How do childless people deal with the challenges of aging?
October 7, 2013 1:27 PM   Subscribe

My partner and I have been thinking about aging recently, as various relatives reach the phase of their lives where they're moving into nursing homes and retirement facilities. Our examples are mostly of people with children, but as most of our friends reach middle age without children, we were wondering: in the US, where we don't have ingrained cultural obligations or socialist structure, how do people go through older age without kids to take care of them? If you're in that group, what are your plans for your old age?

For our grandparents and other relatives, it's been their spouses or children who make the financial and logistical decisions about aging and medical care. My grandmother took care of my grandfather through his decline, moving into a retirement facility and then hiring the necessary help (aides, then hospice) as he moved towards death. Their children were also very involved, physically, emotionally and financially. Those same adult children are very involved in her life, driving her places and helping make decisions about these later years. I expect to do the same for my parents, but I know lots of folks who are estranged from their parents or who simply don't want to take care of them in their old age. What happens to those parents as they age?

I know some people have nieces or nephews or younger friends who help take care of them, and I imagine that some people just get by as long as they can before dying. But are there plans that our friends without kids should be putting into place? Or, even, that we should be putting into place so as not to burden our children/each other in our old age?
posted by linettasky to Society & Culture (30 answers total) 94 users marked this as a favorite
I would generally think that with the amount of money saved by not having children couples can save more for retirement and pay for more at home care. It isn't the same, but in some ways it can be preferable to have an impartial person involved in elder care. If a person didn't save extra they may be short handed.
posted by dgran at 1:34 PM on October 7, 2013 [7 favorites]

Long term care insurance...
posted by cecic at 1:39 PM on October 7, 2013 [3 favorites]

This is what assisted living/life care communities are for! After helping my grandparents transition through various levels of assistance my parents sat down and did a lot of the planning for their own aging, too, to make it easier on us kids. I have no kids and hope to live in elder housing like that some day, too.

Also, yesterday I went and helped an older childless friend get rid of some stuff as she downsizes to assisted living. Younger friends can definitely help with some of the big stuff!
posted by ldthomps at 1:40 PM on October 7, 2013 [1 favorite]

There are some different models. Cohousing shows a lot of potential for helping older people who don't have close family and/or children. See, for instance, this. Friends who have lived in senior-only communities often bemoan the lack of age diversity.
posted by mareli at 1:48 PM on October 7, 2013 [1 favorite]

Considering that half the reason I'm not having kids is that I'm generally at subsistence-level income-wise, I'm just going to start shooting needle drugs when I hit ~70 (or significant poor health, whichever comes first).

This is perhaps a bit extreme, but I am being absolutely sincere. Despite an excellent education and my very best efforts, I do not expect to be able to support myself into old age, and will have no one to support me, and would prefer to escape grinding poverty and elderly homelessness. It's merely a bonus that I've always wondered what it would be like to do heroin, but am not foolish/destructive enough to attempt it now.

Should some extraordinary reversal of fortune occur and I actually find myself with any retirement dollars worth considering, then elder care/assisted living will probably be my path.
posted by like_a_friend at 1:50 PM on October 7, 2013 [24 favorites]

Regardless of having children or other relatives/friends/etc willing to care for you, as a person ages their fate w/r/t care is determined largely by some intersection of their health condition and their wealth. Two things will get you into a nursing home faster, generally: worse health or fewer dollars. Often these are the two big factors regardless of having family. Taking care of an elderly relative who has severe Alzheimer's is often beyond the scope and expertise of even the most caring spouse or child.

But for the situation you're talking about, when there's literally no one to help make a decision for these folks, traditionally the general situation is that they have a social worker assigned to them and they are placed in a nursing home facility. If you cannot afford the nursing home, a state program generally pays for your care, or, depending on the facility, the nursing home may eat the cost.

Alternatives are expanding for sure. Home health care is becoming more and more popular, along with the sort of requisite precautions like having life line and such at home. Assisted living facilities offer a sort of in-between for folks not able to live completely alone but not needing 24-hour nursing home care. Like I said, a lot of this is determined by your health and your money, and of course your location.
posted by Lutoslawski at 1:55 PM on October 7, 2013 [2 favorites]

Mod note: Folks this absolutely needs to be giving answers to the OPs question and not just relaying bad scenario possibilities.
posted by jessamyn (staff) at 2:00 PM on October 7, 2013

I am planning on there being a lot more queer-friendly elder housing. We definitely have retirement savings and I feel like putting any strain on my niece isn't fair at all. If we're lucky enough to make it to retirement, we're going to find a nice place to play strip bingo.
posted by Sophie1 at 2:04 PM on October 7, 2013 [2 favorites]

But are there plans that our friends without kids should be putting into place?

Strikes me that just the usual saving for retirement is the plan here. At least, that's my plan! I'm also making an effort to be in the lives of my nieces and nephews because although I have no expectation of them caring for me in old age I do think it will be nice to have young family around.

Lots of people now and in the future will be unable to care for an elderly parent (or two) anyway, frankly. They won't have the job flexibility that comes from a stable career, or the money to have space at home.
posted by jess at 2:05 PM on October 7, 2013 [4 favorites]

I sit on the board of a non-profit in Canada (which has a similar system to the United States' Social Security scheme) that matches seniors living alone with pre-screened volunteers who help them with basic tasks, such as banking and grocery shopping, as well as just getting outside.

Our non-profit belongs to a patchwork fabric of non-profit community social services organizations that provide services for seniors. It's not a great system.

There is a provincial (state-level) ministry for seniors, but it provides more of a secretariat function rather than providing any real resources or extra capacity to help seniors. At a local level, seniors are under the "care" of local health authorities (hospitals), who collaborate with social workers to ensure seniors' needs are being met.

In practice, however, seniors are on their own, and are expected to be cared for by family. If there is no family, they are expected to be cared for by their social support network (ie, "friends" plus community groups like ours).

When the state gets involved is when seniors are judged by a social worker to be no longer autonomous. This is a bad situation, because the state then becomes the executor, and at least half if not all of the estate (while the senior is still living) will be taken by the state to pay for care at a state-run geriatric home.

So make sure you have prepared a will and power of attorney beforehand.

But how do seniors live on their own with no family to look out for them?

Very badly, and often below the poverty level, with no visits except from people like us (our volunteers) and social workers.

Mind you, many childless seniors have created substantial social networks, so it's not all doom and gloom (not everyone is an introvert). But it ain't easy.
posted by KokuRyu at 2:10 PM on October 7, 2013 [3 favorites]

We have an awesome plan!

There's a group of us and we're all going to live together in a commune! It may be a multi-tenant building, or an apartment or such like, my friend Donna has volunteered her Mom's house in VA. (I'm not keen on that one.) But we'll all be together in one place. We haven't exactly decided where yet, but someplace warm and nice. (Florida, California, depending on our resources.)

A few of our friends have kids, and we've been in their lives since they were embryos, so we're Tia y Tio to them. So we at least know that someone will look in on us, on their way to seeing their parents.

Also, we have Long Term Care insurance, so there's that. (I've had it for 13 years now, so it's good and cheap.)

Then, as we get super-old, assisted living, then a nursing home.
posted by Ruthless Bunny at 2:16 PM on October 7, 2013 [3 favorites]

Do you have a relationship with nieces and nephews? I took care of my beloved aunt who was like another mother to me when she was in her 80s and dying of cancer., as well as my parents several years later. By the way having kids is no guarantee someone will take care of you any more.
posted by mermayd at 2:25 PM on October 7, 2013

I'm planning to keep a local attorney on retainer to look after me. There's a lawyer in my office who does this kind of work. She personally visits her clients in the hospital, nursing home, etc., to make sure that everyone is doing their job properly and is very well equipped to deal with the situation if they're not. She hires other professionals as necessary. She's extremely conscientious. It's not the same as having a kid in the same town who will take you out to brunch on Sundays, but it's certainly better than having the kind of kid that most people have--one that lives on the other side of the country, or who is kind but completely financially inept, or has a bad relationship with you, or has a substance abuse problem, etc., etc.
posted by HotToddy at 2:33 PM on October 7, 2013 [11 favorites]

Or, even, that we should be putting into place so as not to burden our children/each other in our old age?

My only sibling and I live on opposite sides of the country. Our mother, who is single and has no other living family, lives in the middle. Beyond discussions about care and income, one thing that she has undertaken over the course of the last few years is a downsizing of her possessions and the reorganization of important (and beloved) documents and other items. She has seen a few neighbors struggle to clear out their homes and transition into a different living situation (whether merely a smaller space or assisted living), effectively paying for two residences the entire time, as well as neighbors' children who arrived from out of town and were left with that massive job and no obvious inroads into a house full of things after their parents passed away.

It's not for everyone - my mother has always been the kind of person who approaches organizational projects like this with glee - but beginning a similar process could be a kindness to your children.
posted by Austenite at 2:39 PM on October 7, 2013

Having kids is no guarantee of having someone to "take care of you" in old age. You may want to spend some time on perhaps, AskMetafilter, to see just how many folks have serious problems with their parents and/or kids. Thin ice, amigo. I have friends whose kids won't even talk to them, anymore. I have an acquaintance dying now in a hospital and he has living kids who could give a poop. YMMV, of course, or not. ( I did a little caretaking for him a few years back with some health issues, so I guess part of an answer is that some people depend on the kindness of strangers.)

That said, I expect (as a semi-childless man) to run full-tilt-boogie until I crash. I'll take care of me and either die fast and furious, or slow and stupid, but I will die and there's not much to be done about it. All my friends, relatives and loved ones who are dead are still dead. Some went well and in good company; some died alone in a hotel room much less so. Few prepped successfully, though I have some stories to share. And won't.

Once I die, folks will either shake their head and smile, or just shake their head.

I think there's a lot to be said for communal living amongst chosen friends. If I had the power to make it happen, it seems more intentional, potentially successful, and less related to stupid things one did as a parent.

(Note: I'm a known donor. That's the 'semi-childless' reference. No expectations of those kids on my part. This ride has one seat, as far as I am concerned.)
posted by FauxScot at 2:46 PM on October 7, 2013 [6 favorites]

I have an interesting pact involving me (early 50s), my sweetheart (mid 70s) and his only child (a daughter in her late 30s). I'll take care of him and she'll take care of me. I think this plan will work out well for all three of us, especially since her kids will be grown by the time I need her help, whereas she would otherwise be sandwiched by her multi-generational responsibilities. Nonetheless, I'll do my best to make sure I have sufficient resources--financial, legal and otherwise--to avoid being a terrible burden to her.
posted by carmicha at 3:08 PM on October 7, 2013 [1 favorite]

I have a much younger sister with whom I have a solid relationship, and I am a very involved auntie. (My mother took care of her own very involved auntie for much of her life.) Other than that, I am saving like a crazy person.
posted by Countess Sandwich at 3:14 PM on October 7, 2013 [1 favorite]

My grandfather passed away last Sunday at the age of 94. He had 6 kids on our side, and his second wife (still living, first deceased in 1970) had two children. This is the opposite of what you describe; however, there is some relevance to what you want.

In the late 80's my grandparents sold their house in Lincroft, NJ and moved into a retirement community in Lakehurst, NJ. The community featured a a nice amenity where they would slowly take on the work that the tenant couldn't do - so my Grandparents liked to garden - they kept a garden well into his 90s. There were social events and activities provided for them to do, as well as a built in golf course, tennis courts, baseball diamond, basketball courts, pools, and so on. My grandfather, a perpetual motion machine until the past year, was active with everything, but over time he did become less... competitive. The point is, he built a community into his living situation. He lived for a long time, outliving the money they paid in - meaning that yes, the community lost money on someone with his longevity (or at least maxed their extraction). When he died, the life insurance covered his funeral requests. Given that he spent 30 years retired and 25 years there - really that's pretty good.

Where things became complex is over the past two years. He had some episodes were his cancer reared up (I think this was the 3rd time or so) but his health in his mid 90s was less good this time around. More importantly, his wife has Alzheimers... which none of us knew. So here you've got someone sharp as a tack who's health is failing, and they are partnered with someone that is slowly losing their mind and doesn't know what's going on. I'd add that they too had everyone's favorite concept - the "death pact" - now think about getting sick, and your principal resource having their mind erode except for the part where they interpret your illness as triggering their need to try to kill you...

So the family started to step in, and arguably saved my grandfather's life two years ago, giving him another good year and a half before a very rapid decline over the past 6 months.

Here were the things they didn't have in place: they didn't have 24 hour nurse coverage, they didn't have assistance grocery shopping, they didn't have someone to help clean, or to make sure the stove was off, make sure meds were taken. This is where you need to have a legal guardian. This is a paid service, generally you might want a lawyer or a licensed social worker as your guardian. The scary part is, you are giving them permission to take away your rights to agency when you need it done - which, hopefully, you are in a state where you want them to do so.

This isn't a friends issue. This is a 'hello, I'd like to schedule a 24 hour nurse service'. This is 'I need to schedule a grocery delivery service and 2 hot meals delivered daily'. This is a 'we're now using a different aspect of medicare / medicaid and we need to make sure this is handled appropriately.' This is a 'ventalators are ok for 48 hours, but my client wants the plug pulled now that this is an indefinite reality' this is a 'he wants to be made comfortable and to be taken home' issue. This is 'wants a open casket wake at the church and a traditional mass then cremation following' issue. This is the issue where you pay someone early to be there when you go.
posted by Nanukthedog at 3:45 PM on October 7, 2013 [3 favorites]

In my family, my childless elderly aunts are being looked after by the extended family, with the brunt of the work falling to one of their nieces who lives across the street, but with everyone pitching in where needed for chores or doctor's appointments or driving or whathaveyou.

But even with a large extended family, they are still relying heavily on paid help - the oldest has Alzheimer's, but fortunately is in pretty good physical health. There's someone there 24/7 now, and most of the time that's paid help, but oftentimes it's family members. It's working, but only because the youngest (75) is still in pretty good shape.

I am not having children, and I'm also single. I don't have a good answer yet, but looking at my aunts, I know I need to work on that in the next few years; my generation simply does not have the army of nieces and nephews that my parents' generation has (and even then, the great niece/nephew generation is kicking in).
posted by joycehealy at 4:26 PM on October 7, 2013 [1 favorite]

I have seen friends who are in the 12 step community who give lots of time and love to people, often younger people and most often newer in the recovery community -- they call it being a sponsor. It's been pretty amazing to me to see how that community shows up for those who have helped others and now need help, as they're moving on; people will come and take them to meetings if the person can no longer drive, they'll call them, and generally just help them out. Plus, being in those communities keeps them involved closely in life. Mind, I'm not saying that older people should go out and become drug addicts to get some elder care, just that this is one thing that I've seen in my life and has not been mentioned here.
posted by dancestoblue at 4:35 PM on October 7, 2013 [1 favorite]

If you're in that group, what are your plans for your old age?

Thank our lucky stars daily that my wife has a secure job with a good pension and absolutely no danger of every being short of work. Max out the RRSP and TFSA, invest other savings wisely, live somewhere with a climate that we can deal with year round when we are elders, find a home suited to limited mobility. Sever ties with family as needed. Live our lives frugally and happily.

Maintain physical fitness.

Die on our terms if at all possible.

Will everything to each other and then to an animal-related charity.

The hell that my parents and my inlaws went through when dealing with their parents "retirements" has taught me hard lessons about getting old and dying.
posted by Sternmeyer at 4:43 PM on October 7, 2013 [3 favorites]

There is a strong local program to support elders in my area with "aging in place". We also have long-term care insurance.

One of my great-aunts lived on her own until she was 96. Her one son helped financially, but he lived hundreds of miles away and saw her only three or four times a year. Her neighbors and friends helped out, and she hired people for things like lawn maintenance. She never learned to drive, so she either called local taxis or had friends drive her to medical appointments.

Eventually, she had to move into a nursing home, which she actually seemed to enjoy for the last three years of her life. She was a very upbeat and resilient person, and I hope to follow her example!
posted by Sidhedevil at 4:58 PM on October 7, 2013 [2 favorites]

I'm 64, retired, live alone, have no children. I have a brother who lives 2,000 miles away. We stay in touch. I am not in contact with the few other family members I have. I have known for years that I will be the only one responsible for me til the end. I do not have close friends.

I worked hard and saved my money and plan to hire help if/when I need it. But, my main plan is to not live that long, quite honestly. I've had a fabulous life. If I drop dead tomorrow, it will be with zero regrets.
posted by susandennis at 6:16 PM on October 7, 2013 [9 favorites]

Robots. In ~40 years, there will be robots.

And the stuff that other people said... Some reliance on friends and extended family, some on social services, and some on paid assistance.

I'm at the age now where I'm wondering if I'm going to have my parents' care dumped on me in ~10 years. I don't live near them and they're divorced, complicating that situation.
posted by reddot at 5:11 AM on October 8, 2013

When the time to retire comes I plan to move to a country where the cost of living and healthcare are significantly lower than the US.
posted by Gringos Without Borders at 8:36 AM on October 8, 2013

Not having kids who may or may not support me when it's my time allows me to save a significant portion of my income for the future. I live in a one bedroom apartment, drive a small car, will not ever have to shell out for kids' food/clothes/education/extracurriculars/etc. This allows me to max out contributions to a 401K, and funnel around 30% of my paycheck into other savings vehicles. I expect I'll be able to afford robots or thinking meat to assist me if I make it to old age.

When the time to retire comes I plan to move to a country where the cost of living and healthcare are significantly lower than the US.

Good luck with that. The U.S. has fairly loose immigration standards, believe it or not. Countries with affordable and quality medical care generally don't accept newcomers who are over 30 and don't have a Ph.D or other high-value qualifications. Moving to one of those countries at the end of your working life to take advantage of their social safety nets, which you didn't contribute to over many years, is going to be difficult.
posted by Thoughtcrime at 3:14 PM on October 8, 2013 [1 favorite]

in the US, where we don't have ingrained cultural obligations or socialist structure, how do people go through older age without kids to take care of them? If you're in that group, what are your plans for your old age?

I'm in the US with no kids and am now middle aged. I live in a mother-in-law apartment and my landlady is 88. Her partner recently died. Her partner was 90. They lived independently and gradually, over time, more and more people came to help them do the things that they needed to do to keep the house running. Some of these things were paid (lawn care, house cleaning, nursing care when it came to that) and some were just neighborly things (little fixit things, dog walking when it was icy, bringing by food, checking in) and that has worked well for them. Now that my landlady's partner is gone I wander over every few days to make sure things are good and we swap email about minor this and that (nominally about the computer or the dog but also just to say hi). I keep an eye out to make sure nothing seems weird. It's a small town and there are probably four or five people who are doing what I am doing, both out of a sense of neighborly responsibility but also because we are friends, it's a small town, and that is what people do here.

I moved to a small town (from my small town where I grew up which was similar to this one and where my mother who is not as old as my landlady is living a similar lifestyle, though my sister lives ten minutes away from her) specifically because this is the sort of life I wanted to live, now and in the future. I wanted to be a good neighbor and have good neighbors. Our town has a little seniors bus for helping folks get to the grocery store, a decent hospital, a good senior center and a senior living facility which is where a lot of people in town move to when they can't live at home any longer. In a small town that sort of situation is not as weird as generalized "nursing homes" because you live in and around the people you've spent your entire life with. I don't know that it would be my choice, per se, but it does not seem like a bad choice.

As for me personally I am trying to take care of my health and my teeth, maintain and strengthen my relationships with my family and friends-who-are-family, learn to live in very little money, find interests that are maintainable into my later years (as well as some which are impractical in that way and will have to eventually be phased out), try to be mindful of my mental heath and the mental health of those around me, nourish my relationship with my partner who is my age (and who has a child but one who might not be able to offer help to us as older people) and make sure my legal and financial ducks are in a row. My sister and I talk often about future plans and it's not a thing that is going to sneak up on us. My mom likes us paying attention to her but she doesn't want us to put our lives aside to take care of her and I think her independence has trickled down to us. I feel like the later years I want are within my reach and mostly I'm just concerned with making sure I get there.
posted by jessamyn at 4:03 PM on October 8, 2013 [3 favorites]

Live near any existing family and stay involved with them. If you have moved away from your family, make moving back a priority next time you look for work. Your siblings and their children and grandchildren will more willingly help you get through old age if you help them now (free babysitting, etc). When you're old, you want to be everyone's beloved Auntie so-and-so who is so good with the kids, not estranged Aunt what's-her-name who gets no willing visitors. Old age is a burden best shared.

And if you can't move back there yet, get them to move out to live with you. If you have spare rooms, fill them with family.
posted by pracowity at 1:37 AM on October 9, 2013

There are some very interesting schemes popping up at universities around the world, where elderly alumni can move into retirement homes on campus.

The schemes that enable this vary a lot, but basically the idea is that the retired person can continue their learning if they wish, and also contribute to the running of the university if they can, and they get accommodation with varying levels of support included.

I really hope it catches on - it's a scenario that would seem to benefit everyone. Why put an expiry date on learning?
posted by greenish at 8:12 AM on October 9, 2013 [1 favorite]

As someone who comes from a culture where it is expected that children take care of their aging parents, let me tell you that this isn't always as it seems. Because it is "expected" that children will take care of their parents regardless these cultures also have a higher instance of abusive parents because the parents feel they have nothing to lose by being this way.. They "know" that despite their abuse their kids will still take care of them later in life because that's what the society expects of them. I grew up telling my father that when he got older he would be on his own because of how he treated me, but he was so ingrained in the culture that he never believed me. When he turned 60 and realized that I meant what I said he broke down and cried... and I didn't care in the least.

"I know lots of folks who are estranged from their parents or who simply don't want to take care of them in their old age. What happens to those parents as they age?"

They age and die without us.

But even if you are good parents to your children this won't guarantee that they will be there for you while you are aging. Sometimes tragedy strikes and sons and daughters become sick themselves, or they become drug-addicts, or they can even be born with disabilities.... in these cases having children can actually guarantee you will be less able to take care of yourself as you get older. The only guarantee that you will be taken care of in old age is by making preparations and putting money aside. They have some great senior communities in Florida.
posted by manderin at 9:19 PM on November 4, 2013 [1 favorite]

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