Elder orphans, older adults living alone, should be among the chief concerns of health policy gurus and, for that matter, presidential candidates. They are single, divorced or widowed, and without children, or with children living far away. These older isolated individuals need both personal resources and community resources in order to age in place.
According to a new report out of North Shore-Long Island Jewish Health System, there are now more than 9 million elder orphans or individuals at risk to become elder orphans—roughly 22 percent of the older adult population. In 2012, there were 43.1 million adults over age 65, representing about 13 percent of the population, according to the federal Administration for Community Living.
Elder orphans do not have a health care proxy. They may be physically or cognitively impaired. They have no one to care for them, to act on their behalf, if they are sick or hospitalized, if choices need to be made about their current situation and the future. They often have little income and few assets. That puts them at great risk of not having their health care or life wishes honored. They often live in nursing homes, with no one to visit them or provide companionship.
If elder orphans cannot make decisions for themselves, the state appoint may conservators or guardians to be responsible for the elder orphans’ finances and persons. The elder orphans become wards of the state and lose all rights to make decisions for themselves.
The number of elder orphans is likely to grow substantially as the population ages. In 2012, about one in three Americans between the ages of 45 and 63 were childless and living alone, which is 50 percent more than in 1980. We need a strategy for helping them as they age; we need to plan ahead for the next likely larger generation of elder orphans.
By 2030, some estimate that more than 5 million people—of the estimated 70 people over 65, including 9 million over 85–will need to live in a nursing home or alternative care facility because they will not have anyone to care for them at home. It’s not even clear whether there will be enough nursing home beds for these elder orphans, if they wanted to enter a nursing home. Today, there are 15,700 nursing homes with 1.7 million beds and 1.4 million residents, according to the CDC.