Preventing the Elder Orphan Crisis
When you hear the term ‘orphan’, you immediately imagine a child without parents. However, I see all too often the isolation that is either the result of a smaller family as one ages, or the intentional isolation of someone who has a cognitive disorder and isolates themselves from their community. In either case it is at the time where the senior avoids people that they need them the most. The term ‘elder orphan’ or ‘adult orphan’ has been applied to those who find themselves in these circumstances.
For those with a lifelong independent streak, none of this may be a revelation. However, for others with a full social calendar, others may see this transition as a shock as they age. The way to prevent becoming an ‘elder orphan’ is to start when you still have the strength and energy to do so.
This may be a time to examine the distinction between being alone and being lonely. Being alone is simply a matter of how many people you surround yourself with on a regular basis. It mainly refers to your external or social life. Loneliness dwells inside of us. It is the individual and internal effect of said external life and it can actually have an adverse effect on your health. It is a predictor of the following:
- Functional decline. Geriatric-care professionals basically measure this by reviewing activities of daily living and instrumental activities of daily living, otherwise known as ADL’s and IADL’s. An example of an ADL would be grooming, feeding, bathing or putting on clothes. Examples of IADL’s include shopping, home maintenance and managing finances or medication.
- Cognitive decline. This includes, but does not need to be, dementia. Seniors often experience something called mild cognitive impairment, which is a normal symptom of aging and not keyed to a pathology (disease). Dementia is a symptom of a disease of some sort. Assisted living and skilled nursing facilities routinely employ recreation assistants and coordinators to engage elders in social activities that stimulate their cognitive skills.
- Coronary heart disease. The link to this condition is definitely based on an assumed lifestyle but it is still worth noting. The habits of smoking, drinking and avoiding exercise tend to be attributed to the lonely. These lead to heart disease and thus, heart disease leads to a lot of care that likely requires at least one other person, to pick up medicine, cook healthier meals, and so on.
If loneliness and social isolation sound like identical conditions, that is understandable. The key difference is perception. Earlier, I emphasized the subjectivity of loneliness. For that matter, loneliness could be referred to as ‘perceived social isolation’. The more poetic among us have referred to this as feeling ‘alone in a crowd’. In the case of social isolation, a person may not feel alone but is still cut off from friends, family and/or society at large. This may be self-imposed. It may just be the lifestyle you have grown accustomed to. As a potential ‘elder orphan’, you may want to reconsider such an arrangement for two primary reasons:
- Psychosocial well-being. Just as loneliness can exist despite context, social isolation reveals the significance of that context. This means that while one might not feel lonely, there is still a correlation between human contact and long term health. Also, more fundamentally, an individual who uncharacteristically seeks to isolate from social situations is often showing a sign of a cognitive disorder. Lack of healthcare proxy. This has to be the simplest, most direct answer to why social isolation is a concern for ‘elder orphans’. A healthcare proxy is a legal document that appoints an ‘agent’ to make healthcare decisions should you be unable to. Even if you have always been diligent in looking after your health, somebody else needs to be available to step in when you can't make those decisions yourself. You need somebody in your life just to take that role.
- A social circle represents more than just a safety net. For most of us, a full circle of friends and acquaintances gives context to life and allows us to enjoy our days by ourselves and through the experiences of others. We are not just focusing on elder care – this is a question of quality of life. It can be helpful not only to evaluate a senior's social circle yourself, but also to ask others if they notice any changes. Doing so should give you and your loved ones more of a chance to handle changes as they start to occur instead of staring down the barrel of an emergency later on.
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