What will we do if we become “Elder Orphans?”

An elderly cancer patient in North Carolina called 911 recently to ask someone to buy him some food. He’s what a new study is calling an “elder orphan,” one of more and more older people who have no kids, no spouse, and no one to take care of them.
The study by Maria Torroella Carney, MD, shows that nearly one-quarter of Americans over age 65 are currently or at risk to become “Elder orphans.” It’s a growing population that is often invisible to the people around them, alone in their houses struggling to survive. One-third of older Americans are single, a 50 percent increase since 1980. The latest census figures show 19 percent of American women are ending their childbearing years without children. Thus they wind up alone.
I’m very much in danger of being one of those people. I live alone in the woods with no husband and no kids. My family is small and far away. I do have friends and helpful neighbors, but I have a hard time calling on them for help.
Just like my dad. My father is 93 years old and has lived alone in the house in San Jose where I grew up since my mom died in 2002. My brother and I do our best to help, but neither one of us lives nearby. Dad has heart problems, struggles to walk since he broke his hip last year, and falls way too often. He puts off going to the doctor or renewing his many medications because, although he can still drive, he doesn’t understand the medical system very well and the Kaiser Hospital where he goes is so crowded there’s no nearby parking. His house is falling apart around him because he can’t do the maintenance anymore, and his cooking is . . . interesting.
I just returned from San Jose (Did you miss me?). I had planned for a vacation-type visit, but the day before I left, Dad’s doctor decided he needed to have his pacemaker replaced immediately. So I took him to the hospital, interacted with doctors and nurses, picked up his prescriptions, and played caregiver again. He’s fine. But what if I wasn’t there?
Have I told you about Dad’s fall last August? He went down in the backyard. Broke his hip. Crawled all the way across the yard, through the garage and out to the driveway, where he lay waving his hat until a neighbor saw him. This took hours. Thank God the garage door was open. I could not have stopped him from falling, but I could have prevented the torture that followed. I spent a month taking care of him, but then I had to come home. I feel so guilty, but he wants me to live my life, and he wants to live his. He’s proud of being independent. He’d rather die alone in his backyard than in some senior facility.
Let me tell you about Dick and Ann. They’re in their late 80s. Ann is nearly blind. Dick, a burly guy with a strong Massachusetts accent, has been suffering from all kinds of health problems, including pneumonia, heart disease, and legs that just don’t want to work. Ann has a son somewhere, but he’s not around. Their neighbors, friends from our church, take care of them. They drive them around, make sure they have food, and take them to their doctors’ appointments. They do the same for an old woman on their block who lives alone. My friend Cathy even manages her finances because she can’t do them anymore, and the one time her son took over the checkbook, she wound up missing $5,000.
What I’m saying is having kids does not guarantee you won’t become an elder orphan. My brother and I call Dad every week. When something happens with him, we both get there as quickly as we can, but that may not be quickly enough. And we’re not there for the day-to-day needs, the cooking, cleaning, shopping, and just keeping him company. When I visit Dad, he talks and talks, like he’s been saving it up for years. When I leave, I feel incredibly guilty.
My friend Terry, who is about 60, has a plan. She has three grown children and a husband with some serious health issues, but she expects to be alone eventually. Her plan is to rent out her extra bedrooms to other women and create a “Golden Girls” household where they share the house and watch over each other. It sounds good to me. I think I’ll be “Dorothy,” the sensible one.
What I’m saying is that kids or no kids, we’re in danger of ending up alone in our elder years. But if we don’t have children, it’s more likely to happen. We need to make plans. Set up an advance directive and power of attorney. Choose someone who will manage things for us if we can’t. Reach out to other people who can help. It’s hard. I’m not good at asking for help, and I want to control everything. But I know who to call, and I’ve got in writing. You should do the same. Someday I’m hoping to move someplace less isolated, but meanwhile, since I don’t think my dog can dial 911, I have to take care of myself. So should you.
I’d love to hear your comments on this.

Children may help in old age, but it takes more than that

When I walk with Annie down Cedar Street, the road that runs behind my house, I look to see what’s happening at Bob and Shirley’s place. My elderly neighbors have had a hard time lately. About a year and a half ago, Bob had heart surgery. Something went wrong and his brain was damaged. My father, who had similar surgery about the same time, recovered quickly, but Bob just kept going downhill, deep into dementia. Before Christmas, Shirley stopped in her car to tell me she was putting him in a nursing home. I cried the rest of our walk, remembering all too well how it was with my husband, who had Alzheimer’s and died in 2011.

I was surprised yesterday to see Bob standing in the driveway. Annie, ever happy to visit people, needed no encouragement to go see him. But Bob, once a brilliant scientist, could no longer speak well or respond to anything I said. His words were all jumbled up and didn’t make much sense. He kept saying something about a “ride.” He wanted me to “ask Shirley.” He kept insisting, so I went to the door to talk to Shirley.

Shirley was near tears. The cost of residential care plus the pain of being separated had led her to bring him home a few days ago, but he was getting worse every day. He had been out in the driveway for hours and refused to come in. He kept staring at the next door neighbor’s house, waiting for something, it was hard to tell what. You could tell she was exhausted and ready to fall apart.

But she had help. Their two grown daughters visited often, offering practical and emotional assistance. How I wished I’d had that when Fred was sick. His children mostly stayed away. People keep telling me you can’t count on your children to be there when you need help. It’s true, but oh when they are, what a blessing. I’m grateful that Shirley has that.

But her kids aren’t all she has. As we talked on her doorstep, she was expecting her church pastor any minute. The neighbor across the street was coming over soon. And she had hired the same home care agency I used with Fred to give her a few hours off three days a week. It does take a village, not only to raise a child but to care for people who are desperately ill.

The thing is, that village will not be there unless you make the connections. I admit I’m not good at this. When I sprained my ankle in December, I struggled to take care of myself, hopping around on crutches, sometimes crawling, occasionally falling. True I lack husband or children, but I have friends. I’m just not good at asking for help. I need to work on that skill. As do you. Bob and Shirley, married 60 years, have wonderful children and grandchildren, but they also bought long-term care insurance, made connections with friends and neighbors, and hired a home-care agency. The kids were just one part of the equation.

We all wonder what will happen when we get old. What are your thoughts on not having grown children to help you in old age?

Please, if you’re into praying, include Bob and Shirley and all the other couples struggling with dementia.