The 5 States Where the Most Vulnerable Live Alone

Aging alone, especially in the suburbs, has a high risk of depression, isolation, and developing a chronic condition, cites Elder Orphans, Hiding in Plain Sight. Dr. Maria Carney, the research geriatrician suggests the local medical and health care community and organizations need to be aware and offer services before an older adult’s functions decline, and to facilitate maintenance of quality of life for as long as possible. By using the term elder orphan, we hope to raise awareness of the vulnerable and the significant care they require.

Other terms used to identify an elder orphan are aging alone, frail elderly, patients without surrogates, unbefriended, and the vulnerable elderly.

According to the research, the prevalence of the 65 and over aging alone and those at risk of being elder orphans will increase as people live longer, since many adults develop multiple chronic diseases and live at a distance from family. The U.S. Census agrees with research and it shows over 27 percent of the population age alone across all fifty states.

Recently, collated the Census data and came up with interesting illustrations for the senior population. They combined the American Health Rankings, and the Long-term Care Scorecard to give individuals a clear sense of how their state measures in health and care. You can view the 50 states and corresponding cities here.

According to 2010 U.S. Census data, nearly 19 percent of women aged 40 to 44 years have no children, as compared to about 10 percent in 1980. And in 2009, nearly 33 percent of Americans aged 45–63 years are single, a 50 percent increase from 22% in 1980. While being a parent or spouse does not guarantee care in old age, the bulk of America’s elderly are cared for by family, according to the National Alliance for Caregiving and AARP. Close to 34.2 million Americans provide unpaid care to an adult age 50 or older in 2015.

Furthermore, those of us living alone must prepare for the inevitable. Start with the legal docs and find a reliable and trustworthy healthcare surrogate, live near public transportation, find affordable housing, and make new friends. These are a few requirements older adults have and it’s a good idea to look around to determine if where you live will support you later on.

Using the Census data, created the Senior Isolation -- Ranking the 50 States resource. Check to learn how your state measures up and compares to the rest of the country. The resource includes statements from real people who live alone, which illustrate their frustrations and concerns. If you need help and support, check out the nationwide websites designed to assist with isolation. You’ll find help and support from AARP, National Association of Area Agencies on Aging, and the National Council on Aging, to deal with the challenges.

Tool for the healthcare community

The ranking tool offers the medical community a chance to see where their state stands in the number of potential people at risk for isolation and vulnerability. For example, North Dakota and Rhode Island rank 1 and 2, respectively. It’s your chance to ask patients without partners and children, and learn more about their needs. For example, Dr. Carney’s research offers a step-by-step query and guide.

Screen for risk of elder orphan status

  • Do you have a spouse or significant other?
  • Do you have children? Are they nearby?
  • Do you have family members or friends that help you cope with life challenges?
  • Do you have someone to help you make medical decisions?
  • Do you have someone to help with bills, financial decisions?
  • Do you have a health-care proxy or any advance directives?
  • Who would you call if an emergency or crisis situation would occur?
  • Do you have a home health aide to help with personal care such as bathing, dressing, and other activities of daily living?

To identify medical issues

  • Have you fallen in the past 6 months?
  • Do you have 3 or more chronic illnesses?
  • Do you take 5 or more medications?
  • Have you been hospitalized in the past 3 months?
  • Identify Cognitive and Functional Abilities
  • Do you need help with bathing, dressing, shopping, and paying bills?
  • Do you feel sad?
  • Are you lonely?

Retrieve Social Support Information

  • Who could help you in a crisis?
  • Do you have a long-term care policy?
  • Are you a veteran in the military?
  • Create a Treatment Plan. Individuals without support need to have treatment plans.
  • Utilize Service Delivery to Home. For example, utilize home care, pharmacy, and food delivery services.

Make Safety and Injury Prevention a Priority

  • Have you fallen?
  • Do you have a gun in your home?
  • Are you driving?
  • Did you experience any accidents?
  • Do you wear your seatbelt regularly?
  • Have you gotten lost while driving?

The vulnerable population grows and lives in uncertainty. Too often we go unnoticed especially by providers and live silently in danger of a medical crisis. I hope to build more awareness for the group who is in need of protection and advocacy.

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