chores and other menial tasks. Marak suggests the importance of interdependence even when you have no family or adult children to take care of you. For elder orphans, this stage may be difficult but nowadays, there are increasingly more options coming up as more and more boomers are finding themselves in the same predicament. Usually, hiring caregivers and domestic helpers may be an option. Group homes and communes are also convenient. Looking for independent living facilities and homes that have strict security, clean rooms, decent meals, laundry services and cleaning service is also highly recommended.
Third Stage. Dependence.
This stage is when you are in dire need of others to help you with basic daily living activities such as dressing, preparing meals, bathing, grooming, driving, cleaning, shopping and even walking. You can consider continuing-care retirement community in the stage of dependence. These kinds of facilities offer different living arrangements for different people needing care in all stages of their life.
Fourth Stage. Crisis Management.
This is the stage where you may be in need of greater care and you’ll find yourself gravely dependent on health professionals and medical institutions to provide your medical necessities. For older adults who already have chronic ailments early in life or those with a family disposition to certain ailments related to aging, preparing for a crisis in the last stages of your life should be planned well. You must be prepared financially for this, most especially if you are living alone. Cognitive impairments may debilitate you in making decisions for yourself once the crisis starts.
Fifth Stage. Institutional Care.
The last stage is when you may be in need of extensive medical and personal care. This type of care may be provided by a nursing home or a hospice. Before this period, it is best that you have already prepared a “Durable Medical Power of Attorney” that will make legal decisions about your medical care needs. This will be especially helpful when you may be incapable of communicating or understanding what’s happening around you.
The Durable Medical Power of Attorney will make a trusted person (preferably someone you chose) be in charge of overseeing your medical care and make proper health care decisions for you. It includes making decisions on your tests, medications, hydration, nourishment, doctors, hospitals, surgery and rehabilitation facilities you need.
Friendly Cities for “Elder Orphans”
Carol Marak have been advocating for better senior friendly living spaces for years. In her article “Elder Orphans Have a Harder Time Aging in Place”, she calls on more leaders and policy makers to find solutions and develop communities that would make the lives of the increasing number of baby boomers better.
Marak lauded the efforts of The Milken Institute which worked with mayor’s offices in building awareness about the needs of the aging populace. As we grow older, we want our lives to be better not just for us but for our parents, grandparents and our children.
The following calls are what older adults, especially the “elder orphans” need that they request city leaders to provide:
- Affordable, safe and comfortable living places
- Have access to affordable and quality health services
- Enable citizens to be financially secured and be part of a healthy growing economy.
- Have living arrangements based on our specific needs
- Have easy access to elder friendly transportation systems.
- Respect our wisdom and experience
- To be connected to family, friends, communities, and social support groups.
In 2017, the Milken Institute published the results of their research on Best Cities for Successful Aging across the country. These cities were proven to have the best medical health care systems, structures for active lifestyles, lively economies, and healthy environments that keep older adults safe, secure and provide them a “sense of community.”
Milken Institute included 83 indicators based on aging experts and public data that that would determine which cities would make it to the list. The eight major criteria that a city should entail are general livability, health care, wellness, financial security, education, convenient transportation, employment, living arrangement, and community engagement.
Based on their research, they found the following large and small cities to be the friendliest cities for our aging population:
Provo-Orem, Utah bags the first place as the best city for aging people as they improved their services and support systems for older adults. The city provides enough opportunities for indoor and outdoor recreational activities in five of Utah’s national parks. It promotes healthy and active culture while keeping the population’s smoking and drinking rates low. Their vibrant economy also gives opportunities for older adults who still plan to work beyond their years.
Top 20 Large Cities
- Provo-Orem, Utah
- Madison, Wis.
- Durham-Chapel Hill, N.C.
- Salt Lake City, Utah
- Des Moines–West Des Moines, Iowa
- Austin-Round Rock, Texas
- Omaha-Council Bluffs, Neb.-Iowa
- Jackson, Miss.
- Boston-Cambridge-Newton, Mass.-N.H.
- San Francisco-Oakland-Hayward, Calif.
- New York-Newark-Jersey City, N.Y.-N.J.-Pa
- Denver-Aurora-Lakewood, Colo.
- Toledo, Ohio
- Minneapolis-St. Paul-Bloomington, Minn.-Wis.
- Springfield, Mass
- San Jose-Sunnyvale-Santa Clara, Calif.
- Rochester, N.Y.
- Bridgeport-Stamford-Norwalk, Conn.
- Washington-Arlington-Alexandria, D.C.-Va.-Md
- Syracuse, N.Y.
Top 20 Small Cities
- Iowa City, Iowa
- Manhattan, Kan.
- Ames, Iowa
- Columbia, Mo
- Sioux Falls, S.D.
- Ann Arbor, Mich.
- Ithaca, N.Y
- Lawrence, Kan
- Logan, Utah-Idaho
- Fairbanks, Alaska
- Boulder, Colo.
- Champaign-Urbana, Ill.
- Gainesville, Fla.
- Fargo, N.D-Minn
- Midland, Texas
- State College, Pa.
- Cheyenne, Wyo
- Morgantown, W.V
- Lubbock, Texas
- Burlington-South Burlington, Vt