When I think about aging, I often focus on the fact that I have no children. In addition, my husband is almost seven years older than me, and he has Parkinson’s disease. Therefore, I must consider the likelihood that I will face my older age alone.
My circumstances are not unique, though. A 2021 U.S. Census Bureau report revealed that 16.5 percent of American adults age 55 and older (15.2 million people) are childless. Yet, this country relies on adult children, spouses and other relatives to provide the brunt of daily assistance, care coordination and other support for our elderly and disabled population. In fact, another report showed that 89 percent of the 47.9 million informal caregivers in the U.S. are caring for a relative. But not everyone has a spouse, child, grandchild, sibling, niece or nephew they can count on to see them through their golden years. Many others are on their own because their children and other relatives live far away and cannot or will not serve as caregivers. The brutal irony is that this situation is common among current and former family caregivers. Those who have already sacrificed so much in their own personal lives to support aging loved ones are often left wondering who will help them when their time comes.
Everyone should plan for their later years. But for those of us who are likely to be solo agers, there is a particularly urgent need to think ahead. This universal necessity prompted me to write “Aging with a Plan: How a Little Thought Today Can Vastly Improve Your Tomorrow.” In my book, I cover in detail how to build sustainable social, legal, medical, financial and other support systems for aging. Some of these strategies are especially important for those who may well age alone. Below, I have covered a few key components that solo agers should focus on when planning for the future.
Prioritize Saving for Retirement
Yes, saving for retirement is easier said than done, but it is critical. Even if you live a modest lifestyle, you cannot always control your spending. For example, according to Fidelity Investments, a retired couple who is 65 in 2021 can expect to spend approximately $300,000 on out-of-pocket health care expenses throughout the remainder of their lives. That means a solo ager needs a nest egg of around $150,000 for this purpose alone.
Remember, Medicare and supplemental insurance policies do not cover all one’s medical costs. Hearing aids, vision care and dental care are examples of items and services that most seniors need but are not typically covered. In addition, long-term care services, such as nursing homes, assisted living, and in-home care, can cost hundreds of thousands of dollars and generally are not covered by insurance.
Take advantage of any retirement benefits offered by your employer, such as a 401(k) plan and a health savings account (HSA). Those who do not get these benefit options through an employer should consider opening their own individual retirement account (IRA) and HSA to build savings in a tax-advantaged way.
If you have to choose between saving for retirement or paying for a child’s university tuition, you should save for retirement. This may seem selfish, but students can obtain student loans, and there is no retirement loan program for seniors. Moreover, children will appreciate not being burdened with your expenses later on.
If at all possible, obtain professional financial advice in order to build your retirement savings. Low-income earners may be able to receive free financial planning assistance through pro bono programs like the one run by the Financial Planning Association.
Weigh Your Housing Options
Think carefully about your living situation as you grow older. Many people want to “age in place” and stay in the homes they have occupied and loved for decades. But your large multistory home may not be safe for you, especially if you live alone. There are many fall hazards in the average home, but stairways pose a significant safety risk for older adults.
Loneliness is also a serious concern. Social isolation is associated with a multitude of problems, such as high blood pressure, insomnia, depression and cognitive decline. If you lose the ability to drive, develop mobility issues or live far from friends and family, you may have very limited social interaction while aging in place. Keep in mind that your local friends will also begin experiencing their own age-related hurdles to remaining active and social, compounding the issue further.
Consider moving to a retirement community. If you have ample funds, explore continuing care retirement communities (CCRCs). These are high-end facilities that offer a wealth of activities, amenities and services, such as adult education classes, on-site dining options, transportation and more. They are also known for providing a full spectrum of long-term care on one campus. Since independent living, assisted living, memory care and nursing home care are all provided in one familiar location, residents do not have to make a drastic move to another community each time their needs increase.
More affordable alternatives include independent living, age-restricted or 55+ communities and village networks. Retirement communities like these can help you remain socially and intellectually engaged and prevent you from becoming isolated or losing your sense of purpose in life.
If you are intimidated by the prospect of downsizing and moving because it is an overwhelming amount of work to do alone, you can seek assistance from a relocation specialist. Several friends of mine have raved about the help they received from relocation experts (also known as senior move managers). The person they hired helped them select what items to take to their smaller home, arranged the entire move, and put everything in place in the new residence. The specialist even donated or disposed of all belongings that were not moved.
If you plan to remain in your current home, be realistic about adaptations you’ll need to make to ensure it remains a safe, comfortable and functional living environment as your health and abilities change over time. You may need grab bars in the bathroom(s), a chair lift or ramp for stairs, wider doorways to accommodate mobility aids and more. An occupational therapist can conduct a room by room assessment to recommend home modifications for aging in place.
It’s best to tackle the most basic additions and modifications one at a time to spread out the expense and inconvenience associated with installation and/or remodeling. Completing these incremental changes before they are urgently needed will increase the likelihood that you could continue living in your own home with minimal assistance if you were to experience a temporary or permanent health setback. While there are financial assistance programs and durable medical equipment loan programs to help seniors modify their homes, typically these are only available to those who already demonstrate a medical need for such modifications.
Make Legal Preparations
For those of us who will age alone, it is crucial to have our legal documents in order. If you will not have a trusted family member who knows your wishes and can make decisions for you, then you must arrange, through appropriate legal documentation, to have your wishes carried out.
For purposes of medical care, you should have an advance directive. Advance directives are state-specific, and you can download the appropriate form on CaringInfo.org, a program of the National Hospice and Palliative Care Organization. You can also turn to an elder law attorney for the drafting of all of your personal legal documentation. Such attorneys can tailor documents to your personal circumstances and preferences and provide invaluable advice about advance directives, wills, trusts and other legal preparations.
One component of the advance directive is a living will. This allows you to indicate your preferences for end-of-life care if you cannot make decisions for yourself. The second component of the advance directive is a health care power of attorney by which you appoint a health care agent who will make medical decisions for you if you are decisionally incapacitated. Incapacitation may occur long before death due to dementia or a temporary or permanent illness or injury. Your agent may be called upon to consent to recommended treatments or, at the end of life, to decide to stop treatment and switch you to comfort care only (hospice care).
When choosing an agent, you should appoint a friend or relative who knows you well and will follow your wishes. The person should be accessible and willing to invest time in assisting with your medical needs. You should also appoint an alternate agent just in case the original person is unavailable or incapacitated when needed. Have periodic conversations with your primary and alternate decisionmakers about your wishes for medical care and make sure they have copies of the appropriate documents they need to serve in this role.
You also need a financial power of attorney in which you name a financial agent (and an alternate). You want to have a trusted person handle your financial affairs if you cannot do so yourself. Authorized by proper documentation, your agent will be able to pay bills, file taxes, manage your assets, apply for Medicaid and more.
Truly isolated individuals who cannot rely on family members or friends to serve as their agents may want to explore their options for hiring professionals instead. Elder law firms and care management companies have begun offering comprehensive services to function as a safety net for solo agers and so-called “elder orphans.” These personalized packages might involve estate planning, surrogate decision making, medical and long-term care coordination, financial management, and more by experienced professionals. However, services like these do come with a hefty price tag. Be sure to properly vet any provider you are considering and get initial and ongoing fees in writing before signing any contracts or legal documents.
Build Support Systems for Medical Care
Receiving quality medical care as you grow older and experience more complex health problems can be challenging because our country faces physician shortages. It is also easy to neglect your health if you do not live with anyone who urges you to seek care when you need it. Those with means might consider adding a concierge doctor to their care team. While you will have to pay a monthly retainer fee, concierge doctors offer more personalized care and far more access than most other time-pressured primary care doctors.
If you are a senior with multiple medical problems, it is a good idea to consult a geriatrician. Geriatricians are experts in treating older patients and coordinating their care. However, there is a huge shortage of these specialists, and they are extremely busy. A lot of people can’t get appointments with geriatricians at all or have to wait weeks or months for appointments. Therefore, you will still need a primary care physician whom you can see on short notice for routine care or sudden illnesses (sore throats, rashes, etc.).
Whenever you go to an important medical appointment or have a procedure done, you should ask someone to accompany you. It is important for a second pair of ears to listen to what is said during the visit, ask questions, take notes and advocate for you if necessary. A patient’s own understanding can sometimes be clouded by anxiety, and not everyone is comfortable asking questions about their own care. Don’t worry about burdening others with such requests. You will likely have plenty of opportunities to return the favor. Those who do not have a friend or family member who can accompany them may want to consider hiring a home health aide who can serve in this capacity.
Another option is hiring a geriatric care manager (GCM). Also known as Aging Life Care Professionals, GCMs are often nurses or social workers who identify your needs and determine how they can best be met. For example, a GCM could help you find appropriate doctors and evaluate your need for in-home care and other supportive services. If you cannot make decisions for yourself, your health care agent may hire a GCM to help coordinate your care.
Commit to Aging With a Plan
Things can change very quickly in life. Some individuals can say with certainty that they will be aging alone without family. Others may be confident in their current support systems only to have divorce, estrangement, illness or even death upend their plans for old age. The possibility of being a solo ager can be unpleasant to think about, but failing to consider and prepare for this scenario leaves you vulnerable to unnecessary hardships and stress. Taking the measures above can help ensure that you will not be isolated and helpless when facing the myriad challenges of old age. The key is planning ahead and putting some safeguards in place. For more information on how to successfully prepare for whatever the future may hold, visit SharonaHoffman.com.