The Aging and Alone Care Needs and Preferences

The aging segment who live without the support of grown children, a spouse or partner has made small gains in awareness from the health care professionals. Other than a handful of friends, in many cases, we have little to no personal support if and when we get sick. I'm hoping to change the amount of attention we receive.

The research study, Elder Orphans Hiding in Plain Sight by the geriatrician, Dr. Maria Carney, suggests, the local medical and health care community and organizations need to be aware and offer services before an older adult’s function declines and to facilitate maintenance of quality of life for as long as possible. By using the term elder orphan, scientists hope to raise awareness of the vulnerable and the significance of care.

I know the difficulties of growing older and living with one or more chronic conditions because I helped my parents. My mother lived with heart disease and my father with Alzheimer's. Fortunately for mom and dad, they had four children to rely on for personal care, and other activities of daily living. My sister and I do not. Neither of us is married, nor do we have children. And being concerned about it struck me immediately after the death of my parents.

I didn't care so much until I understood the struggle of decline.

And even if you do have loved ones, who's to say that they'll be around when and if you need them? Our society has changed so much. Today, family members move around the country taking new jobs or even new lives and experiences abroad, leaving an older parent to fend for herself. The U.S. Census (2010) estimates 27 percent of people 65 and over live alone. Today, that number reaches closer to 30 percent and in some cities, well over 41%.

The same Census data (2010) says the prevalence of aging alone will increase, since close to 19 percent of women aged 40 to 44 years have no children, as compared to about 10 percent in 1980. And almost 33 percent of the aged 45–63 years are single (2009), a 50 percent increase from 22 percent in 1980.

The five states with the highest proportion of the 65 and over segment living solo are North Dakota, Rhode Island, Nebraska, South Dakota, and Massachusetts. Since I have a high probability of remaining alone, it's my passion to guide others in this predicament. I launched a Facebook group called elder orphans, and look for ways to create resources for us.

One of our most significant risks is isolation. If we live in the suburbs, we have a higher danger of suffering from the condition. According to Dr. Carney, social isolation is a factor for medical complications and mortality, and found that it correlates with advancing age; being male and single; living alone, and having no children. Other researchers discovered an association between social isolation and retirement migration to cause poor health, restricted mobility, admission to institutional care, low morale, inadequate rehabilitation, and mental illness.

What solo agers need from clinicians

As an older adult, age sixty-five, I've had my share of doctor visits, treatments, and medical tests. The patient paperwork does query for marital status, age, illnesses, diseases, and symptoms. What it does not ask for is my living arrangement, my emotional and financial support system, and if I have the legal docs in order. If they did, I believe more individuals like me would feel compelled to put a plan in place and seriously consider the consequences if we do not. Other insights to capture from a solo aging patient:

• In case of an emergency, who would you call?
• When was the last time you fell? Was it in the past six months?
• Do you have 3 or more chronic illnesses?
• Do you take 5 or more medications?
• Have you been hospitalized in the past three months?
• Do you need help with bathing, dressing, shopping, and paying bills?
• Do you feel sad? If yes, how often?
• Are you lonely? Do you have close connections?
• Do you drive? If you do not drive, how do you get around?
• Have you had a car accident in the last year?

Even in the Facebook group, we confront such issues on a regular basis. Recently, several members (in the same period) dealt with surgeries and planning for post care. It's a surprise to see the intelligent conversations around such complicated matters. You'd think we were patient advocates, not the actual patients! Each day, we have several discussions around medical concerns and preparing for treatments and tests. It’s encouraging to see members chime in with reliable options and solutions.

But one sore spot for me when visiting my physician, and its when my doctor doesn’t ask me about my health goals, and what do I do to stay healthy. I would enjoy hearing additional tips and resources to keep up my health. Instead, I rely on my research and reading materials if I want to learn more.

I’m not vulnerable at this time and hopefully will not be for many more years. But there are many older folks (and even younger ones) who live in a precarious situation. Too often we go unnoticed especially by providers. And we live silently in danger of a medical crisis. It’s my mission to build more awareness for the group who is in need of protection and advocacy.