“Solo Agers” is a relatively new term, one that replaces the much less appealing “elder orphans” label that was in use previously. In short, it refers to those who are growing older without close family support. 

There are many nuances, but generally, solo agers don’t have a live-in partner, siblings, or adult children (or may be estranged from them). So there is no one clearly positioned to help make decisions or provide assistance as needed.

Absent the support system many older adults enjoy, some understand the importance of starting early and creating a team that includes us. We begin our work together by doing the following:

• Conducting a comprehensive medical assessment, along with a complete list of medical conditions, medications, and providers.

• Utilizing an agenda template to help them prepare for medical appointments.

• Establishing access to all their relevant patient portals. 

• Creating a quickly accessible Grab-n-Go kit to accompany a customized emergency procedure for them to have at their fingertips.

• Assisting them with identifying individuals who have agreed to serve as a healthcare proxy and as durable power of attorney, if needed.

But that’s really just the foundation. As a practical matter, there are additional situations and considerations that are important “just in case” they get sick.

Where the Rubber Meets the Road

Solo agers are often tremendously independent. Many have lived by themselves for years, happily managing all aspects of their lives: personal, professional, financial, medical, etc. As a group, they tend to be quite protective of their privacy and place high value on their ability to make their own decisions.

However, problems can occur when life’s unforeseen circumstances crop up, as they often do as we age…

Challenges With Physical Independence

Our client Ellen had lived alone for decades. But when she was diagnosed with cancer last fall, and despite her fierce independence, she knew she could not manage everything alone. For example…

Her progression through the diagnostic testing phase required extensive preparation, accompaniment at procedures, and multiple trips to and from a range of medical facilities. She underwent multiple surgeries — some outpatient, some inpatient — each of which came with its own set of transportation and other logistical difficulties. Upon returning home, she was faced with further challenges related to activities of daily living (bathing, dressing, eating, etc.).

Working together, we were able to establish a combination of resources to fill the gaps, including close friends, private car services, and paid professionals for in-home nursing and home health aide care.

But none of this was easy or obvious. Had Ellen not been proactive in contemplating options and enlisting support, her recovery and eventual return to full independence would have been in jeopardy.

Challenges with Process

Many illnesses and conditions are not apparent from the start. Rather, a series of diagnostic testing occurs as medical professionals attempt to identify root causes and recommend possible treatments or next steps.

In some cases, the primary care physician is instrumental in organizing testing, identifying specialists, and making introductions or referrals as needed. In other cases, and depending on the primary care practice, the individual in question is faced with managing all of this on their own. Not only can this result in delays in care, but it is particularly stressful for solo agers who are forced to navigate a complicated process and healthcare system by themselves in the midst of a health event or crisis.

Some of our solo aging clients feel comfortable enlisting the help and counsel of close friends. Others have relied on us exclusively, as maintaining privacy was most important to them.

Here as well, preparation is key to ensuring as smooth an experience as possible.

Challenges with One’s Values

One of the more challenging aspects of healthcare for solo agers relates to the incremental decision making required as one moves through a care episode. Do you want to embark on diagnostic testing? Which specialist(s) should you choose? How much do you want to know now or in the future about your options and the trajectory of your condition?

Some of our clients, for example, feel that extension of life is most important; they are willing to endure long periods of recovery to reach that goal. For others, quality of life is paramount, so they are willing to accept a greater risk of recurrence or the implications of not choosing treatment at all.

Of course, there is no correct answer to any of these questions, and that ambiguity can make it extremely difficult to choose the best path. These decisions are trying under the best of circumstances — working through them as a solo ager is all the more challenging and stressful.

What is most important is that one clearly identifies and articulates their values and preferences regarding whatever decisions they may be faced with.

Summary

Solo agers can remain independent and in control as they grow older, but that independence requires planning. A temporary illness or unexpected hospitalization can overwhelm someone who has successfully managed independently for years.

Building a support system before a health crisis occurs helps ensure medical care, daily needs, and important decisions can be handled smoothly when they matter most.

With the right preparation and trusted people in place, solo agers can face the challenges of aging with greater confidence and the type and degree of care that reflects their values.