I have the makings of an elder orphan. That is a term now used to describe older adults who have no support system – no families or friends left as they age, at least, none in the immediate area who can and are willing to be caregivers or provide support in other ways. I have no family, but I do have a lot of friends. I am not alone in this respect. Almost half of all women over 75 lived alone in 2015, and that percentage increases as we age. Nearly 23 percent of people over 65 are — or risk becoming — elder orphans, according to a study done by New York geriatrician Maria Torroella Carney.
Here is a story about one of them: A woman of my acquaintance, an elder orphan, was living in her home with round-the-clock aides. She had a fall, and was admitted to the hospital. The hospital at discharge said she was no longer able to live in her home, and they discharged her to an assisted living facility. She is extremely unhappy about this and resisting all efforts to help her adjust to the new environment. While she has no family, she does have the support of some people from her church who are trying to help her. There are other stories in the news of older people found dead or ailing in their homes, often full of clutter, and no one knew they were even there. As a colleague of mine sighed about one of them “a social worker’s worst nightmare.”
What can we do to ensure that we will be able to live out our lives with dignity and as much independence as we can muster when no family is there to step in when we start to fall apart? We need to create The Plan, and to do that, we must face the reality that we will age, and if we live long enough, we will need care. These are not pleasant topics, but, as they say in business, “Failing to plan is planning to fail.” Having a plan is no guarantee that things will work out as you projected, but at least, you will have a starting point.
That starting point is the paperwork. As I have written before, we need to be sure our wants and desires are made know to those who would care for us. And, we need to have people in place, including someone with Power of Attorney to handle our financial matters and a Health Care Proxy to make medical decisions when we cannot. If you have not named a health care proxy and you become incapacitated, it may be a court-appointed guardian who determines your care, and you may not like the result. In many states, there is little or no oversight of guardians, which can lead to disaster.
Having these two people in place isn’t enough, though. We elder orphans need a whole social support network – people who can advocate for us on a day-to-day basis in the hospital or at doctors’ appointments, and help out with the daily stuff we can’t do. (Be sure to sign HIPPA forms for anyone who might be advocating for you, and give them to your doctors and hospital). Building and maintaining a social support network is probably the most important thing we can do for ourselves. That means getting out and getting involved with people in our communities. The woman mentioned above has social support from her church. Other avenues are neighbors, senior centers, local clubs and libraries. But most of all, we need to face the hard questions and deal with them. Wishful thinking is not a plan.
 Health Insurance Portability and Accountability Act of 1996