Solo Old Age: How to Prepare

Artha Freeman, 66, has been divorced for nearly 15 years, lives alone in rural Colorado with no family nearby and has no children. Far from being lonely, she’s enjoying the solo life. She owns a horse farm, has a strong network of friends for good conversation and, in normal times, for travel and dinners out. She likes to dance, eats organic fruit and vegetables, and is financially secure. She expects to be independent well into her later years — unless the right partner appears. “I have never felt better physically, mentally, spiritually and emotionally,” she says. After the coronavirus arrived in Colorado, she found other ways to stay connected with her friends and switched to online dance classes four times a week.

In being on her own, Freeman has much in common with many of her fellow aging baby boomers, who tend to have fewer children than previous generations (or none at all), have experienced more divorce and have enjoyed more work and educational opportunities. “The boomers are the first generation to have easy access to reliable birth control and to experience fewer social restrictions on who and when to marry,” says Sara Zeff Geber, a retirement coach and author of “Essential Retirement Planning for Solo Agers.”

[SEE: Aging-Related Sleep Problems and Memory Loss.]

According to census data, the rate of childlessness among boomers now in their 50s and 60s is close to 20%, twice what it was for women born in the late 1920s. And the divorce rate of those 50 and older has doubled since the 1990s, says Lynn Friss Feinberg, senior strategic policy advisor at the AARP Public Policy Institute in Washington, D.C. These demographic realities will have significant implications, experts say, as this generation reaches old age; the first baby boomers will turn 80 in 2026. They, too, will wake up to the fact that health and functional issues risk greatly limiting their mobility, and potentially grapple with isolation and loneliness. Both, experts say, are associated with heightened health risks including dementia, heart disease and early death. The physical isolation made necessary by the pandemic has only underscored the importance of connections.

Without family to step in, “solo agers will be particularly vulnerable in the years ahead due to a rapidly shrinking paid caregiver workforce, limited alternatives to nursing homes for those with physical or cognitive impairments and the real risk of social isolation,” says R. Sean Morrison, chair of the Department of Geriatrics and Palliative Medicine at Mount Sinai Health System in New York.

Early Action

Planning, important for everyone, is especially key for those on their own, says Aaron D. Schindler, a certified financial planner in New York City. Individuals will want to draw up a health care proxy appointing someone they trust to make health care decisions for them when they can’t, create an advance directive that spells out their wishes regarding medical treatment, and grant someone a power of attorney to handle financial and legal matters. Schindler recommends accounting for the probability of needing long-term health care by saving as much as possible and considering long-term care insurance. Some states offer tax breaks as an incentive to buy such policies. “Long-term health care costs can wipe out retirement savings quickly,” Schindler warns.

One 73-year-old California woman who prefers not to be identified is married but considered a solo ager because she and her husband have no children or close family and women so often outlive their husbands. She has thought about what she might do if she is no longer able to climb the stairs, and where she would live if unable to stay in her home. She has informed friends about the fiduciary she has hired to manage her affairs and has prepared advance care documents and a will. “In speaking about my wishes, it’s been important for me to say what I intend, but to also anticipate how other people will hear what I am saying so that there is as little misunderstanding as possible,” she says.

Freeman, too, has gotten her paperwork in order, and has named her sister as her health surrogate. “But what I do want everyone I know to know,” she says, “is that I never want to be dependent on assisted or nursing home living and will spend my last nickel to pay for care in my own home.”

[READ: A Guide to Home Isolation During the Coronavirus Pandemic.]

One tool in development that might one day help in that regard encourages the recording of an individual’s wishes on videos designed to be uploaded to sanctioned registries or electronic health records. Hearing a patient discussing his hopes and fears and strong convictions about how he wishes to be cared for should he become cognitively impaired may be a physician’s only guide when there is no surrogate or document, says Angelo Volandes, a physician and researcher at Harvard Medical School and Massachusetts General Hospital. Volandes is a co-founder of a nonprofit organization that encourages patients and their families to make more informed decisions by supplying them with videos that range in subject from end-of-life planning to cancer treatment decisions.

Ken Covinsky, a geriatrician and professor of medicine at the University of California–San Francisco School of Medicine and a member of the American Federation for Aging Research, suggests that solo agers with complex health and social problems may benefit by getting their care from a geriatrician — assuming they can find one. There are only about 7,500 of these specialists in the country today; the American Geriatrics Society expects that 30,000 will be needed by 2030. “In geriatrics, we look beyond each disease and concentrate on how to optimize well-being,” says Covinsky. “Solo agers are at higher risk than others for social isolation, and loneliness is a determinant of poor health outcomes and mortality.”

New Choices

In the end, Morrison says, many people with physical or cognitive impairments will have no other option than a nursing home. While many boomers insist that they want to age in place for as long as possible, experts point out that making some lifestyle changes now may impact how they age and perhaps help them avoid that fate. Joy Loverde — an adviser in eldercare issues who wrote “Who Will Take Care of Me When I’m Old?” — says that the burdens of maintaining a home and the possibility of becoming isolated make a case for solo agers to consider new housing options that offer a community lifestyle.

The Village to Village Network, for example, encourages communities to form within established neighborhoods. In some 300 (and counting) locations, from Boston to Berkeley, seniors remain in their homes, paying dues that go toward renting an office, hiring a staff and providing all kinds of services and activities. Increasingly, aging individuals and couples are turning to cohousing, a style of living with private homes and shared community spaces, where residents support each other and share meals and activities.

[See: Beyond Bingo: Innovative Activities at Today’s Nursing Homes.]

Sharon Brooks, president, East Coast, for the senior living marketing solutions firm GlynnDevins, believes the importance many seniors place on aging at home as a way of remaining independent is misguided, given the data showing that people who live in communities have better health outcomes. For those who choose to, however, there is much technology that has sprung up to help. Apps will check in on you daily; Alexa will read to you and play music; robots may wait on you; and computers allow you to stay in touch with friends and to join online discussion groups.

It’s that social network, and in particular one’s real relationships, that are key to well-being, stresses Eric Widera, a geriatrician at UCSF. Plenty of people who live alone “have high levels of psychological and social well-being,” he notes — both of which are strongly associated with a long, healthy life.

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Solo Old Age: How to Prepare originally appeared on usnews.com

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