Challenges of Aging Alone

10

November 28, 2019 by Jean

old woman with dogSince I last posted here about my friend with the degenerative illness, my life has been taken over by a health care crisis that she has fallen into (literally: she seems to have fallen out of bed). My involvement began when I got a phone call from the hospital ER on Halloween morning. Hours of imaging and evaluations revealed no injuries that would warrant hospitalization, but her level of cognitive confusion and physical deterioration argued against discharging her home. In the end, the hospital kept her overnight “for observation,” while I worked with the social worker there to arrange a temporary placement as a private-pay patient in a rehab facility until more permanent arrangements could be made. I am now hard at work on trying to get her accepted to and moved into an assisted living apartment before the serious winter weather sets in.

One of the advantages of being a teacher is that you can find a silver lining in just about any crisis by treating it as a “learning experience.” Here is what I’ve learned in the past month about the challenges of aging alone:

  • Those who are aging alone have a special responsibility to plan ahead; we cannot afford the luxury of denial. When I expressed my frustration that in the several years since my friend’s diagnosis with a disease that was surely going to get worse, she had done nothing to plan for the day when she wouldn’t be able to manage alone at home, she said “Well, it was hard to wrap my brain around the reality of it.” She had some vague idea that she would be able to continue living alone in her big two-story house with the help of aides, but she never took a clear-eyed look at the costs (about $250,000 a year for aides 24-7).
  • Health care organizations and providers are largely oblivious to the constraints and needs of those aging alone. If you are aging alone, you need to repeatedly bring this to the attention of your health care providers. At one point, the ER doctor was planning to discharge my friend home, and I had to dig in my heels and insist that this was not a workable plan. I think they assumed that there was a family member who could drop everything to take her home or move in with her and provide care. On several occasions, providers who were speaking with me on the phone (the hospital social worker, a nurse at the doctor’s office) referred to my friend as “your mom” or “your mother.” There seems to be a widespread assumption in health care that every elderly person has a daughter who will do the heavy lifting when care arrangements need to be made.
  • It is very difficult for someone who is not normally involved in the details of your financial life to step in and take care of getting bills paid. Although I have my friend’s Durable Power of Attorney, it has still been difficult to get information about what her normal bills are and how she pays them. After a particularly frustrating day spent trying to get a handle on this, I sat down at my computer and typed up a single page of “essential financial information” for my younger sister (who is my emergency contact). It includes the password to my computer (where all my financial records are kept), a list of institutions where I have accounts, a list of my regular sources of income and when and how I receive them, and a list of my regular bills with information about when and how I normally pay them. I’ll print this out and put it in an envelope with a key to my house to give to my sister when I travel south to visit family over the holidays.
  • There are limits to friendship as a support system for those aging alone. Regular readers of this blog know that I am a strong advocate of developing and maintaining a rich and extensive friendship network that you can call on for help in times of need. My friend did this for most of her adult life; she was outgoing and generous in her willingness to help others, and she made friends easily. But as her illness progressed, that friendship network shriveled. Once she stopped driving (about five years ago), her ability to maintain friendships by getting out and doing things with people declined; this took a toll especially on newer and more casual friendships. But older friends also had difficulty hanging in there. Some, I think, were not ready to face the intimations of their own mortality in my friend’s situation. Her tendency toward negativity also made her an increasingly difficult person to be around. As my friend’s cognitive abilities deteriorated, she also declined invitations and isolated herself as a way of hiding that deterioration. In recent years, as she made greater demands on the friends who were left, some stopped returning her calls. By the time we reached this crisis, there were only two of us left to pitch in and help – a devoted friend who has been going to her house every day for the past month to care for her elderly cat, and me.

 

Of the lessons I’ve taken away from my friend’s situation, this last one about the limits of friendship has been the hardest one for me to take on board. Developing and nurturing an extensive friendship network has been my primary insurance against the vicissitudes of aging without a life partner or children or family nearby. I need to do some hard thinking about how to create a safety net for myself when that network is not enough. Until then, I remain thankful for my friends and committed to trying to create a world that is supportive of those aging alone.

10 thoughts on “Challenges of Aging Alone

  1. Linda Woodall says:

    Thank you for this. It’s my biggest concern (at age 62)–what if something happens to me? I’m single and have no one to deal with these things. I’m trying to put measures in place as much as possible, but there seems to be no recognition that a person might not have a spouse or child to take care of you. And, as you point out, friends aren’t always an option….if they are today, they may not be in the future when you need someone.

    Even getting a colonoscopy–the hospital won’t let you take an Uber home. They insist that whoever you’ve drafted to drive you home sign documents stating that they are responsible for your care after the procedure. They are just the chauffeur! What if the person doesn’t know you well enough to take legal responsibility for you? Just what do they expect to happen then?

    When I talk to estate and financial planners, I get no solutions as to what to do if you have no one to handle your affairs if you are incapacitated. I actually had one say, “Well, well–what are we going to do with you?” and then just dismiss the matter.

    This is a real problem for many of us.

    • Jean says:

      Linda, Thanks for your comment. I’ve heard similar colonoscopy stories from others who are aging alone. It’s useful to know that there is nothing in the colonoscopy procedure that requires these constraints; it is just hospital policy (most likely inspired by liability lawyers), and such policies tend to be regional. I have had three colonoscopies, at two different hospitals in two different regions in the country, and I was never required to have someone stay with me afterward. The first hospital did ask me to sign a legal form as they discharged me saying that I wouldn’t make any important decisions in the next 24 hours. I asked, “Isn’t signing my name to a legal document an important decision?” 😉

      I am very interested in organizational solutions that provide support networks beyond one’s personal friendship group. An organization called The Transition Network has developed something called a “Caring Collaborative” which organizes neighborhood-level networks of support. So far, these only seem to be in very large cities (New York, San Francisco), and I’m not sure if there’s enough critical mass for this model to work in smaller places. A better option for smaller places is the Village-to-Village network. Village organizations combine volunteer support with paid staff, and the staff are supported by a membership fee. One problem that I think many of these models face is that they have trouble attracting younger members who don’t yet need the support networks that the organizations are trying to build.

  2. Jean R. says:

    I’m sorry you had to get a crash course in what happens when someone in our age group can’t go home again after a health issue puts them in a hospital. I’m sorry your friend had to go through that too! It’s one of my biggest fears. But she’s lucky to have you instead of a social worker/stranger looking out for her interests and to help her transition.

    I’ve tried to keep passwords on my estate planing book for my niece but they keep changing so I’m not sure how helpful that will be. I also keep on my kitchen counter top where an EMT could find it, a note book labeled “Emergence Care Plan and Notes for Jean ***** and Levi, my dog. It contains eight pages with an index to things like: a contact page for doctors, for family, for my current medications, current health issues, Insurance, the house, dog’s emergence care and chip numbers, and my preferred hospital. After reading your list, I decided I need to add a page for reoccurring bills and where to cancel stuff like the newspaper. In my estate planning book which I keep locked and my niece has a key to the file I have copies of all things related to income and investments, passwords…

    I’ve seen a secession of home health care people coming into my sister-in-law’s house for over a decade—I stopped by often as she lived close by—and it’s a real crap shoot to get a good one. The personal is always changing and her daughters still had to coordinate a lot of stuff. I’m turned off by that idea of long-term home care, thus I’ve put money down on a continuum care campus independent unit being built. Just hope I get there before something happens to me. I’ll have lots of opportunities for entertainment there—LIVING as opposed to being at home waiting to die. No matter what we choose, it’s costly!

    • Jean says:

      Jean, This isn’t my first crash course, but when I was trying to make arrangements for my mother, it was as part of a larger group of siblings. This time feels lonelier.

      I agree with you that “aging in place” with long-term care at home is not always the perfect solution it is often presented as; it can be very isolating. I’m hoping my friend will be a bit happier once she is settled somewhere because she will have more social stimulation.

      I really like your red binder idea. Thanks for that tip.

  3. Diana Studer says:

    Our neighbour declined suddenly over the past year. He has a middle-aged (working full time) son who is devoted to him. Father is in a stepdown facility (about as far from his son’s work and home as it could possibly be) after weeks in hospital. And then? So many questions, so many difficulties.

    • Jean says:

      Diana, This is a good example of how difficult these decisions and transitions can be, even for those who have spouses and children to help. That is why it is so important for us who don’t have close family to plan ahead as much as we can.

  4. Emily Schiller says:

    This is such an important topic, Jean. Thank you so much for writing about it. I just “shared” it on my FB feed; I hope that is alright with you. I have several friends who are currently in this position and many more who might be one day.

    • Jean says:

      Emily, You should always feel free to share any of my posts. When I post them on my own FB page, I always mark them as “public” so that they can be shared freely.

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I am Jean Potuchek, a professional sociologist who has just stepped into the next phase of my life, retirement, after more than thirty years of college teaching. This blog is about my experience of that new phase of life.

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