“Solo agers” (also known as “elder orphans” — not my favorite!) is a term often used to describe an adult over the age of about 55 who does not have a spouse, adult child, or close family member on whom they can rely to provide practical, physical, and/or emotional support regarding medical or financial decisions in the event of incapacitation.
Such situations can exist by choice, or from changing life circumstances, such as the loss of a child or spouse due to divorce, death, or estrangement. A 2016 study estimated that about one in five adults over the age of 65 falls into this category.
Most operate independently in all facets of their lives and never think about the need for a Care Partner, let alone a hands-on caregiver who could help if they became ill or disabled, even temporarily. The truth is solo agers tend to do just fine — until a crisis such as a fall or illness occurs. When that happens, their vulnerability quickly becomes evident.
What’s Different for Solo Agers?
A major component of our work with clients is helping them plan for all eventualities related to their health and home environment. Many of those with traditional support systems in place — spouses, adult children, siblings, etc. — are a bit complacent, assuming that “their person” is fully aware of their preferences for care (especially at end of life).
That may or may not be the case (we still encourage planning for all of our clients), but either way, solo agers do not have the same privilege of reliance. Everything falls back to them and whatever steps they have taken to establish support services and make their wishes known.
Among the solo agers we meet, some purposefully avoid even thinking about ever needing help. Whether due to fear, not knowing where to start, or some combination, they don’t spend time thinking through the options.
At the other extreme, there are solo agers who do quite a bit of planning. They think through all the eventualities and develop plans and even backup plans in case a primary designated representative is no longer able to execute their duties.
Most solo agers, of course, fall somewhere between these two points.
Where to Begin
For those with no plans in place, we advise starting with two decisions:
#1. Identify someone who could make decisions for you medically if you were not able to do so for yourself.
#2. Identify someone who could assist with financial decisions under those same circumstances.
Beyond these two fundamental decisions, it can be helpful to look at others and observe the things that a spouse or adult child does for an older person. The responsibilities can vary widely, from providing minimal support with things like grocery shopping and housework to full-time hands-on physical caregiving.
Older individuals also rely on “their person” for social contact and a sense of connectedness, along with assistance in identifying alternative living arrangements, managing finances, and serving as the healthcare or legal decision-maker in the event they become incapacitated.
As these responsibilities are identified, start to consider how all of these things would occur if you could no longer do them for yourself.
Further Suggestions for Planning
Sometimes, it is fear that prompts us to take action. For my husband and me, the COVID-19 pandemic brought issues related to defining “our person” and our “alternate person” to the forefront. We both made revisions to our healthcare proxies as a result.
Here are some specific suggestions for planning…
- Identify a person you feel comfortable asking to be your healthcare proxy in the event you cannot make decisions for yourself. Be sure to have an alternate on file.
- Have a formal conversation about the role and reassure this person about all the plans you are putting in place — make them part of the process.
- Execute a written healthcare proxy and have it available in writing and in electronic format so it can easily be shared.
- Complete a healthcare directive / living will that outlines your wishes — not only for end-of-life care, but for all the iterative decisions that might be necessary if you were to experience a slower decline in your health.
- Meet with your healthcare proxy and alternate, discuss the details, and share the documents.
- Conduct periodic meetings to update them on your health status and to identify if anything has changed.
Sometimes, non-family members are reluctant to agree to serve in such capacities for fear of not knowing what to do. Your responsibility in asking this person is to address the fear and relieve them of anxiety as best you can.
Being a “solo ager” is a unique circumstance, one that requires planning in the event you are temporarily or permanently unable to make healthcare decisions for yourself. We encourage you to think ahead and make provisions, so that you have peace of mind that your wishes will be carried out by someone you trust.
Asking someone to serve in this role is a major responsibility. Your planning and communication are what will help them to say yes.