With luck and good genetics, you might be able to live on your own terms till the end of your days. But chances are, if you live long enough, you’ll eventually need help with things like cooking, cleaning and personal care. And independence becomes harder given the growing number of people who are aging as “elder orphans”.
According to AARP, over 20% or 8.6 million people over 65 are, or at risk of becoming an elder orphan. These are senior citizens who do not have a spouse, significant other or children to help care for them as they age. A far greater percentage have adult children who, for whatever reason, are unable or unwilling to help care for them. These numbers will steadily increase until they double by the year 2050. That’s a lot of people who will need help to age in place.
Aging alone is tough given that the vast majority of elder care is provided by families through “informal caregiver” networks. These networks are relatives, pressed into service by need, largely without any specialized training. They are the people who cook, clean, and assist elderly people with basic personal care needs. According to a 2010 report, “The Evolving Balance of Formal and Informal, Institutional and non-Institutional Long-Term Care for Older Americans: a Thirty- Year Perspective. Public Policy & Aging Report”, two thirds (66%) of older people who need assistance received all of their home-based care from a family caregiver, usually wives and daughters. Of this group of family caregivers, almost one third are themselves over 65 years of age. Approximately one quarter of elders received both informal care with some paid caregivers. Under 10% relied solely upon on paid caregivers.
The Family Caregiver Alliance’s National Center on Caregiving reports that in 2015 there were nearly 66 million informal family and friend caregivers who cared for older adults who were unable to manage their “activities of daily living” or ADL’s such as bathing, dressing or eating. This statistic includes a “live-in” category of off-spring who move in with parents or grandparents to help them with unskilled care. It also includes a “drop-in” category of care from an informal family networks of adult children or family friends who are visiting caregivers. Typically, they share the duties of elder care, with some providing food, others providing transportation or other assistance.
As a result of the growing number of elders needing care and the reduced numbers of family members willing and able to provide it, the Home Care Provider industry has grown rapidly to accommodate older people without family caregivers. As one of the fastest growing health care sectors, home care providers are a more affordable alternative than assisted living facilities, which cost between $4,000 to $9,000 per month or skilled nursing facilities, which can cost more than $3,000 per day. In comparison, home care costs average about $50 per day. Hands down, home care is the most affordable option.
What does this all mean? For my parents’ generation of 90-somethings, things are as good as they can be. They are happily out-numbered by their numerous children who are willing and able to help. But for my generation of 60-somethings, the outlook isn’t so rosy. Many of the elder boomers, including me, are positioned to become elder orphans. These statistics are even tougher in the LGBTQ community, where seniors are half as likely to have family members to rely on for caregiving. This is further accentuated by the LGBTQ community custom of building a “chosen family” of close friends who ultimately age together in age cohort, meaning that everyone reaches the age of dependence at the same time.
What do we do? Most elder care specialists recommend planning ahead. One exceptional resource is the online publication titled, “An Action Plan for Successful Aging – 40/70 Rule” sponsored by Home Instead Senior Care which encourages 40-something adult children and friends talk to their 70-something relatives or friends about how to meet their future needs. This planning guide is free and useful for people with and without potential family caregivers to build the necessary networks.
Given that the vast majority of older adults hope to age in place, planning ahead is the best hope. In the words of Benjamin Franklin, “By failing to prepare, you are preparing to fail”. Now’s the time to have those conversations.
Anna Schlecht is a board member of Senior Services for South Sound and a member of The Olympian's 2017 Board of Contributors. She can be reached at firstname.lastname@example.org.