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Planning for Elder Orphans

By Deborah Jeanne Sergean

The term “elder orphan” describes someone older than 65 living alone who has no living spouse or children to help with care needs in later life. The number of elder orphans has swelled compared with previous generations. About 25% of Americans 65 or older are considered elder orphans and of these, 69% are women.

As their need for various supports become greater, they can experience increased loneliness, isolation, financial hardship and physical and mental health problems.

The growth in elder orphans stems from many societal shifts. Lower rates of marriage since 1982 and lower childbirth rates since 1971 represent a big factor, according to the Centers for Disease Control and Prevention. “Gray divorce” has also contributed to the rise in elder orphans, as the rate for those 50-plus has doubled since 1990, states a 2017 Bowling Green State University study.

Financial and life planning can help mitigate the effects of lacking family support.

“I have a few girlfriends who are in that situation,” said Henrietta resident Debra Kostiw, author of “Forget Me Not: The #1 Alzheimer’s and Dementia Guide for Professional and Family Caregivers,” who often speaks on elder issues. “I often think of them and wonder what they are going to do. Who will be their advocate and stick up for them? I’ve seen people get bulldozed over who have a good support network.”

She encourages people to begin building their support network in their 50s and 60s by joining groups, including a religious body, clubs and more. Building those ties helps people stay connected to their community and to resources that can help them age well.

“As we age, we tend to get more isolated,” Kostiw said. “Keep those lines of communication open with others.”

She further recommends lining up two or three trusted people good with decision making and aligning with one’s wishes to designate on a power of attorney and a health care proxy. The power of attorney is a legal document that allows another person to make financial decisions on one’s behalf. The health care proxy names a person to make healthcare decisions. In both cases, the person designated is obligated to carry out the designator’s wishes.

Kostiw encourages people to share contact information among all of their helpers — such as a housekeeper, driver, care companion and trusted neighbors — so they can keep everyone aware of needs as they arise.

Choosing an independent living community may seem like a good option to provide a continuum of care into assisted living and then nursing care. However, Kostiw warned that the continuity is often lacking, as residents may be moved to the other side of the campus once their needs escalate.

“Their belongings and chart will go with them, not the dining staff and housekeeper,” she said. “It’s a completely different staff of people. Some communities are better at this than others, but what I’ve seen the staff isn’t discussing all the person’s favorite preferences. It’s not the person-centered care we hope it is.”

Christine Peck, licensed master social worker and associate vice president of programs at Lifespan of Greater Rochester, said that older adults who lack children and friends to name on their healthcare proxy and power of attorney documents should look at a private geriatric care manager or management group. These professionals can discuss the client’s goals and needs of how they want to be represented as their needs change.

“Some choose a licensed and bonded fiduciary,” Peck said. “Choices of that could include an attorney, financial firm, aging life care manager or aging services community-based organization.”

Others in the community can help too. Peck encourages older adults to maintain a close relationship with their primary healthcare provider and to use the services such as nurse care managers and social work available.

Technology can make life easier as an elder orphan, but it is key to start using it early to build familiarity. Many libraries offer free computer lessons. Instructors such as Daniel Jones of Daniel Teaches also provide one-on-one help.

Automate banking, bill paying and grocery delivery to make it easier to get things done and reduce the need for driving. Scoping out transportation options early can make it simpler to use it when it is need. Check into what ride share and public transportation options are available. Some religious organizations offer a senior ride ministry, and some municipalities provide low-cost or free
scheduled rides. Look at meal delivery options, including Grub Hub to obtain restaurant food or Meals on Wheels. Try meal kits such as Hello Fresh and Blue Apron or heat-and-eat choices like
Real Eats. As cooking becomes more challenging, these choices can lighten the load.

“Prescription delivery is another option that a lot of people aren’t aware of or even if they are, view it as a service that one would use temporarily during an acute health issue,” Peck said.

Most local pharmacies will also deliver a few other items along with the medication.

Peck also encourages older adults without children or spouses to reach out to a companion care agency, even if they do not need many services.

“Having that group know you and have an understanding of you will make it so much easier if your needs increase in the future,” she said. “You’ll have someone to help advocate for you.”