As more adults face old age alone, society needs to rethink its approach to health and elder care before this demographic shift puts further strain on an already taxed system, according to one Western researcher.
For most of human history, adults have generally been part of dense family networks who cared for them as they aged. But increasingly, adults are facing their 'golden years' without a spouse or children. This new living condition portends millions facing an absent support system in old age when care is generally assumed by one's immediate family.
To gain a better understanding of what the future holds for aging Americans, Sociology professor Rachel Margolis partnered with Ashton Verdery of Penn State University to conduct a demographic study using historical census data. Projecting to 2060, this is the first study to consider outcomes for older adults living without multiple types of important kin.
They recently published a paper, Older Adults Without Close Kin in the United States, in the Journals of Gerontology.
The researchers first explored people who lacked a spouse and biological children – two types of kin that do almost all the care-giving for people in older age.
Margolis and Verdery found 6.6 per cent of U.S. adults 55 and older have no spouse or biological children, while 1 per cent of older Americans have no surviving relatives of any kind, including a spouse, partner, children or biological parents or siblings. These numbers will likely rise.
What's more, the divorce rate for 55-64 year olds more than doubled from 1990-2015, according to the National Center for Family & Marriage Research. And once divorced, people are less likely to remarry.
The study projects the number of kinless white men, without a partner or children, going from 6.6 million in 2015 to 8.2 million by 2060.
This new isolation may prove challenging.
"Health institutions and Social Security are set up for people who are connected to other family members. The increase in the percentage of people lacking these two types of kin simultaneously is really important," Margolis explained.
The study also explored older adults lacking four different types of kin, including biological and non-biological children, a spouse or partner, siblings and parents.
"This group is also increasing in percentages and numbers. This is important because a big part of most Americans' conversation networks is kin. It's only the most educated people who mostly talk with non-kin. It's important to think about the implications of who people are going to be connected to, when more people are not part of dense kin networks," she explained.
According to Margolis' study, the increasing population of kinless older Americans can be attributed to people never marrying or having children. This is the primary driver for white men, black women and black men. For white women, the primary driver of kinless-ness in old age is a previous marriage – meaning they are either widowed or divorced in old age.
These trends should be of increasing interest to policy-makers, Margolis added.
"We're thinking about how big of a problem this is, about types of kinless-ness that are expected in older age and types that are unexpected. If you are never married and never have children, in a certain sense, you know you're not going to have that kind of kin when you are older and you can prepare for it a bit more," Margolis said.
"One big implication of this is for health systems. Often, hospitals and other types of health-care organizations are billed and organized such that family members are expected to take care of people when they leave the hospital. If there are no kin nearby, available to take care of someone, then people are often taking up hospital beds."
There are considerations to be made for institutional care as well, she noted. People who don't have a partner or children are much more likely to end up in institutions at the end of life and increasing numbers of aging, independent adults can put a strain on an already taxed system.
"All of these systems are set up for people who are part of dense family networks; we haven't really thought seriously about how our mindset is going to adjust with much greater numbers of people who are not going to have these connections," added Margolis.
"One way of dealing with this is to involve social workers in older adult care a bit earlier. (We can) start to have people, when they are much younger, make plans for what they want to happen when they need this type of care, to make plans with non-kin. As people are more and more not involved in dense family networks, they have other types of social connections. But often, people don't have those conversations. 'What do I want to happen to me when I'm old?' These are serious questions."
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Rachel Margolis et al. Older Adults Without Close Kin in the United States, The Journals of Gerontology: Series B (2017). DOI: 10.1093/geronb/gbx068