There’s a hidden segment of the older adult population that the healthcare industry has recently spotted. It’s the aging single group of people 55 and over. They are the aged, community-dwelling individuals who are socially and physically isolated, without an available known family member or designated surrogate.
They’ve been in plain sight for decades, but since boomers enter the 60 years, the aging single demographic will intensify, due to their status of having the highest divorce rates and childless marriages. And in a matter of a few years, the prevalence of the generation’s chronic diseases will put a heavy burden on the medical care providers, causing an overload on health care and other services.
According to the U.S. Census, 2010, 27 percent of seniors across America age alone. The same survey discovered nearly 19 percent of women aged 40 to 44 years have no children, as compared to about 10 percent in 1980. Furthermore, in 2009, almost one-third of Americans aged 45–63 years are single, a 50 percent increase from 22% in 1980. The trend shows no signs of reversing to the former condition.
However, being a parent or a partner does not guarantee care in old age, but since the bulk of America’s elderly are cared for by spouses and children, who will advocate for the solo agers?
I belong to the group; I am 66, childless, and spouseless. I was one of the three siblings who helped my parents with elder care responsibilities, and it was tough for my sisters and me. Mother lived with congestive heart failure, and my Father had Alzheimer’s disease. From the caregiving experiences, I know firsthand the highly concentrated attention elder care requires.
After my parents had passed, a startling thought occurred -- “who will care for me?”
For people in my situation, alone and growing older, we face extraordinary challenges, especially when the medical decisions are made without the feedback of loved ones.
Last year, I started a Facebook group for elder orphans (a medical term for people aging alone) and the count tallies past 4500. The group discusses the challenges, and members offer support and connection in hopes to relieve the stress and worry that many feels.
Through active participation, I’ve learned that we need education, support, and guidance from health care providers to assist us with preparation for the tough road ahead. But more importantly, we need the medical professionals and teams to acknowledge the status, circumstances, and the issues, and then screen for the aging alone dynamics which carries a basket of risks.
Worries of Those Alone
Some of the worrisome concerns discussed in the group and handled by members:
- Ageism -- just because we’re growing older, doesn’t mean we should give up on aging well. We desire recognition for our strengths and given a chance to offer our skills and to give back and be a productive member of society.
- How to remain healthy without resorting to medication or surgery -- we would enjoy learning alternatives to going under the knife or consuming various meds.
- Find out how others cope with issues and create one’s solutions -- we want to hear how others deal with challenges; what worked for them and then decide if it’s a good fit for us. And if the solution is not a fit, what other options might work?
- Discover useful local and national resources -- we’d like to learn about community services, especially the ones that help us age in place. We don’t have advocates or family members who can research for us, so, we depend on others for direction.
- Navigate health, care issues, and chronic illnesses - we want to thrive and be well even when living with diabetes, dementia, heart diseases, cancer and other diseases.
- Gain social interaction -- our toughest challenge. Most of us want connection and to make new friends but have difficulty leaving our house due to immobility concerns.
- Select a health care proxy and surrogate - we need help and direction when choosing someone to speak on our behalf if we should become too ill or incapacitated.
These topics are a few of what the group addresses, plus a few more. Most of us are not health care professionals, so the practical tips and advice come through other’s experiences.
However, at the local community-based services and medical teams, the professionals can do so much more. Just recognizing the fact that we’re living alone, and then assess the risks, would help the older person understand what’s needed to remain safe, healthy, and independent even when no one is around to check on us.
In recent medical research about elder orphans, geriatricians found several risks that affect the elderly:
Low social support affects the physical and psychological health and in some instances, will increase mortality. A decreased social interaction stems from little support which correlates with depressed affect and arousal, reduced cognitive and social skills, and altered mental functioning.
And for some members of the Facebook group, it’s their only source of social interaction and connection. While for others, they make great strides to maintain face to face interconnections and build friendships. But overall, social detachment is a huge concern.
Isolation and loneliness
Isolation is the state of having minimal contact with others. Even though being isolated can cause loneliness, both are not equal, and both are the risk factor for a physical and cognitive decline.
The online activity that some members find on Facebook is their only source of communications and reaching out to other people. It’s not one’s preference to be alone all the time, but the physical immobility is their greatest burden that keeps them in the house.
It is an important risk factor for social isolation. Like the study mentioned earlier, childless adults often do have support networks, usually consisting of relatives, friends, and neighbors. However, these systems are less likely to provide the long-term commitment and comparable high level of support that children give to parents.
Most members of the group do not have children, but for those who do, they’ve lost communication with the family, they live a long distance away, or they’re forgotten.
Community-based aging resource centers and senior organizations must have goals that assist with our medical, functional, social, and safety needs.
- Help prevent hospital admissions and help us understand how to avoid them
- How to create advanced directives and choose a reliable, and trusted health care surrogate
- Teach elder abuse education and where to find support and help
- Show how to create a care plan far in advance of needing acute care
- Instruct how to build a personal care team of friends we can count on
- Give us options and ways to build social connections and help us avoid isolation
- Help us find transportation when needed
It is challenging for clinicians and social services and even the patients who live alone. But when recognized and assessed properly, the aging singles have potential to struggle less with managing health conditions and the complexities involved in care.