With luck and good genetics, you might be able to live on your own terms until the end of your days. But chances are, if you live long enough, you’ll eventually need help with things like cooking, cleaning and personal care. And independence becomes harder given the growing number of people who are aging alone as “elder orphans.”
According to AARP, more than 20 percent or 8.6 million people older than 65 are now, or are at risk of becoming, an elder orphan — a senior citizen who does not have a spouse, significant other or children to help care for them as they age. A far greater percentage have adult children who, for whatever reason, are unable or unwilling to help care for them.
This number will increase steadily until it doubles by the year 2050. That’s a lot of people who will need help to age in place.
Aging alone is tough given that the vast majority of elder care is provided by families through “informal caregiver” networks. These are networks of relatives who are pressed into service by need without specialized training. They are the people who cook, clean, and assist elderly people with basic personal care needs. According to a 2010 report, “The Evolving Balance of Formal and Informal, Institutional and non-Institutional Long-Term Care for Older Americans: a Thirty-Year Perspective,” two-thirds of older people who need assistance received all of their home-based care from a family caregiver, usually wives and daughters. Of this group of family caregivers, almost a third are themselves 65 or older. Approximately a quarter of elders received both informal care and some paid caregivers. Less than 10 percent relied solely upon on paid caregivers.
The Family Caregiver Alliance’s National Center on Caregiving reports that in 2015 there were nearly 66 million informal family and friend caregivers who cared for older adults who were unable to manage their “activities of daily living,” or ADLs, such as bathing, dressing or eating. This statistic includes a “live-in” category of offspring who move in with parents or grandparents to help them with unskilled care. It also includes a “drop-in” category of care from informal family networks of adult children or family friends who are visiting caregivers. Typically, they share the duties of elder care, with some providing food, others providing transportation or other assistance.
As a result of the growing need for elder care and the reduced numbers of family members willing or able to provide it, the Home Care Provider industry has grown rapidly to accommodate older people without family caregivers. As one of the fastest growing health care sectors, home care is a more affordable alternative than assisted living facilities, which cost as much as $9,000 per month, or skilled nursing, which can cost more than $3,000 per day. In comparison, home care costs average about $50 per day, clearly the most affordable option.
What does this all mean? It’s not an issue for my parents’ generation of 90-somethings, who are happily out-numbered by their numerous children who are eager to provide care. But for my generation of 60-somethings, the outlook isn’t so rosy. Many baby boomers, including me, are positioned to become elder orphans.
These statistics are even tougher in the LGBTQ+ community, where seniors are half as likely to have family members to rely on for caregiving. This is further accentuated by the LGBTQ+ community custom of building a “chosen family” of close friends who ultimately age together in a cohort, meaning that everyone simultaneously reaches the age of dependence. In response, LGBTQ+ organizations like SAGE USA are forging new models for aging alone for older LGBTQ+ people.
What do we do? Most elder care specialists recommend planning ahead. One exceptional resource is the online publication titled “An Action Plan for Successful Aging — 40/70 Rule” sponsored by Home Instead Senior Care, which encourages 40-something adult children to talk to their 70-something relatives or friends about how to meet their future needs. This planning guide is free and useful for people with and without potential family caregivers to build the necessary networks.
Given that the vast majority of older adults hope to age in place, planning ahead is the best hope. In the words of Benjamin Franklin, “By failing to prepare, you are preparing to fail.” Now’s the time to plan for aging wellness.
