Elder care is an increasing concern for older Americans. According to AARP’s 2015 report, “Caregiving in the U.S.,”43.5 million people are caring for an aging parent, and this number is only expected to increase as the massive Baby Boomer population ages.
Unfortunately, there’s a growing gap between the number of seniors needing care and the number of caregivers available to give that care. Of even greater concern are the many older adults who don’t have children, are not in contact with their children, or whose children live far away. Without immediate family nearby, a growing number of older adults are finding themselves isolated and forced to take care of themselves.
If you fall into this “caregiver gap,” you might be wondering what you can do to successfully grow older without spending a small fortune retrofitting your house and hiring people to run errands. Here’s what it takes to thrive as an older adult when you don’t have children to help.
The Growing Caregiver Gap
According to a study conducted by the AARP Public Policy Institute, the caregiver support ratio in 2010 was 7-to-1. That means that for every high-need senior over age 80, there were seven potential caregivers – typically adult children and other family members – available to assist them with their daily needs. By 2030, this ratio is expected to fall to 4-to-1, meaning there will only be four potential caregivers for every high-need senior. By 2050, the ratio will be down to 3-to-1.
This ratio is declining because Baby Boomers had fewer, if any, children than previous generations. Those who did have children often live hundreds or thousands of miles away from them. Baby Boomers also have a higher rate of divorce than previous generations, resulting in more single Boomers.
A study published in Current Gerontology and Geriatrics Research found that as of 2016, 22% of seniors could be defined as “elder orphans” living alone with little or no support system. This number does not account for aging parents whose children aren’t available to care for them due to distance or other factors.
Most Older Adults Think They Won’t Need Help
There’s also an extreme mismatch when it comes to how many older adults believe they will need care. In a 2010 national survey sponsored by Genworth Financial, only 37% of older adults believed they would need long-term care as they age. The reality, however, was that 67% would need long-term care after age 65.
The United States is not the only country facing a caregiver crisis. In March of 2018, Bloomberg reported that in Japan, where over 27% of the population is 65 or older, one out of every five women in prison was a senior. More and more Japanese women are aging without a support system in place, and as a result, they’re committing petty crimes like theft in order to go to prison and get the care they need.
The Bloomberg piece highlights some distressing consequences of aging without family support. The women interviewed all expressed similar feelings of isolation, loneliness, and lack of purpose. Many desperately needed the three meals a day they now get in prison. Even more, they needed the community of friends they developed once inside.
The Risks to Elder Orphans
Many factors can lead to senior isolation. The death of a spouse is a common cause, as are declining health, poverty or reduced income, and a fragmented family. Seniors forced to age alone face a number of serious risks.
Increased Risk of Injury and Harm
Seniors experiencing cognitive decline face a higher risk of harm when they live alone.
A 2004 study published in the Journal of the American Geriatrics Society found that 21% of seniors with cognitive impairment suffered harm as a result of self-neglect or injury when living alone. In all of these cases, emergency personnel were called in to administer help.
Increased Risk of Depression
Many studies have found that senior solitude can increase rates of depression. One study, published in the Journal of Aging and Health, found that seniors living alone showed more depressive symptoms than those living with others, even if they had supportive interactions with friends.
But depression isn’t inevitable if a senior lives alone. A different study, published in the Journal of Women & Aging, found that seniors living with others “reported higher levels of depression and poorer functioning” compared to seniors living alone. Your risk for depression depends on your personality and genetics, as well as your relationship with the people you live with. A real sense of connection is vital.
Increased Risk of Negative Health Outcomes
Unsurprisingly, seniors living alone can experience more health issues than seniors who have a solid support system.
One study, published in Annals of Epidemiology, found that isolation and non-supportive social interactions can lower immune function and raise cardiovascular activity; socially supportive interactions have the opposite effects. Research published in the Journal of Aging and Health found that seniors who felt a sense of belonging had fewer negative health effects than those who felt more isolated.
A study published in Social & Science Medicine found that isolated seniors experienced increased nutritional risk. Yet another study, published in Epidemiology, found that a decrease in social ties led to an increased rate of mortality in both women and men.
The Financial Side of Aging
No one really wants to think about aging and needing help. But it’s a reality each and every one of us must face eventually. And you can’t think about aging without thinking about the financial aspects of it.
If you don’t have children, chances are you’ll have to pay someone to help you meet your daily needs on some level. And whether it’s home-delivered meals or a home health aide, personal care can be very expensive.
Seniors often drastically underestimate how much care will cost. According to data published at SeniorCare.com, 72% of those needing senior care must pay for these costs out of pocket. On average, this can add up to $25,000 over a lifetime. Some people assume Medicare will shoulder most if not all of what they need, but Medicare is only estimated to cover up to 12% of long-term care costs.
Seniors who can rely on children or other family members have it a bit easier financially. Family caregivers often take on much of the financial burden of caring for their loved ones by purchasing groceries, paying bills, or hiring outside help if their parents can’t afford it. This help comes at a significant cost to themselves. NPR reports that caregivers, typically women, incur an average of $143,000 in lost or diminished wages due to caring for an aging family member. When you add in their lost contributions to Social Security and pensions, this figure nearly doubles.
If you don’t have children or family willing to help, it’s up to you and you alone to shoulder the financial burden of the care you’ll need in your senior years.
Assisted Living Costs
The cost of assisted living varies widely depending on location. Averages hover between $3,500 to $4,500+ per month as of 2017, and these costs generally rise 1% to 2% each year. You can find out how much assisted living facilities charge in your area through Genworth Financial.
An overwhelming majority of seniors would prefer to age in place — meaning, in their own homes. But the reality is that someday, you might need assisted living, so you must make sure you have enough put aside for it. The best way to do that?
Build Your Retirement and Cash Savings
Work as long as possible to build your retirement account, as well as your cash savings and investments, so you have plenty on hand to pay for unexpected costs like a home health aide if you’re injured or fall sick.
You may want to think about continuing to work after retirement to further pad your savings account. If you don’t want to stay at your current job, you could start a business after retirement or find a low-stress part-time job that will also help you stay active.
Successfully Aging In Place, Alone
If your retirement date is approaching, it’s important to start planning for this next phase of your life now while you’re still healthy, independent, and strong enough to make changes.
Choose a Supportive Neighborhood
One of the most important choices you can make as you age is where to live.
A study published in Aging and Mental Health found that while living alone can increase a senior’s feelings of depression, perceptions of neighborhood social quality can mitigate those feelings. In other words, how good you feel about your neighbors, and your neighborhood as a whole, can make a big difference in your quality of life.
In addition, as you age, driving will become more challenging. You’ll need to make more trips to the doctor, and it will be harder to leave home. That means you should find a close-knit neighborhood where you can easily walk to places like the grocery store and library. A study published in the American Journal of Epidemiology found that people who lived in highly walkable neighborhoods reported increased levels of activity compared to those living in neighborhoods where walking was more difficult.
Your ideal neighborhood should have some kind of public transportation and be close to medical facilities. It should also have a great senior support system in place, ideally with a senior center and other recreation facilities.
Consider House-Sharing or Communal Living
If you’re worried about the costs or isolation of living alone, a cohousing or communal living arrangement might be a good fit for you. Senior communal living has been around for a long time, and “boutique-style” communities are springing up all over the country. These communities are micro-neighborhoods or villages where older adults can live close to each other and share the responsibilities of keeping up their homes and neighborhood.
Some communities are centered around a common interest, such as living a sustainable lifestyle or practicing a shared hobby. Others are simply a mix of older adults who need the help and support of their neighbors.
Older women, in particular, are discovering the perks of living with other older women. AARP reports that in the U.S., four million women aged 50+ now live in a house with other, non-related women aged 50+. (Think “Golden Girls” for the 21st Century.) This represents nearly 16% of the total female population in this age bracket, according to the Population Reference Bureau – and these numbers keep going up.
If you’d like to learn more about senior communal living, check out the book “Your Quest for Home: A Guidebook to Find the Ideal Community for Your Later Years” by Marianne Kilkenny.
Make New Friends
If you choose to relocate to make aging in place easier, make an effort to build some social connections in your new community. Not only are friends good for your health; they will also become part of the support network you’ll depend on as you get older.
It can be difficult for older adults to make new friends, but it helps to realize that other adults are likely in the same boat – they’d love to have a friend or companion to have lunch with or take a class with.
One great way to meet people is to adopt a dog. A dog makes it easy to strike up a conversation with perfect strangers, and it will certainly be a great companion for you. Just make sure you understand how much a dog really costs so you don’t put a strain on your finances.
Consider joining a church or other religious organization. Look into Toastmasters International if you’re interested in public speaking, or join a Rotary Club if you’d like to improve your community. You can find other volunteer opportunities through sites like Create The Good and VolunteerMatch.
Meetup is another way you can find people in your community who are passionate about the same things as you are. Do you want to train for a 5K? Learn photography? Talk to fellow fishing enthusiasts? Meetup can help you find others with the same interests.
Join a Village
The Village to Village Network is a national organization that helps seniors stay in their homes by building “villages” to support them. Today, there are over 200 Villages around the country, and more are being built each year.
The Village to Village Network creates and organizes a community of senior helpers who do things like assist with snow removal, perform household chores, provide transportation, and assist with computer problems. Most Villages also have a busy social calendar to keep members in touch and engaged with each other.
Membership dues average around a few hundred dollars per year. However, the services and support you can receive from a Village are invaluable, especially if you live alone. You can find your local Village here. If there isn’t one in your area, you can always start one with help and support from the larger network.
Join a Timebank
Volunteering to help others always feels good. But sometimes volunteers are faced with a mismatch when it comes to their own needs. For example, what happens if, after volunteering to help seniors in your community for a decade, you suddenly need help and there’s no one available or willing to help you?
One solution is timebanking, or time-based currency. Here’s how it works: if you provide five hours of service to someone in your community, you receive five credits in your timebank. These five credits are worth five hours of help from someone else. Whether you run errands for another senior, cook a meal for a bedridden neighbor, or tutor a child after school, the credits are all the same. In addition to fostering a sense of connection and purpose, these credits can prove useful as you age.
You can start accruing credits in your “bank” at any point in time, then redeem these credits as you begin to age and need more help to meet your daily needs. Search for a timebank in your area at TimBanksUSA or start one in your own community.
Install an Alarm
Technology is making life increasingly easier and safer for seniors. One example is Alarm.com’s Wellness service.
Wellness is a movement-tracking system that monitors your activity patterns. It can tell remote caregivers things like how much time you spend in bed, which room you’re in, and when you last opened the front door. The system also learns your habits and can alert caregivers if it detects activity (or a loss of activity) that falls outside your normal routine.
This might sound a bit creepy at first, but the service gives seniors an easy way to stay safe and connected. It can also take some of the burden off caregivers by relieving the need to be in a senior’s home 24/7. If a senior is still somewhat healthy and able to live alone, Wellness enables a caregiver to check in remotely without having to make a drive.
Wellness typically costs $45 to $60 per month, plus an upfront installation fee.
Use Voice-Activated Technology
Voice-activated technology can make it easier for seniors to live alone while staying connected with family and friends – no need to dial a phone or learn how to use Facebook.
For example, the Ask Marvee app integrates with any Amazon Alexa device. With Ask Marvee, you can send an “I’m OK!” message to everyone in your network. It can also give you the latest family news, tell someone you’d love a visit, or ask someone to call you.
Ask Marvee is free for the Basic package, which gives you five family contacts and several features such as Social Visit requests, Morning Beacon (which tells your family you’re OK), and Family News. The Premium package costs $15 per month and gives you 10 contacts, all the features of the Basic package, and a Call Me request. The Family package is $20 per month; with this package, you get an additional 10 contacts plus all the features of Premium.
LifePod is another system that takes virtual caregiving to the next level. LifePod uses artificial intelligence (AI) to help seniors remember daily tasks and remind them of things like upcoming appointments and birthdays. It can also read audiobooks, tell jokes, play music, and deliver the news, all prompted by voice commands.
In addition, LifePod compiles daily reports on your activities and gives loved ones and caregivers an easy way to check in throughout the day. The developers are working on ways for the system to detect falls and other health-related needs. LifePod is currently in beta testing, but you can sign up to be notified when it becomes available.
If you just need help remembering to take your medications, apps like Medisafe can help you stay on top of your next dose. The app can also be connected with clinics so your healthcare team can monitor your adherence to your medication schedule.
Hire a Geriatric Care Manager
Geriatric Care Managers step in and fill the role usually played by adult children. A Geriatric Care Manager is a licensed nurse or social worker who serves as “a sort of ‘professional relative,'” according to the National Institute on Aging.
A Geriatric Care Manager will:
- Evaluate your in-home care needs
- Make regular home visits
- Address emotional concerns
- Coordinate medical plans
- Provide stress relief to caregivers
Geriatric Care Managers can be expensive; some charge as much as $150 per hour. You can find a Geriatric Care Manager through the Aging Life Care Association or the U.S. Administration on Aging’s Eldercare Locator.
How to Stay Healthy as You Age
Carol Marak is in her mid-60s. She lives alone in Dallas and recently started the Elder Orphan Facebook Group. In an interview with The New York Times, Marak says she walks six miles a day and eats mainly vegan meals. The reason? She knows she’s ultimately responsible for herself and is determined to stay healthy for as long as possible.
One of the best things you can do as you age is to maintain a consistent exercise program. The more time and effort you put into maintaining good health, the longer you’ll be able to live an independent and active lifestyle.
Staying active also has direct financial benefits since you’ll need to spend less on medical care and home health aides and tools. So it’s a win-win all around. But what should you do be doing to stay healthy as you age?
SilverSneakers is a free fitness program for older adults on Medicare and other health plans. It provides free access to over 14,000 gyms, recreation centers, and fitness classes all over the country. Its goal is to empower active aging and help seniors develop a healthy lifestyle.
The program is great if you’re unable to afford the cost of a monthly gym membership. It can also help you connect with other older adults who are similarly committed to staying healthy.
A study published in Alternative Therapies in Health and Medicine found that seniors who took part in a yoga class for six months saw improvements in areas like standing, flexibility, and balance. They also saw significant improvement in their sense of well-being and energy compared to control groups.
While it’s easy to do yoga at home, older adults can benefit from taking a class since it can be a great way to connect with others and make new friends.
Swimming is often touted as the world’s best exercise. Because it’s low-impact, it’s ideal for seniors, especially those who are overweight or have arthritis. The water takes much of the stress off bones and joints, turning a workout into a pleasurable experience.-
Swimming can even improve the symptoms of arthritis. Research published in The American Journal of Cardiology found that swimming can improve blood vessel function and reduce inflammation in patients with osteoarthritis.
Learn Something New
It’s also important to give your brain regular workouts as you age.
Learning something new can improve your memory, especially if it challenges you. Research cited by the Association for Psychological Science (APS) found that activities within your comfort zone (like doing word puzzles) don’t provide much cognitive improvement, but learning a skill outside your comfort zone can really boost your brain power, even as you age.
According to lead researcher Denise Park, “The findings suggest that engagement alone is not enough. The three learning groups [in the study] were pushed very hard to keep learning more and mastering more tasks and skills. Only the groups that were confronted with continuous and prolonged mental challenge improved.”
So commit to learning something new every month. You could enroll in a class at your local community college, learn a foreign language, or take a T’ai Chi class. Sign up for continuing education classes in your area or head over to the library or senior center to find out what’s available near you.
Senior isolation is a real problem, and it will only grow as the Baby Boomer generation ages. If you’re approaching retirement and don’t have family you can depend on to help meet your needs, it’s essential to start planning now while you still have the strength and ability to make changes.
“People need to understand that these choices will be made. Preparing now means that YOU get to make them!” says Dr. Bill Thomas, named by The Wall Street Journal as one of the top 10 Americans shaping aging, in an interview in SeniorCare.com. He adds, “Not preparing is choosing to let other people decide your fate.”
If you’re an older adult without children or close family, what are you doing to build a support system? What changes have you made to successfully age in place?