Most people assume that aging is the same for everyone: gray hair, memory lapses, achy joints — and family ready to lend a hand. Elder law and elder care specialists seem unaware how family-centric their materials are. For example, an estate lawyer gave me a ten page form of which eight pages focused on spouse, ex-spouses, children and children’s children. An elder care specialist couldn’t complete a sentence without the word “family,” though asked about people without family.
Even Nolo, a great source of understandable legal information, defines estate planning as “the process of getting your affairs in order so that you make things easier for your surviving family members when the time comes.”
Family looms large in discussions of estate planning and advance directives. The issue most important to seniors without family — finding individuals to serve as medical and financial surrogates — is rarely mentioned.
Beyond these “official” roles are the even more important advocate and personal assistant roles filled by family members. These range from providing treats and outings to standing firm if a facility wants to move their relative to a less desirable room.
Family members play a key role in noticing early symptoms of decrepitude and intervening (seeking medical advice, taking away the car keys). People without family are more likely to ignore symptoms and delay seeking help. By the time anyone notices, their problems are often beyond manageability.
People without family are more likely to end up in facilities and more likely to receive poor treatment in facilities. They’re also more likely to be preyed on by scam artists of all sorts.
As health deteriorates and physical powers wane, people with family usually end up relying on their family (for better or worse). Even children in distant locations will step up to manage their parents’ affairs and help them as they lose the ability to live independently. A 2011 AARP report (PDF) estimates that the “economic value of [family caregivers’] unpaid contributions was approximately $450 billion in 2009, up from an estimated $375 billion in 2007.” For 2014, the Rand Corporation estimated the value of “informal caregiving”to be $522 billion.
The list of services family members render is long and various. What happens if you have neither responsible children nor a competent spouse nor self-sacrificing friends? If you’re wealthy, you can partly fill the gap using Geriatric Care Specialists (referred to by one specialist as “rent-a-daughters”). If you are not … well, no one really knows how people without family manage.