Who Can Support our Unsupported Seniors?

At this time of year, when families are coming together for Easter or Passover, seniors who do not have strong family connections can often be overlooked. But according to a study by Dr. Maria T. Carney, published in Current Gerontology and Geriatrics Research, vol.2016, Article ID 4723250, close to one-quarter of all adults over 65 either do not have, or are at risk of not having, any family members to help them with health care decisions and other life events that confront us as we age.

Dr. Carney describes these people as “elder orphans,” because they cannot rely on family members to assist with these decisions.  But this group is not only made up of people who have no children, are estranged from their families, or whose families are themselves unable to provide support for others.  As the older population continues to absorb more Baby Boomers, an increasingly significant reason that seniors are navigating the terrain of aging on their own is choice.

These are the same people who have chosen to stay unmarried, manage their own money and own their own homes.  They may believe that one of the reasons they have good relationships with siblings, nieces and nephews, children and step-children is because they do not burden them with their problems.  And they may not realize that the potential for poor health and declining competency could make it difficult for them to continue to be as independent as they have been throughout their adulthood.

When it comes to celebrating holidays and talking through their concerns, many of these seniors have created “families  by choice” with their close friends.  But these friends may be of similar age as the “solo seniors,” facing the same issues at the same time.   And if the senior has not put her intentions regarding decision making in writing, most existing laws and policies make the assumption that support should be coming from family. For example, surragacy statutes, which have been adopted in most states, establish a hierarchy of indiviudals who are authorized to make medical decisions for an individual who lacks capacity, starting with spouses, parents and children, and only including trusted friends close to the bottom of the list.  Thus, the senior who has chosen not to involve family members in these decisions may suddenly find that she is forced to defer to them for the most intimate and important decisions of her life.

Rather than referring to these indivudals as “elder orphans,” I prefer the term “unsupported senior.”   The issue is not whether someone has family, but whether the needed supports – from whatever source – are in place.   Over the past couple of years, more and more seniors have come to my office to draft or modify planning documents because they recognize that their family members would not provide the desired support if it was needed. Together, we have discussed what friends and family might do, and put together a network that includes some family and friends, professional caregivers, fiduciaries and advisors, and the legal documents to give them the necessary authority and provide appropriate oversight.    In some ways, we in the private sector are lagging behind the non-profit agencies that provide companion services and in-home assistance with no questions asked, or the court system which appoints the most appropriate guardian for someone regardless of whether they might have family.  We may need to completely change our laws and institutions to assure that no senior -whether she has family or not – faces the journey without support.





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