July 31, 2015

Aging in Place: Solitary Confinement for Some Elder Orphans?

"Elder orphans" is the phrase du jour about aging. It describes seniors who are single or widowed; they have no children, at least in the area, and no support system. And they find themselves alone with no one to help care for them should they need it.

This group of “orphans” will increase sharply as baby boomers age, and as average life expectancy in America continues to stretch toward 80 and beyond.

Like most seniors, I want to “age in place” – a frequent topic on this blog. In the last two posts, I explored the prospects for the rest of my life. Will I be able to remain at home, or will circumstances force me to move into a senior residence?
My musings reflect my own wish to age in place, a desirable goal... for me. But many elder orphans -- and their families -- surely see things differently.

Independence or Imprisonment?
Aging in place can be dangerous, especially for vulnerable elder orphans. The risks they face are detailed in a case study by Maria Torroella Carney, chief of geriatric and palliative medicine at the North Shore–LIJ Health System

Almost two million Americans 65+ rarely or never leave their homes. Another six million are "semi-homebound."

It's easy to understand why so many of us wish to remain at home. We like our familiar surroundings, and we fear "institutionalization" and the financial drain it brings. We often fight to remain in homes we can rarely leave.

In fact, for those of us 80+, more than three quarters remain in their own homes. In spite of the positive perceptions of aging place, a study published last year found that people in assisted living facilities actually got outside more often than people who remained in their own homes.

While aging in place may bring seniors a sense of control, it requires a variety of services, especially for elderly seniors. Providing those essential services requires a support team, money, and a flexibility among team members to manage many ever-changing issues.

It's a tough job. I can attest that the support of family and friends is crucial.

Here's is an example of the difficulties faced by an elder orphan,

Jim -- an Elder Orphan
Jim is not a real person, but a composite of several people I know or know about.

Now 74, Jim had been CEO of a large manufacturing company in Cleveland. He stayed on the job beyond age 65 because he enjoyed it. Tellingly, he also said, "If I'm not president of this company, then I'm not sure who I am.."

Jim has had Parkinson's disease (PD) for nine years. The disease finally forced him to retire four years ago.

He and his wife Marie enjoyed an active social life while he was CEO. But Jim's work buddies faded away during his retirement. In time, he realized they were just business acquaintances, not friends.

But Marie had several good women friends, and she and Jim continued to socialize with them and their husbands. Then, a year and a half ago, she lost her five-year battle with breast cancer.

Peter is their only child. He's gay, and he lives in San Francisco with his partner and their adopted Vietnamese daughter. It took time, but Jim eventually accepted Peter's sexual orientation. They're now on good terms and speak often by phone.

Thanks to his excellent long-time executive assistant, Jim never needed to use a computer on the job. As a result, he now struggles to email his son and to order the murder mysteries he loves on amazon.com. As his PD progresses, these tasks become increasingly difficult.

Jim and Marie designed and built their lovely home, an hour's drive from downtown Cleveland. He was an avid gardener, but he now depends on hired help to do the work he loved. He had to stop driving.

Peter is understandably worried, as his dad's world gets smaller and smaller. Peter also sees some warning signs of dementia in his dad. He has been urging Jim to move into an upscale senior residence nearby, explaining that the move will bring him social contacts and activities that will make him happier and healthier.

But Jim says he loves the house with its reminders of Marie and the wonderful life they shared. "I can still get around, more or less," he says.

1 comment:

fwes said...

Thank you for your invigorating and interesting post.An important point to note is that it is often the caregiver and not the PD patient that is left holding the short straw. As a person without spouse, the caregiver is the one that is likely to become the elder orphan. In our PD support group we have had a series of discussions on "caring for the caregiver".

Two major themes have arisen: 1. It is especially important that the caregiver have disability and long-term care insurance. 2. It is tempting for the caregiver to withdraw socially and to lose their support group of friends; it is important that they arrange time and ways for the caregiver to maintain an active social life and have a "friends" support group in place for them when the time arises.

We PD patients must be very sensitive to this issue, and unselfish in our assisting in making this kind of time available for our caregiver. They care for us in love; this is a way that we can care for them in love.