This past April, I attended the 2019 Aging in America conference in New Orleans. In addition to (mostly) fabulous weather, delicious food, and great jazz, I attended some inspiring sessions. There were two in particular that offered great ideas for solo agers: “Goodbye Magical Thinking–Real Life Planning for Solo Agers” and “The Caregiving Crisis: Who is Going to Care for Everyone?”
Goodbye Magical Thinking–Real Life Planning for Solo Agers
This session was presented by Joy Loverde, author of “Who Will Take Care of Me When I’m Old?” and “The Complete Eldercare Planner” and Dr. Sara Zeff Geber, President/Owner of LifeEncore and one of the American Society on Aging’s 2019 “Influencers in Aging.”
So what is magical thinking when it comes to aging? According to Loverde and Geber it’s “the belief that we are going to live healthfully until we suddenly die peacefully, in our sleep, after a fabulous day at the beach and an amazing dinner.” In other words, denial. As I learned in another conference session on palliative care, 70% of Americans wish to die at home and 70% don’t. Think about that for a moment.
And who are solo agers? Geber said she initially conceived the term solely for people who don’t have children, but like the MN Solo Senior Task Force, she expanded the term to include people who are aging alone for any reason.
The advice in this session boiled down to three things for me: 1) get your legal documentation in order with the consult of an elder law attorney to make sure your health care and financial wishes are known, 2) consider communal living in one form or another, and 3) maintain a strong friendship network, particularly with people younger than you. While little of this was new to me, it was a good reminder and fire under my butt to complete my legal documentation. It was also affirming to see a completely packed room of people and know that I’m not alone with these concerns. Additionally, several things really stood out for me:
- Avoid guardianship or conservatorship if at all possible, i.e., the state making health and financial decisions for you if you’re deemed mentally incapacitated. Apparently there are many horror stories out there and little oversight in this area.
- Realize that your relationships will become even more of a revolving door as you age and make sure you ‘refill the pipeline.’ I’ve been struggling with this one lately, as several of my friends have moved away, and several have decided to have children when I thought we were ‘aging alone’ together. It’s hard not to feel abandoned. But this was a good reminder that this is just life; the only constant is change. And the only thing you can do is to keep making new friends across generations and hope that if and when help is needed, people will be there for you and you can be there for them.
- I’m not alone in thinking the “aging in place” movement isn’t the greatest idea for solo agers. Geber agrees with me. She said the top two challenges she hears about aging are ensuring the money lasts and the many unforeseen problems with aging in your existing home. Aging in place is a huge amount of work/responsibility for a single person who is likely also dealing with health challenges. So I intend to age communally, whether that be in co-housing, with roommates, in a NORC (naturally occurring retirement community, e.g. a condo complex with friends/people looking out for one another), or next door to friends with a ‘village’ to support us.
- Think about who you’d call at 2 a.m. if you needed help and adjust your life accordingly if there isn’t someone you can name. A session participant brought this up. She works with seniors and cited the time when one of her clients was very sick, but not sick enough to call 911. The client didn’t know what to do. This is related to your housing choices as you age. Living alone just doesn’t sound great to me because of things like this.
- In addition to getting your legal documentation in order, make a video of yourself expressing your medical and financial wishes and make sure several people have copies. This is an easy way to make sure your wishes are known.
The Caregiving Crisis: Who is Going to Care for Everyone?
This session was presented by Sheila Warnock, Founder and CEO of ShareTheCaregiving, Inc. and Co-author of Share the Care. Warnock cited the shortage of professional caregivers that will only get worse in the coming years, and therefore the need for people to help one another.
The idea for the ‘Share the Care’ guidebook was born primarily out of her experience being a caregiver. She was the sole caregiver for her mother in the 80’s and also helped care for her best friend Susan, who was diagnosed with cancer. In 1988, a therapist told Susan she needed to stop trying to be so strong and should reach out and ask others for help. Warnock became part of a group of 12 women (mostly strangers to each other) who worked together for three and a half years to care for Susan. The contrast of caring for her mother without support to the experience of sharing responsibilities with a group proved to Warnock that this new collaborative approach to caregiving was something of immeasurable value and needed to be shared with caregivers everywhere. Thus, the Share the Care guidebook was developed: a step-by-step format showing others how to pool their time, efforts, and resources to assist a friend or loved one facing a health, aging, or medical crisis.
It seems like such a simple concept that should happen organically, but in reality it isn’t and doesn’t. For example, Warnock said that her experience has shown that church congregations are great at helping with short-term care needs, such as bringing food to the patient/family, but not good at long-term care needs. This isn’t because people don’t want to help, but because they don’t know how and there’s no one organizing/directing them. As the Share the Care website says, “Caregiving will touch everyone at some point in life yet it often remains in the shadows of the public/media spotlight because it does not make for a picture that melts the heart but rather one to be avoided at all costs. Not so much because people are uncaring but rather frightened and uneducated. Sometimes, friends disappear when illness strikes because they don’t know ‘what to do or what to say.’”
Warnock briefly explained how Share the Care works. Two people come together and identify a group of caregivers. Then, using a weekly rotating captain system, two captains contact the patient/friend and ask what he/she needs for the week. These captains farm out those tasks to the remaining group. This ensures that the patient/friend doesn’t have to ask for help, which takes an emotional load off of them. Each caregiver determines at the outset what he/she is willing to assist with. For example, some may feel comfortable helping with activities of daily living (e.g., bathing, dressing, feeding, toileting), while others might prefer to make grocery runs or help mow the lawn. Additionally, caregivers can choose their level of involvement as a “full member” or “free floater.” A session participant asked if this can work for patients with dementia, and Warnock assured her it can and said there’s a chapter in the book dedicated to this. She said the key to helping patients with dementia is to keep the group of people that have direct contact with the patient very small, and have a larger group helping behind the scenes.
Warnock acknowledged that there are limitations to this system, and at a certain point, paid care may need to be involved. She said that Share the Care may not be able to completely substitute for paid care, but complements it well by reducing both the hours and cost associated with it. I do wonder what happens if you’re a group of friends living and aging together and you all need caregiving assistance at the same time. Who is the caregiver and the patient? My hope would be that lightning wouldn’t strike everyone at the same time, and between that and the financial benefit of sharing paid care, a solution could be found.
I feel the greatest strength of the Share the Care concept is the reduction in liability concerns and restrictions placed on what caregivers can do. This is the result of the absence of a coordinating third party and the fact that the patient likely already has some type of relationship with each caregiver. I asked Warnock if anyone has ever had liability issues using Share the Care and she said there have been none to date over 24 years.