You may not be planning to grow old alone, but no one can predict the future. Today’s greater freedom to live on our own terms—choosing not to be married or have children—means that more of us are aging on our own. Add to that the fact that we’re living longer—the longer we live, the more likely we are to be less connected. In fact, 26 million Americans over age 50 live alone today, and one in six Americans age 55 and older are childless.
Result: A steady increase in recent years in the number of older adults who enter the hospital with no network of support. That solitary status can present serious challenges that affect health outcomes.
There are two different terms to refer to people who are aging alone. Solo agers live without friends and family often by choice—but once they enter a care setting they are called elder orphans. If that sounds alarming, it’s intended to. It immediately conveys to everyone in the care system that special attention and services are needed because the support that people normally get from loved ones is absent.
Bottom Line Personal asked Maria Torroella Carney, MD, chief of geriatrics and palliative medicine at Northwell Health, how to put yourself on the best footing in case you should find yourself aging alone…
Independence should be your goal. People who like the idea of aging alone may resist the advice to build a support network. The irony is that by acknowledging that we all will need assistance at some point and making plans to get that assistance, you lay the groundwork for a longer period of independent aging. Too many people wishing to go it alone suddenly find themselves vulnerable, and then it’s too late. What could have been a manageable challenge with proper planning becomes a crisis.
Start planning now. If you’re in your 50s, it’s time to give thought to what you’ll do if you should find yourself alone. It is never too early to plan. Generally, it is appropriate to begin such planning around the time you start creating your will. Ask yourself how you’ll handle these considerations…
Housing. Is the place where you’re planning to live conducive to solo aging? Do the building and grounds require a lot of upkeep? Is it near good medical care? Would you need a car? Is it accessible for someone with limited mobility? It’s easy to convince yourself that you’ll never struggle with stairs or that you’ll always be able to mow your own lawn. Problem: Housing is “sticky”—it is not easy to pull up stakes after decades of living in the same house, especially after you’ve developed mobility problems. Best: Start planning now to right-size your living situation to accommodate the changes to come.
Transportation. How would you get home from a colonoscopy after being sedated? What if you had a hip replaced and couldn’t drive for weeks? What if you developed dementia and were no longer safe behind the wheel? The answers to these questions might involve moving to a walkable community or a place with cheap, reliable public transportation. Or they might involve other people—should you consider taking on a roommate or moving closer to a relative?
Finances. Will you have enough money not just to retire but to retire with significant and potentially costly health problems? Because money is the key to ensuring that most of the other pieces fall into place, it’s crucial that you get this right. Best: Hire a good financial planner now who can help you take a realistic look at your expected retirement income and arrange your finances so that you can accommodate aging alone. With the right planning, there’s no reason why you shouldn’t enjoy many years of living on your own terms.
Medical care. How will you pay for treatments and hospitalizations? If you were suddenly incapacitated, who would make medical decisions on your behalf? If your cognition was impaired, who would make sure you went to doctors’ appointments and advocate to ensure you were getting the right care?
Activities of daily living. Imagine coming home from the hospital after knee surgery—could you get in and out of the bathtub alone? If your vision failed, who would make sure your bills were paid? If you experience memory problems, how could you be sure to make it to doctors’ appointments? We divide the activities of daily living into basic activities and executive activities. The basic activities are things like brushing your teeth, bathing, dressing and using the toilet. Executive activities are those that involve decision making, such as selecting groceries, complying with medication regimens, making phone calls, paying bills and picking up prescriptions. There’s a chance you’ll need help in either or both categories. If you suddenly couldn’t dress yourself, you’d need to have an aide come into your home—but what if you lacked the cognitive ability to hire the aide? Gathering as many resources as possible before such an impasse will give you the best chance of dealing with it.
Social connections. How will you satisfy the universal need to feel part of the human family? How will you engage in the conversations and shared activities that keep your morale up and your brain sharp?
Do some brainstorming about who you know right now who could help you with all of the above in the future. Perhaps consider moving closer to a niece or nephew…or ask a friend if he/she would make medical decisions for you if you became incapacitated…or talk to your religious leader about pairing up with someone in your congregation. Important: Don’t make such arrangements with only a promise and a smile. Pull in an attorney to make sure everything’s in place in case you’re ever unable to advocate for yourself.
If you’re truly all alone in the world: Reach out to a social worker to learn what options are available in your area. Each state has an Area Agency on Aging, which can be a resource, as can Eldercare.acl.gov, a website sponsored by the US Administration on Aging.
Build up relationships. In laying the groundwork for successful solo aging, it makes sense to build and maintain relationships with distant family members, friends and/or neighbors. Such ties are one of the recognized social determinants of care, since they allow elders to address health issues head on instead of waiting until they become emergencies. Building reciprocal relationships now can help you stay healthy longer.
There is another benefit to building social connections. People with social connections enjoy better health outcomes, and not just because they have people to take them to appointments. We’ve all heard about socially isolated people who have surrendered their will to live. After they lose their social ties, depression sets in and their health fails. Because of this, there’s a common perception that anyone without a spouse and children is doomed to an early grave. But that does not have to be the case.
Opportunities for finding friends abound. Community centers are a great resource, as are day programs. Something new to consider: A congregate living environment designed specifically for solo agers. More and more of these are springing up around the country.