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Recently, I asked folks in my online community to let me know what topics they’d like me to cover and what they’d like to know more about. Some of you wrote to me to ask for more information about solo aging.
It is a delicate balance to ensure that I am responding with relevance and that I include important topics (in this case, solo aging) in the mix of ways that I interact with you.
Say, don’t stop reading or watching here if you’re not a solo ager! Or if the term “solo ager” or “solo” seems confusing or non-applicable. Let me assure you that today’s information is relevant to your thinking! Read on. There is a lot of value in what I’m talking about today for anyone who is aging. (Anyone here not aging?).
After all, I consider my job as one to poke the bear and provoke thought, right?
There’s a saying that popped out of my mouth one time, and I continue to use it due to its seeming relevance:
“Solo agers must specially plan, and they especially, must plan.”
See if you know all this stuff. See if you’ve had THIS kind of PIE before.
Let’s begin with the definition of solo agers. Today, I am dedicating PIE to the solos in our lives.
Solo agers are persons who, by choice or circumstances, are aging alone and without the support traditionally provided by family.
No matter their choice or circumstances, solos or solo agers may find themselves without the typical support system or backup that other aging folks may enjoy. For example, plenty of agers may have an adult son or daughter to accompany them to a medical appointment. Not so for the solo ager.
A solo ager may find it difficult to designate someone as their agent or proxy with Healthcare Power of Attorney. They may wonder who to list as their Emergency Contact on a form or have trouble meeting people to begin to even find good candidates for those roles.
So, the ‘specially planning’ is pursuant to the solo ager’s unique needs and concerns. The ‘planning especially’ part means so as not to get caught short – or to live their best life, depending on whether you want to look at all this from an ‘Uh-Oh’ or an ‘Ah, yes’ -point of view.
Those of you who have been with me for a while or have heard me speak will likely recognize my favorite format for assessing a scenario. We’re going to talk about the PIE! Have some with me now.
The PIE is a visual that gives way to a tool that I used for evaluation or assessment of needs and priorities. I use this in nearly every consulting conversation I have and plenty of teaching instances, too. First, concerns, needs, and questions should be placed into a category, as in “each piece” of the pie. And secondly, to provide topics or headings when we return for deeper dives. There is always plenty of PIE to share.
My PIE has six pieces: Medical, Legal, Financial, Insurance, Housing, and Support. Why are these significant to solo agers? I’m glad you asked!
Let us consider our six-piece PIE, solo-style.
“Solo agers must specially plan, and they especially, must plan.”
Medical – Along with maintaining good health and understanding and navigating our wacky healthcare system, I often encounter solo edgers who are sorely in need of or who would benefit from accompaniment to their medical encounters. Now, you might say that’s in the support department or piece of the PIE, and while that’s true, I am merely pointing out that solos or solo agers do not have built-in family in the form of sons and daughters or loved ones available to perform this important function. They have no one to talk things over with or help them to access their healthcare.
On the flip side of that solo agers are often invisible in a medical situation. Providers don’t know that for their patient, Ms. Smith, simply getting to the appointment or stopping by to pick up a prescription can indeed present a hardship. There may be no one to “debrief,” even conversationally, after the appointment and to ensure all was properly understood. Providers don’t know that Ms. Smith lives alone, and they have no window into just how small her world of support – which affects the medical – truly is.
By the way, these pieces of the PIE are not standard in size or shape. The sizes vary, and the juice seeps out from one piece to the other. The lines blur.
Legal – This is the piece of the PIE where many solos are hit squarely in the face. Often, there is no one to designate as agent or proxy with Healthcare Power of Attorney. As a patient advocate, I encounter lots of situations where no one has been designated or where there is no one to designate. So often, that comes back to bite!
The question behind the designation question is, “Who will make decisions for me if I’m unable to do for myself?” No matter, if I’m gooed out on medications, on the gurney, inside critical treatment and decisions, are needed, or if my cognition deteriorates beyond my ability to make sound decisions. Who will be there? A solo ager may struggle not only with designations but also with finding candidates for this extremely important role. They ask
“Where do we meet people younger than our contemporaries?
“How do we cultivate the level of that relationship and bring the conversations to a point where comfortable designation is possible?” (Comfortable for all parties).
“How, then, do we educate the person serving in this role so that they will carry out our wishes?”
Planning for care and the end of life—all the way out and beyond—can be dicey for solo agers. How do they get their wishes carried out even beyond death? Who will they designate to ensure they have their say? It requires careful consideration and conversations” with an “s,” as I like to say.
Even if you are not a solo ager, are you enjoying this PIE? Many of these pieces have the same questions and concerns. Have another bite.
Financial – The questions surrounding designation of the financial agent are like those of the medical piece of the pie. (Who’s the best person if I am unable? How and where do I find these people and bring the relationship to the point that designation is possible?). And then there are considerations like “the Caregiving Pocketbook” (as I call it): “How am I going to finance my care needs, sometimes largely an unknown ?” If we’re smart, we’ll look at that now. Preferably looping in our designated financial agent with Power of Attorney.
Housing is a big one. It’s so much more than the ol’ “Should I stay or should I go?” question for the solo ager.
“Am I safe at home? Can I successfully remain here?”
“Can I tend to my needs, groceries, get to medical appointments and faith community?”
“Am I isolated or lonely at home?”
“Do I need to create or insert myself into Community, meaning creating situations where there are eyes on me, and I have friends. Friends that I can both do for and can do for me?” (Purpose, also, if you’ve not already figured that out).
Again, let me remind everyone here that solo agers are often left out of the housing planning, if you think about it, municipally or by those who design congregate housing. Or even cruises! Did you know that it costs more to travel alone on a cruise? Cruise lines often charge a solo supplement, which is an additional fee on top of the fare, that can be 25–100% of the double occupancy rate. (OK, that’s not crucial; it’s an irritant. However, it is another way that solos are shown to be “different,” so they must react differently.
Insurance – Our PIE is juicy! The PIE lines blur, the filling and juices traveling all over the plate, this time because the Medical piece is spilling over to Financial and comingling with Insurance. Not only is a selection of insurance that meets a person’s unique needs of the person important and daunting, but it is often a matter of accessing the right coverage and understanding it. Then there’s effectively using it to get the care you deserve. Many a patient advocate or designated team member has had to step in when there is no family member to assist. The Ms. Smiths of the world may be debilitated during treatment to the point where they cannot assert themselves or are confused by medication. Sometimes, cognitive impairment may be in the way.
This is so often true when someone finally wants to use their long-term care insurance, and they have no clue what their coverage is nor how to initiate a claim. No well-meaning adult child to step in and assist, so this kind of thing needs to be anticipated and a plan made for using your insurance when you really need it.
Support – the biggest piece of the PIE for a solo ager! Likely half of it! Absolutely is key. Solo agers must build their team, and they must establish Community. (I capitalize Community because it is so very important and it deserves emphasis). The team, which I sometimes refer to as the Microboard, is the collection of people who are going to help you enjoy your pie. In other words, and to incorporate one of my mantras,
“We can all have a say about how things will go and where we’ll end up.”
Your team is going to help you with that. Your team, a team that you select, is made of the persons who can step in when you need help. (The visual person I am imagines the desiring solo ager as someone who “can’t quite reach their piece of PIE across the table,” or needs someone to cut, or fetch, or simply to look out for them to ensure they even get their PIE.
The ever-important Community means a place to be a part of and to contribute to. It leads to peace, safety, and belonging. Community is the antidote for loneliness and isolation. We all know the challenges and risks of those two among our aging population in general. Solo agers must build their community since much of it does not come in the form of a ready, built-in family.
This is a big PIE! It’s sloppy and it’s juicy and the slices are uneven. Solos, as well as general agers, should address each of these topics and plan accordingly. The good news is that here is where we can customize for unique needs.
Revisiting plans is also important. Things change. People change, circumstances change, and laws change. Keep things going your way—and have your say—as long as you can.
It is important that solo aging not always be viewed as or associated with dire circumstances. Quite the opposite. I view it as opportunity!
If we flip the script, as they say, solo agers can and do enjoy a lifestyle second to none. They are not burdened by or saddled with the care of blood relatives. In fact, solo agers get to choose their family. They enjoy freedom and options for a lifestyle untethered by some of the obligations which regular agers find themselves burdened, like family drama and having to care for someone just because they are related. Solo agers need only keep themselves safe and happy.
Let us roll with the safe and happy and with PIE! As a solo ager myself and someone who manages all the pieces of the PIE professionally, I am here to tell you that these challenges can be met. It’s as simple as this:
We need to learn what may be ahead for us and plan.
If we’re smart will create some contingency plans.
We will build our team and create our community, one that we can invest in long before we need to withdraw. Give before we take.
This is what I do with the solo agers with whom I consult, and this is what I do as a solo ager for myself. The kind of self-assessment (and PIE) I have been talking about will serve any of us who are aging.
Please continue to send emails asking questions and letting me know the topics and concerns on your mind. I love hearing from you.
How about you and I have some PIE! If you wish to discuss identifying what may lie ahead for you and building your team, I would be honored to consult with you. Simply visit my website to learn more about how we can do this together, or book a session here to meet by phone or video.
I hope that something discussed today provokes thought and perhaps action and helps you move more comfortably into the future.
Nancy Ruffner is a patient advocate whose focuses include aging strategy, healthcare navigation, and solo aging. Nancy consults with clients in a triage fashion, offering one-hour consultations to find a path, gain a deeper understanding of “how stuff works” in eldercare, or specifically problem-solve. Schedule your Power Hour now, without obligation of commitment or continuing costs. nancyruffner.com