A Rite of Elderpassage – One More Time
INTERESTING STUFF – 1 October 2016

Elder Orphans – Part 1: Definition

About 18 months ago, I started a conversation here about elder orphans. It is a distinct characteristic of old age for tens of millions of old people but recognized as such only recently.

Somehow I dropped the ball on this and am only now getting back to it. The intention this time (and you are allowed to call me out if I don't follow through) is to cover the issues in installments that will appear here on a regular basis – about once a month or so.

Let's start today with the definition – who/what is an elder orphan? This is more important and more complicated than I anticipated because as I began catching up on the newest information, I was shocked at the universally negative description of life in old age itself and worse for elder orphans. Some samples.

Even Dr. Maria Torroella Carney, chief of geriatric and palliative medicine at the North Shore-LIJ Health System in New York City (who may or may not have coined the phrase, elder orphans, paints a terrible picture.

”According to Carney,” writes Carol Marak in Huffington Post, “older adults have a higher risk of having trouble with daily tasks, experience cognitive decline, develop coronary heart disease and even die.

“The risks increase for people living alone and socially isolated. They have higher incidences of medical complications, mental illness, mobility issues and health care access problems. This is not good news for us, the single without children.”

Well, geez, just shoot me now.

Ms. Marak, who keeps a Facebook page called Elder Orphans, also writes, at Next Avenue in a piece titled, Elder Orphans Have a Harder Time Aging in Place:

”...once 65 hits, the changes bring reminders that we’re no longer the same. We don’t move as quickly, we don’t multitask as well, nor do we easily adapt.

“Those are the simple cues. As we age, the physical and mental challenges delivered through loss, immobility and dependence are the ones that put us at higher risks.

“However, the effects of aging land harder on an 'elder orphan,' because the worry and concern of 'what will become of me if I can’t care for myself?' triples when no one is around.”

There is no way to know where that “triples” reference comes from nor do I buy it. Not for a minute do I think elder orphans worry three times as much as non-orphans about the effects of aging.

However, even without that hysterical tone, some academics sound as dire in their definitions of elder orphans: “both childless and friendless;” “people over 65 who are single or widowed, have no children at least in the area, and no support system;” “have low social capital.”

Some of you who have been here at TGB for a number of years perhaps recall what I discovered about the literature of growing old after I had been studying aging for half a dozen years. As I wrote in the About page for this blog:

”...I spent the greater part of my time away from the workplace researching what it is like to grow old. I wanted to know what I was in for and it wasn't a pretty picture.

“Whether popular books, magazines and newspapers, scholarly and academic research, psychology and medical texts, movies, TV shows, advertising and comedy too, the conclusions were universal: old age was all about the three Ds – disease, decline and decay leading to a fourth D, death.”

And that was the best anyone had to say about growing old which is why I adopted the subtitle for this blog, "what it's really like to get old." It's nowhere near that bad.

In the decade since then, as the boomers have reached the beginning of their elder years, old age has become “cool” to write about as both popular and academic reporting has taken a more realistic and positive attitude toward it.

Except, apparently, among the people who have at least acknowledged the existence of elder orphans. I'm going to assume that these people mean well but I reject their descriptions of old age just as I did a dozen years ago.

Yes, some old people will become sick, lonely and dependent on family or others but nowhere near a majority of old people and I'll back that up with research and statistics in a future post.

Today, let's get to a definition of an elder orphan. At the risk of stringing out what would have been a one-page blog post until I started reading, here is a definition in list form from Ms. Marak's Huffington Post story linked above:

”Who are elder orphans?” she writes.
We are the socially and physically isolated aged living in local communities

We live without a family member or a designated surrogate

We have a higher vulnerability to losing the decision-making capacity

We use only a few community resources and are lonely

We have a high risk of losing independence and safety

We aren’t acknowledged (as a group) that will need more attention and care”

No. NO. NO. There is no evidence for a word of that.

Lack of family or close friend, in itself, does not make anyone more vulnerable, lonelier, less safe or liable to loss of cognitive abilities than old people with children or close friends.

I suspect Ms. Marak has confused research on loneliness in old age with being an elder orphan. Some elder orphans are lonely. Some old people with families are lonely. The two characteristics are not synonymous and alone is not the definition of lonely.

Here is a better definition of an elder orphan from 18 months ago:

An elder orphan is an old person who is single, lives alone, has no children or family member or friend who can act on his or her behalf in handling health, legal and financial issues.

An elder orphan has no one, or is uncertain of who, to list on that “next of kin” line in forms, no one designated to carry out end-of-life wishes, and see to the funeral and burial.”

That was a decent definition a year and a half ago but it needs expanding at least this much: Some old people who have children or other family members are elder orphans because they are estranged from their family or children and/or don't want them involved in decision making.

It's amazing how many people I've run into who feel this way. Having relatives doesn't mean you trust them – or even like them.

As my friend Wendl Kornfeld – who knows a whole lot about elder orphans and who you will be hearing more from during this series of blog posts – says:

”We urge people without family to be their own strongest advocate and to support that by creating a community as their family.”

And that is what we will do in this series: break down the issue into easily doable chunks. And we will do it without making anyone feel that being an elder orphan is a calamity that makes our lives worse than that of other old people. It is not.

Comments

Very timely post. I agree that the picture painted is overly grim and I certainly don't associate being single and living alone with being isolated and vulnerable. I'm 68, single, live alone, no children, an older sister who lives overseas. I have friends, I work full time and feel connected to various social groups, so in general I don't feel isolated but...I've got an upcoming hip replacement surgery that is bringing me face to face w the harder aspects of being single and childless. I can call on friends, for sure, but they all have complicated lives and there are clearly limits to what I can ask of them--unlike a close family member (assuming good relationships with family). And so, I am newly concerned about what will happen as I get older and encounter more health problems.

Wow, Ronni, you are looking at a very complicated issue. I'm 79, 3 kids far from me with a larger than usual extended family some even close to my age with a spouse in long term care. This is both good & maybe not so good. As mentioned, others & family especially, have their own lives & issues which often preclude asking for even the smallest amount of help.

You've taken on a huge task (not surprising of course!) to wander through this maze. I'm looking fwd. to all your hard work & research. Thank goodness you are out there helping all of us with "plates" full of issues such as mine. I am most grateful. Looking fwd. to it. Thanks again. Dee :)

Husband 81. I'm 77. Adult Children alienated. Having children doesn't necessarily matter, as you've indicated. Last of both sides of family. Living independently in downsized one story home. Definitely wanting to plan for care if incapacitated & someone trustworthy to handle final estate. Hmmm. Sounds as if there might be an opportunity for a new business concept. If only I were younger!


Yes, well-defined, Ronni.

In a way we're each alone on this journey, which I would call "Elder One's." Different words for same description.

At 74, I'm weighing where and when to move my one last time. I'll deal with the 'how' when it's closer to reality, though that might nullify the whole idea. Maybe I need to think of that first as I'll be moving from, rather than closer to.

Just yesterday there was an article in our local paper that a new website will soon be available, called "Picket Fence," which is a site for older people. Apparently it will connect us elders and provide some of what we wish or need, be it a reference for services or like-minded get-togethers. It sounds like it might be a venture worth looking into, and they've already set it up in six communities, so it might be coming to one near many of us TGBers. I'm not advocating for this site.

There's a wave of interest in our age group (as well as a questionable recognition of our purchasing power) recently, and I believe it might ease some of the difficulties of being an elder orphan.

This is a good topic and I too look forward to future installments. Thank you.

Once again, Ronni, an excellent reflection on an issue that our ageist society mis-defines. I was invited by one member from Parks and Recreation to do a presentation during their state conference. I called the head organizer to tell her what I would present. Her response was that P&R focussed on many different populations, they had enough speakers for the aging population question and anyway, what I was suggesting might do better for a conference with newbies, that most of the staff attending the conference were veteran staffers of P&R. Most people do not get that we are all in this together. We are all going to age unless disease or accident gets us first. And yet, as a society, we have done a very good job, by over focussing on youth, in turning a blind eye to this fact. But I know, from personal experience, that one can have an idea about something (as Dr. Carney does) at one point in one's life and experience that reality very differently at another stage of one's life.
It is true that there are many elders who get pushed aside, whether in a family situation, in an "old people's home" or by virtue of being able to do less and doing it more slowly. That is a problem in our society and one that does need to be dealt with. But, as you point out, developing our own communities and, even, by golly, through the internet keeping tabs with what is going on in the world are all means by which to remain active.
Anyway, this is a topic near and dear to my heart and I could go on and on (maybe I will write a book contradicting the findings of Dr. Carney! (-: )

By our ages we have all likely had brushes with folks needing help as they age. Great topic and many stories pleasant and not will surface. Look forward to its unfolding.

My husband died when I was 59 and I lived alone for 30 years with no family nearby; in essence I was like an elder orphan. Then circumstances last year made it necessary for my daughter to live with me so I am no longer an elder orphan.

Having known all of the concerns of being an elder orphan, and no longer having those concerns, I have experienced both sides of this subject. Frankly, other than having someone to advocate for me , life is not much different. I still make my own decisions and do what housework that I am able to do. I do not feel any different and my lifestyle has not changed.

Sure, It's comforting to have someone to rely on when trouble occurs so those looking ahead to that time might cultivate a best friend or an organization to fill that gap.

Lack of an advocate is a big disadvantage of being an elder orphan and can usually be resolved with the assistance of elder services. Most cities have some organization that provides an advocate should you become ill or incapacitated. In Tucson it is PCOA (Pima Council on Aging). Social services might provide the service if there is not a private group to do so.

Knowing that most elders experience an accident or a severe illness as the years accumulate, it's best to research help available while you are able. It's too late after disaster strikes.

I am 67 (68 soon) and my husband is 70 (71 soon). My mom is 89 and still living independently in her own (very nice) mobile home in Southern California. Two of my siblings live near her. She is still driving, taking classes and visiting friends and her mind is sharp (I think that helps her figure out ways to do things that are hard physically). I feel concerned both for my mom and for myself. Yes, my husband and I have children-one daughter is very alienated and in another state. Our son is (at the moment) close by, but overwhelmed with work and a family. A stepson doesn't seem very helpful. We have some close friends who are more like family. I don't think having kids guarantees a person help in their old age. I wish there were much more societal support, but I think networks through the internet can be valuable. Anyhow, yesterday ran across an interview with a geriatrician on a website called Gracefully podcasts (found on Facebook) called" How to deal with an older family member who needs help? My conversation on Grace Slansky with Dr. Laura Mosqueda, who heads the National Center on Elder Abuse and is in residence at Keck Medicine of USC."The geriatrician, Dr Mosqueda, has some interesting things to say about independence in the elderly ( support networks can be formed that are not family) and also tells the interviewer that her questions about her elderly aunt were ageist (I think she said mild elder abuse, but I thought that was a bit strong). Anyhow, maybe people can google this interview and the site.

Four months ago, I had a knee replacement (a big deal and long recovery) and was completely supported by my husband, though I think my time in the hospital was exhausting and worrying to him. I wonder what will happen next time if he is too old to help, if he is not there-if he needed that kind of support, which I don't think I could give. The questions are myriad.

My way of dealing with this situation is to cultivate and keep friendships with people of all ages.

With no near relatives, I have, with their permission, designated one middle-aged but long-time friend as my advocate and a second as an alternate.

I think it is important to put this kind of thing in writing, and have legal stuff in hand to avoid any problems if/when problems occur.

I don't like the term elder orphans because it suggests that if you have children or younger siblings, you are not on your own. That's not necessarily so, as other people have pointed out in the comments. As we age, we would like to think that family or friends can be our 'insurance' against growing old without support. But children may not be able to handle the responsibility of attending to our needs, and friends may move away or become ill themselves. So it's frightening to some that every eventuality can't be foreseen, and you might end up old, ill and alone, in spite of your best efforts. I think that the best you can do is to stay fit for as long as possible and ensure that you will have enough money for some level of care as you age. I think the worst you can do is allow fear about growing old alone to destroy your enjoyment of your remaining years. Thank you for this post. It is a good conversation.

I am 61, single and have no children. My closest relative is a brother 3 miles away. I don't like the term elder orphan but I would fit that category when the time comes when I am no longer independent. I am planning for the time I may need assistance with ADL. I would like to think I could live with other people who are compatible in a setting where we all look out for each other. Not a group home or assisted living but somewhere where we are still a part of the larger community doing our shopping, running errands, walking in the park, attending concerts, plays and book clubs and so on. This would be ideal. And, I think these kinds of networks or communities are already happening.

I am fortunate that I have a daughter and two sons. My sons are busy with their families and work and even though one lives nearby he already has too many responsibilities. I am not sure I would want to live with any of my children should my health decline even though I tease my daughter about "taking care of me" I hope to live on my own until I die.

So far my husband and I are in good health at the age of 76 but one never knows. I pay to have the house cleaned every two weeks as I have always hated that chore although I do vaccuum in between due to all the dust and cat hair from our 2 feline kids.

When my husband was in the hospital 3 years ago due to a cardiac arrest, and quadruple by-pass surgery, and on the rehab unit, he was incensed when the social worker asked him about going to a convalescent hospital if need be. I explained that they have a standard list of questions for elders preparing for discharge. I willingly gave up all my activities for about 6 months to oversee his recovery but I wonder if he would do the same for me ?

My good friend has decided to move about 300 miles away to relocate near her only daughter as she is a widow with no family nearby. She had to go to the ER, and was hospitalized recently due to an intestinal blockage and it was very scary for her. Her next door neighbor had to drive her to the ER in the middle of the night.

There is a danger with "elder orphans" that I have observed. I've seen predators move in on a couple of my neighbors who could not cope on their own. There is absolutely nothing that can be done about this, because these people are adults. You can't tell these creeps to go away. The care these elders need isn't something neighbors can or are going to give, since they have lives and problems of their own, so truly evil people may entrap them.
One of the male "orphans" here married a much younger woman and she inherited his house and next door rental when he died. She took good care of him, I supposed, although she was very wary and unfriendly and we really had no way of finding out what was going on. Obviously, this kind of arrangement seldom works for women, who are unlikely to find younger men to take care of them in their old age.
An "orphan" friend of mine has fared better, because he found a trusted person that he was able to designate as his heir, and he has a good caregiver. He was the most worried and pessimistic of this lot, and he did well to plan ahead.
I would not be optimistic if I were an elder "orphan." I would do everything I could to prepare.
I should add. I think, so as not to be misunderstood, that women like you, Ronni, who have been independent, have earned their own way in life and continue to provide for themselves in old age fill me with awe! Kudos to you for being the trendsetter you are!

Interesting subject, Ronni! I like the suggestion of "Elder Ones". Orphan has a negative connotation; it suggests being deprived, as defined by Merriam-Webster. Looking forward to reading more about this - thank you!

Great post! Looking forward to the rest. I'm widowed with no children and one older relative far away, so I'm essentially alone. I have stepsons where everything will go, but im inclined to want to give some to a foundation I believe in. My biggest fear, as I'm not in a "right to die" state, is being stuck mindless in a facility with tubes and ventilators. I have a health care directive and a living will filed with my Dr., at home and in my car. My second problem is who to name as my durable POA, as I know no one whom I want nor who is willing. Does this mean my lawyer has to do it? I would love a community where we elders all live close with common areas for socializing and a system to check on and support each other. But I can't afford the expensive AL places.

In my thirties, I was approached by an old woman in a small Mexican town, who held out her hand to me, saying, "Soy huerfana, soy huerfana." It was very puzzling to me at the time, very confusing that she was old and saying that she was an orphan. Now I understand, as I am in that category too.

I'm definitely not about to buy into the gloom and doom school of thought. Not saying that things can't get very frightening at times, but it is of the first importance to deal with this solitary state on the material, emotional and spiritual level. Taking care of legal and financial matters, building community, taking good care of our health, these are important. Helpful and fallible. And, so important, as Medea said, " Midst all these trials, still have I myself." Or from the Bible, " In whatsoever be my state, therein to be content."

Thank you so much, Ronni, for making this an ongoing subject! So helpful!

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