The Caregivers Podcast

This week, Dr. Mark sits down with Dr. Sara Zeff Geber, a leading voice and author on the topic of solo aging. Together, they discuss what it truly means to age without reliable family support, debunk common myths surrounding solo agers, and explain why independence alone cannot replace a structured care plan.

From creating advance healthcare directives and selecting younger decision-making proxies to leveraging professional fiduciaries, congregate living, and community resources like the PACE program, Dr. Geber offers practical strategies for navigating older adulthood with confidence and purpose.

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What is The Caregivers Podcast?

The cost & courage of caring - stories that spark resilience.

Welcome back to the Caregivers

Podcast.

I'm your host, Dr.

Mark Ropaleski, and you can call

me Dr.

Mark.

On this show, we often talk about

the person who steps in as a

caregiver.

A family member gets the call

after the fall.

A spouse sits beside the hospital

bed.

An adult child hears the discharge

instructions, asks the questions,

remembers the medications,

and helps carry someone through

that big moment when they can no

longer manage alone.

But what happens when you're the

one who needs care and there's no

one whose role it is to step in?

Our guest today is Dr.

Sarah Zef-Geber.

Sarah is one of the leading voices

on solo aging,

a term she helped bring into wider

use to describe people aging

without reliable family support

when care is needed.

That can include people without

children, people without partners,

people who are widowed, estranged,

geographically isolated, or people

whose support network may care

about them but may not be able to

actually manage a crisis.

This conversation is not just

about living alone.

It's not just about loneliness.

It's about the moment independence

is no longer enough.

It's about what care actually

requires when there's no one

already in that role,

and it's about the plan that has

to exist before an emergency

arrives.

Sarah, welcome to the Caregiver's

Podcast.

Before we begin, please take a

moment to subscribe and follow the

Caregiver's Podcast wherever

you're listening or watching.

It's completely free, and it's one

of the best ways to support the

show and help these conversations

reach more caregivers and families

who need them.

Dr.

Sarah Zef-Geber, welcome to the

Caregiver's Podcast.

We're so happy you're here with us

today.

Thank you for having me.

I'm happy to be here.

Well, in the tradition of the

podcast, we're going to jump right

in, and Sarah, tell us, for

listeners who may not know the

term,

what is a solo ager, and can you

help us understand the different

ways someone can end up aging

without a reliable person to step

in when care is needed?

Sure.

It probably helps for me to tell

you how I came upon that term in

the first place,

because to my knowledge, I am the

first one to start using it, and I

started using it about 10 or 12

years ago.

And at the time, I had noticed

that so many of my contemporaries,

who we were all then in our late

50s, early 60s,

were starting to spend a great

deal of time taking care of their

aging parents.

And that wasn't a factor in my

life, because I had lost my own

parents when I was in my 30s, so

that was kind of behind me.

And yet, here were people in their

50s and 60s who were taking care

of their 80- and 90-something

parents.

And I was out with a friend of

mine one evening, and she and I

both do not have children.

And I remarked on how much time

she'd been spending doing that,

and I said to her,

Sandy, who's going to do that for

us?

And of course, we had no answer to

that.

And that is really what led me on

the quest to figure out what, as

solo agers, we could do.

Now, at the time, I was defining a

solo ager as anyone, married or

single, who did not have children.

Because children are the obvious

caregivers for their parents as

the parents get older.

So, I started using it in that

context, and so many people pushed

back and said,

You know, I do have kids, but I

still consider myself a solo ager

because my parents live

X thousand miles away, or I

haven't seen my daughter for 12

years.

All kinds of situations that

people brought to me, saying, I'd

like you to consider me a solo

ager.

So, I thought, you know, I need a

new definition.

So, I changed the definition.

And now, and for the past five or

six years, my definition has been

anyone aging or preparing

for older life who knows they will

not have the support of family.

Many people may assume that solo

aging is mainly about living alone

or even feeling lonely,

but what do they misunderstand

about what solo aging actually

means?

Well, solo aging certainly doesn't

mean that anyone is lonely

or that they have necessarily

isolated themselves or that

they're unhappy.

And some of the myths that we hear

about solo agers are,

well, they're really

psychologically not quite right,

or they're lonely, or that life

leads you to become selfish.

So, solo agers come in all

different genders, sizes, sexual

preferences,

it just runs the gamut.

And again, my original

description, and the one that I

still do strongly urge people to

consider

if they are in the situation where

they do not have adult children,

is that they are putting

themselves at risk not knowing who

is going to kind of quarterback

their care

if and when they need care.

So, that's the real distinction.

So, just so listeners are clear,

and I think it's a really

important distinction,

you can solo age with a great

quality of life and be very active

and very engaged

and very holistically involved

with the world around you.

Absolutely.

And I think one of the things that

people don't understand

or just had no reason to look into

at any point in their lives

is the fact that almost 20% of

baby boomer women did not have

children.

So, that's a huge number of solo

agers right there.

And that's almost double the rate

of solo aging in all previous

generations.

So, you're starting out with a

preponderance of solo agers among

baby boomers.

And then if you take a look at

the, what I call the family

diaspora in this country,

you know, kids grow up, they move

away, they go to college,

or they move away for some other

kind of job.

And as often as not, they don't

come back.

So, they're now living several

thousand miles away, often, from

their parents.

And I have a neighbor around the

corner from me who,

she and her husband have two

children.

Sorry, no, she and her husband

have one child.

And he had the nerve to marry a

Danish woman.

And so, where do you think they're

raising their kids?

They're in Denmark.

They're in Copenhagen.

And my friends at this point are

perfectly healthy and able to go

visit them several times a year.

But that won't always be the case.

So, it's a very typical example of

people who have a long-distance

relationship with their adult

children.

Well, gone are the days when many

people didn't travel past 100

miles from their birthplace,

right?

That's just not our world anymore.

Yeah.

Is there a moment, Sarah, when a

solo caregiver...

Is there a moment when a solo ager

realizes, not just fears, but

really understands when care is

needed

and that there may be no one

waiting in the wings?

Well, you know, the solo agers who

get it the easiest

are those who were responsible for

care for their own parents.

And they've seen the trajectory

that aging often takes.

And if you aren't taken out of the

game by heart failure or cancer or

one of the top killers,

if you aren't taken out in your

50s or 60s or maybe even 70s,

then you're probably going to live

a life that includes a point in

life where you're going to need

help.

There's no disputing the fact that

as we get older, we get a little

more frail.

We often end up needing other

people to help us.

So, it's moving in that direction.

And again, for people who have

seen their parents go through that

trajectory,

they get it.

They understand that they're going

to have to set up something for

themselves

if they plan to live that long.

And of course, I say plan in jest

because we don't know.

And we all know people who have

lived very, very healthy lives up

into their mid-90s living alone

with no help.

But what people often fail to

realize is that that's the

exception, not the rule.

And it's an extreme exception in

most cases.

So, again, it's understanding that

there will come a point in your

life when you'll probably need

some help.

And taking the time and the care

to arrange for that ahead of time

is what I strongly advise solo

agers to do.

It's interesting how having been a

caregiver sort of puts you in a

learned state of mind

that you kind of might be better

prepared than you think, even if

you are a solo ager.

Yes.

But without that experience, it

could come as a shock.

Is there a particular kind of

grief that comes with realizing as

a solo ager that no one's coming?

Like, not loneliness, but just the

knowledge that if you become sick,

injured, or frail, or can't speak

for yourself,

there's no built-in caregiver

whose role is to step in.

I suppose it could.

I've never thought of it in terms

of grief.

There's a realization and

potentially some fear that sets

in, possibly some grief over, you

know,

you may be grieving over your

lonely, not lonely, your more

independent self.

Grieving over your potential loss

of independence.

Yeah, I think most people really

strive to remain as independent as

they possibly can.

And that doesn't usually involve,

or the image of that doesn't

usually involve somebody taking

care of them

in what ends up occasionally being

a more intimate way.

I think there might be some grief

also in mourning the absence of

communal warmth or family warmth

that comes as elders transition to

a more frail state,

but still have a quality of life

that's in an adaptation with the

help of others.

It feels like you're talking about

grieving over something that you

may never have had.

Or may never have, yeah.

I mean, most, and I shouldn't say

most, many, many solo agers have

led very independent solo lives

very happily for often decades.

And the thing that I encourage

people to do the strongest,

and gosh knows, it gets pushed

back.

But I encourage people to build

and maintain a community that

often involves living communally.

And I don't mean like an old 60s

commune where you throw everything

you own into a pot

and it's kind of a free-for-all.

But finding ways to live close to

people that you care about, that

you like, that are your friends,

and whether that means moving into

a co-housing community

or maybe giving up your

single-family home

where you don't know your

neighbors very well or at least

very intimately.

choosing a life in like an active

adult community

where you're, you are in a

one-level home or often a condo

and you're close to your neighbors

and there's organized,

there are organized activities.

These are, these are the kinds of

things that can build community

for solo agers when they don't

naturally have one in their middle

years.

It still provides an opportunity

to give

and maybe a redefinition of what

is meaningful to the individual

as they embark on that new

journey.

But it sounds from what you

described,

there'd be plenty of opportunities

that can sustain meaning,

contributions, activities,

looking after new friends as

things arise.

Many of our listeners have spent

years caring for someone else.

There's no question about that.

And I really like to know what

happens psychologically

when someone realizes they've been

the person others could rely on

and then there may be no one who

can care for them in the same way.

That's not one that's kind of

within my purview to answer

because I have never been a

caregiver myself.

yet because of what I do, what I

talk about in the milieu that I

surround myself with,

I understand that I will very

likely need care at some point.

So, I'm not a good one to answer

that question.

No.

And from your entourage of

experiences and people you've

worked with,

do you get a sense that there's a

spectrum of how people process

that reality

and some get quite introverted and

almost down and depressed,

whereas others sort of can

continue embracing and just

reinventing themselves

as they age solo?

Yes, a number of the solo agers

that I encounter have been

caregivers.

Occasionally, I run into someone

who still is.

But mostly, I talk with people who

are in their 70s and 80s,

sometimes their 60s,

and their caregiving days are

usually behind them.

So, they've gotten religion

because they had to do it

and they realize they're getting

older.

So, that's my touch point on that.

Okay.

So, when a solo ager has no

reliable caregiver,

what are the first parts of life

and care that start to become

unsafe?

What do they need to be on the

lookout for?

Well, before that ever happens,

I recommend that they make sure

that they have a very robust

medical directive,

advanced directive for health

care,

so that they have chosen someone

in their life to speak for them if

they cannot.

Same is true for their financial

situation.

You know, to have gone to a

financial advisor or someone who

can help them understand

how much money they have, how much

money they may need,

and where it's going to go,

and whether their spending pattern

makes sense for the money that

they have.

Because I think the last thing any

of us want, solo ager or not,

is to run out of money.

I have, I can't tell you how many

times I've been told by people who

are not solo agers,

I don't want to be a burden to my

children.

And my only response to them was,

okay, so don't be, start planning.

Because if you just sit there with

the conviction that you're not

going to be a burden

and don't do anything about it,

you're the highest form of

hypocrite.

So, having a financial plan,

having a care plan set up for

yourself is very important.

Now, I think the best way to kind

of surround yourself with people

who might fulfill those roles for

you

is to live closer to people.

Also, I've known a number of

people who have made these kind of

agreements with close friends

that they're going to be each

other's person.

And yet, they are approximately

the same age.

It is tricky, isn't it?

And that doesn't make a lot of

sense.

Well, it's going to make sense for

one of them.

But the other one is going to be

out on a limb without a support

system.

So, when you're looking around for

the people that you want to choose

as your decision makers,

your proxies, we call them, look

to the younger people you know.

It might be a younger niece or

nephew or a younger sibling.

Nieces and nephews are usually

younger.

It might be the son or daughter of

a friend.

It's someone that you have

hopefully known for a while and

that you consider a responsible

person,

able to make those kinds of

decisions for you if you're unable

to speak for yourself,

and that you then talk to them.

Tell them what you would like in

your life if you can't manage on

your own.

Is there a particular place you'd

like to be?

I encourage people.

I get such a response, such an

unfortunately negative response to

this.

But I encourage people to look

around their area.

Understand where the skilled

nursing facilities are.

Understand where the assisted

living communities are in your

neighborhood or your greater

metropolitan area.

So that if and when the time comes

that you need care, you can say,

you know, I've been to this

particular community a couple of

times.

I like them.

Call this person.

Let them know that I'm ready to

come in.

Hopefully they have space for me.

So doing all that ahead of time is

a pretty important thing.

Now, for those solo agers who are

able to afford it, I encourage

looking into traditional senior

living,

which means a life plan community

or a month-to-month rental

community where you can live

independently.

Or if you need more help, you can

move into the assisted living

portion of that or pay an

additional amount for assisted

living.

A lot of people think that they're

just going to stay home and age in

place.

That is very difficult for solo

agers.

Very, very difficult.

Now, if they're quite wealthy,

they can hire all the help that

they need.

But that's a very lonely

existence.

When the only people you see are

the ones that come in to help you

change clothes or get up in the

morning.

I think that, to me, that paints a

very sad picture.

And a number of studies recently

have shown that moving into an

assisted living community is

actually cheaper than bringing

help with significant numbers of

hours into your home.

So, consider those factors and,

you know, check those out.

You can easily find those

statistics online.

So, you know, consider that kind

of what's called congregate

living, where you live close to

other people, yet you have your

own independent space.

Lots of important conversations

need to be had on oneself when

living and aging solo, but they

still need, there's no way of

avoiding them.

Mm-hmm.

It's interesting, you mentioned

earlier that you often get

negative feedback from what you

were about to say.

What's the negative feedback that

specifically you were referring

to?

I'm not sure what you mean.

Well, you mentioned you often get

feedback about some things that

you say that maybe people aren't

ready to hear.

And it just sort of struck me as

you mentioned it.

Maybe it was about certain types

of conversations or looking at

alternatives, but it just struck

me for a moment.

You'll have to tell me what struck

you.

Yeah, no, well, we kept talking

and then I'm having a bit of

trouble placing it.

I wanted to sort of follow up a

little bit here about this,

because one of the most

frightening scenarios to me is

cognitive decline in a solo age,

or the idea of slowly slipping

away from yourself when no one

around you is there to notice.

I mean, who sees the early signs

when there is no spouse, adult,

child, or close family member

watching the pattern over time?

I don't know.

Who does?

What kind of situation have you

put yourself in?

If you've moved into a congregate

living kind of situation, then you

have a much better chance of

somebody catching that early.

But that, you know, that's a scary

thing for all of us, whether you

have adult children or not.

It's scary for all of us, and

there's not much that we can do

other than pay attention to some

of the guidance for keeping

ourselves as healthy as possible,

keeping our brains as healthy as

possible.

So there's no particularly

different answer on that for solo

agers.

Again, being social, building a

community around you is, in my

opinion, the single most important

thing that solo agers can do.

I agree.

To ensure for themselves a rich

later life.

Well, I think it creates sort of

little nodes of opportunity for

someone else to observe you and

maybe strike up a conversation or

maybe express a genuine concern to

someone else in the community or

in the position of leadership.

But something that just sort of

says, hmm, maybe we should check

in on them or maybe we should have

a conversation with them.

Yeah, and then what?

Well, walk us into the hospital

room now.

A solo ager has fallen, has had a

stroke, has received life-changing

diagnoses, and someone asks, well,

who should we call?

What happens when there's actually

nobody to call?

Well, I'll tell you what happens.

And it's not pretty.

What happens is you are, the

medical community came up with a

term for people like that.

Before I came along and studied

this and wrote about it, they came

up with the term elder orphan.

And when I heard that term, I was

absolutely horrified.

It just sounded like the most

negative way to describe someone

without family.

And yet, it does happen.

And it's going to happen more and

more if people don't do some

planning around that.

But back to your question, what

happens?

Well, you become a ward of the

court.

And the court assigns you a

conservator and or a guardian.

And all the decisions about your

future are left to that person who

never met you before, who doesn't

know your life story, who doesn't

know anything about you.

And believe me, I tell that to

people, hoping they will open

their ears and open their minds to

what it means to build community

so that that never happens to

them.

Because that is what happens.

What percentage of solo agers do

you think just stay away from

having those important

conversations with themselves and

others to sort of prepare?

Is it 10 percent, 20, 50?

Well, statistics show that that's

a fuzzy one because you're asking

how many have the conversations.

Or how many seem prepared or

unprepared or how many sort of

stand out and sort of say, I'm not

going there.

I'm just going with the flow.

Well, AARP did a study on that a

couple of years ago and found that

close to 50 percent just, you

know, hadn't been there at all in

their own minds as well as

conversations.

That's a striking number.

It's a striking number.

Yeah, it's a striking number.

How much does our health care

system actually depend on an

unpaid family caregiver in the

background?

And what are the implications to

solo agers when that person just

doesn't exist?

Yeah, that's a really good

question.

And, of course, our health care

system falls far short of being

able, excuse me, being able to

help people when they get older.

We are, in my opinion, it's

shameful disregard of older adults

in this country.

And so we don't have the safety

net.

We don't have the social systems

that some of our neighbors over in

Northern Europe have.

So we have to, and that's, you

can, I don't know the exact

numbers, but you have only to go

to the AARP statistics

to look at how many millions of

dollars are spent by family

caregivers every year.

And that's why it's so scary when

you don't have a family caregiver

and are going to need to rely on

others somewhere.

I think the indirect costs for

caregivers in terms of their own

lost wages in lack of productivity

are pushing $400,000 per person.

And I think the average owner

spends about $7,500 U.S.

dollars per caregiver.

Yeah.

Do you think this is a problem of

evolution of a society that's just

become so individualistic?

Or do you think this is merely

just the system that's putting

profits over people?

Well, it's somewhat of a

politically charged question,

isn't it?

It is.

Yeah, I think it's a function of a

couple of things.

I think it's partially a function

of how our society has shifted and

changed.

Again, I came up with the term

family diaspora to describe what I

see around me,

especially people who are in more

expensive areas.

Their kids grow up, go away, can't

afford to buy a home where they

live,

so they're going to move

elsewhere, maybe several thousand

miles away.

There's opportunity elsewhere.

Some towns can't support a growing

group of people coming of age and

needing to work.

So it's just huge numbers of

people moving away from where they

grew up

and moving away from their own

parents.

It's partly that.

It's partly a function of the

horrendous divide in our country

between the haves and the

have-nots.

And the have-nots, as always, are

left in the lurch

without anything to rely on other

than family caregivers.

If you're wealthy enough, you can

bring in aides and people to help

to do that.

You can help your elder relative

move into a lovely retirement

community

where they'll get the help they

need.

But that's not universally true

because it's not universally

available to people just

financially.

So, yeah, there are some—I don't

like to, you know, be the chicken

little running around saying,

the sky is falling, the sky is

falling.

But in many ways, for solo agers,

it is.

We really have to make plans.

There's a company that I became

aware of and I'm a big supporter

of quite recently.

They just opened their doors in

January called the Child Free

Trust.

And it is a solution for people

who do not have children.

That doesn't include all solo

agers, but people who actually do

not have children

to build an estate plan that

doesn't involve an adult child

or somebody coming in to rescue

them.

It's all done by these

professional fiduciaries.

So, you know, it's a great

solution.

It's not horrendously expensive,

but it's certainly available to

the middle class at $1,000 a year.

So it's worth checking into for

people who do not have children,

for sure.

The states of California and

Arizona have chosen to license

professional fiduciaries.

These are independent individuals

who can take over that function.

In the rest of the 48 states, I

don't know.

They don't have that option.

Key word being fiduciary.

And I think our listeners need to

really understand that word.

That's someone working for you who

has your best interests in mind,

who's not trying to sell you a

product,

who's not working for a bigger

company that's trying to make

profit

by churning investments and things

like that.

So that's a really important word

that's, I think,

popping up on the grid a lot more

these days, fiduciary

responsibility.

Yes.

And the term was born in the

financial sector.

It classically means having, when

you hire a fiduciary,

they have to, they are bound by

law to work in your best interest.

Not theirs or anyone else's.

However, the noun, fiduciary, is a

person, at least in these two

states,

is a person who can handle your

affairs.

And a number of fiduciaries,

especially in California,

because that's where I live and

that's what I know,

have opened their doors to the,

being the healthcare proxy as

well.

I know my husband and I, we don't

have children,

we don't have any relatives that

live anywhere nearby,

and we will have a professional

fiduciary manage our affairs.

Obviously, we're going to be the

primary person in each other's

lives,

but one of us will go first and we

don't know who.

So when that happens, a

professional fiduciary will step

in

and manage the affairs of the

spouse left behind when that's

necessary.

So what I'm hearing is that the

process is achievable and doable,

and there are blueprints.

We just need to engage as solo

agers in the process

and be willing to be open to it.

Many solo agers have people who

care about them.

There's no question.

That's not the same as having

someone who loves them,

knows their needs, and understands

their wishes,

and has agreed to step in when

things get hard.

So what is that gap between casual

support and committed care?

That's a good question.

It's a matter of, sometimes it

comes down to having a

conversation.

If you have someone who cares

about you,

and ideally they're a good bit

younger than you are,

and you'd like that person to be

your proxy,

then you need to have a

conversation.

And build a relationship, yeah.

Yeah, it's amazing to me how many

people I talk to who say,

oh, yes, I have an estate plan.

I've named my nephew as my proxy

for health care,

and my niece is going to be my

proxy for my finances.

And my next question to them is,

so you've had that conversation

with them?

Oh, no, I haven't talked to them

about it.

I just put their names down on the

line.

And can you imagine getting a

phone call at 2 a.m.

from some hospital saying,

you are the power of attorney for

Jane Smith,

who just took a bad fall and is

unconscious?

That's not something you want to

spring on anyone,

especially somebody you like.

And it certainly leaves them

unprepared

and probably shoots anxiety

through the roof

in terms of having to make a

critical decision

about someone they may not be as

close as they need to be

or should be when it comes to

making those calls.

So for a solo ager,

I mean, the frightening question

is not just

who makes or who will make medical

decisions for me,

but it's also what happens if that

person I chose

can't do it anymore

and there's no one else to call.

What does a real backup plan look

like?

There is no backup plan

other than a court-appointed

guardian.

So I guess if you do have someone,

though,

who you've designated,

but you're witnessing them become

more frail

or maybe seeing cognitive decline

in them

or their health is slipping,

you actually need to sort of work

on kindling a new relationship

with someone to maybe even take

over for that person.

It's not a static one-time event,

but it's actually a real process

that you need to navigate and

steer.

Yes, it's an ongoing thing because

that's why I suggest that people

redo their estate plans

every eight to ten years because

the landscape changes.

People change.

People move.

People's health situation changes.

And that all needs to be taken

into account.

If you sit down with an attorney

to develop an estate plan,

he or she will have you name at

least two,

if not three backups to your

proxies.

And what you just answered my next

question is that sounds to me like

you need a chain of people

or a chain of options who've

clearly agreed that if the person

ahead of them can't step up,

then they would be next in line.

So I think that's hugely

important.

Yeah, absolutely.

A lot easier to do when you've got

a community and a network of

individuals you've invested in

so you can actually come up with

those three or four names, let

alone one.

Yes, it's easier then and it's

easier to do when you are feeling

good.

It's easier to do when you say,

Oh, I'll put that off for another

year or two.

I've got time.

You don't know whether you have

time.

So, you know, if you're over 50,

do it now.

You'll change it.

Things will change.

But what if they don't?

You know, what if you don't have

that time?

These are really important

questions, which I think people

avoid, but we need to embrace.

Living independently as a solo

ager works really well until it

stops working well.

When a crisis happens, what are

the caregiving roles that suddenly

have to be covered?

And how can a solo ager prepare

for those roles before they need

them?

Well, it's just really in the way

we've been talking about.

There's nothing more that you can

really do.

You know, you can make it easy on

the people that come behind you by

making sure you don't leave

two tons of stuff you've collected

over the years for somebody to

sort out.

Because that person you like a

lot, that lovely niece that you

have grown to adore over the

years,

she's going to be burdened with

that.

Is that what you want to do?

Probably not.

So, you know, again, get busy

while you're still feeling healthy

and strong and be prepared for

your later life.

It sounds like it's just planning.

It's not like, you know, doomsday,

a doomsday narrative.

It's just part of the next.

We plan all our life.

And the planning doesn't stop at

65 or whenever you engage in that

process.

So I think that...

Sometimes it just starts then.

Yeah, well, that's true too.

And I mean, that's a really

important thing.

It's always a challenge if you

haven't been a good planner

earlier on to suddenly take on

this task without any practice.

But it's certainly one that still

has a loud voice that calls.

For a solo ager listening today

who feels totally overwhelmed by

our conversation,

what's the first step and what's

like the one thing they shouldn't

put off but that can at least get

things going?

I think the best place to start is

to kind of take stock of where you

are.

I wrote a book for solo agers,

came out in 2018.

It's still very, very relevant

today.

And in that book are a lot of

worksheets and self-assessments.

Those are the kinds of things that

will help you get started,

that will help you start to think

about some of these topics in the

context of your own life.

So I would encourage that.

Mm-hmm.

Not that you have to write it out

and buy my book, but some kind of

planning.

There's a lot of other things, by

the way, out there on solo aging

now.

I've had a number of people kind

of jump on the bandwagon and

become colleagues of mine.

There's a wonderful website called

Navigating Solo that a friend of

mine in the Boston area started.

And there are a lot of resources

on that website for solo agers.

So, you know, keep the internal

dialogue going.

Keep thinking about it and begin

to do a few small things.

Journal about it.

That's a great idea.

Absolutely.

Talk about journaling in so many

other stages of life,

but maybe that is like a real time

where you've got some quiet

and some of the background noise

is gone,

but you actually have a chance to

sit with pen and paper.

Yeah, good point.

Good point.

Write some stuff to yourself.

You know, a lot of the strongest

solutions like care managers,

professional fiduciaries you

referred to,

patient advocates, senior living

communities do require financial

resources.

Like, what's the roadmap for

someone who's aging alone and

maybe financially struggling?

Yeah, you know, there aren't,

again,

there aren't a lot of safety nets

in the U.S., unfortunately.

We are very unfortunately seeing

an increasing number of people on

the streets who are over 65.

So, that's the sad side of it.

But if you have a stable place to

live,

number one, find out if there's a

PACE program, P-A-C-E.

How about that?

And I never can remember exactly

what that stands for.

But it's a program for older

adults where they,

it's kind of like an adult day

program.

But they have transportation.

They will pick you up.

They will bring you to their

center wherever their activities

take place.

You will be there all day,

have your meals there,

and then will be taken home.

So, it's almost like being in a

retirement community,

but you don't sleep there.

They are sometimes connected to

low-income housing.

So, I would very much suggest

looking into that.

Another thing I would suggest is

to get on the list in your

community for government-assisted

housing for older adults.

It pretty much exists everywhere.

Check with your county department

on aging

and see what resources are

available in your community.

Because unless you live in a very,

very small rural community,

I know there are some services.

There are, because the Older

Americans Act is still in force,

and they supplement the funds for

senior centers,

for departments of aging.

There are resources out there,

but it really depends on you

to understand where your resources

are

and make use of them.

But again, the first question to

ask

when you contact the county

department on aging

or a senior center is,

is there a PACE program in my

area?

And am I eligible?

You have to be what they call dual

eligible.

You have to be Medicare eligible

and Medicaid eligible for a PACE

program.

Yeah, there's a theme here that's

really important,

and I think it probably knows no

boundaries.

I think up here in Canada,

there are versions of that.

I think in Europe and Australia

and elsewhere,

we have listeners.

find a means to build some

community and connection

outside of your home so that it

can prepare you

and also keep you feeling a little

better

with a sense of community and

connection

to start engaging in that process.

I think it would probably be very

empowering.

The one thing I've noticed about

solo agers,

especially those who have been

solo for a long time,

so I'm not really talking now to

the recent widows and widowers

or recent divorcees,

but more to the people who have

been single

for whatever reason.

Maybe they lost a spouse decades

ago

or they've been divorced for many,

many years

or they never married

and who never, also never had

children.

And most of those people that I

encounter,

many of them friends of mine,

have made fabulously rich lives

for themselves.

You go into any non-profit in your

community

and I almost guarantee you will

find

among the older volunteers

a preponderance of people who are

solo agers

because they don't have family

to kind of devote their time and

energy and heart to.

So they support the causes that

they favor.

It might be working in a food

distribution center

or a soup kitchen

or it may be working with

abandoned animals.

It could be just about anything.

It could be working for a

political cause you believe in.

But you'll find a lot of solo

agers there

because that's how people without

family

bring meaning and purpose to their

lives.

You hit the nail right on the head

and we're hearing more and more

now

about the crisis of meaning in our

society.

And what a wonderful opportunity

to gain strength as a solo ager in

that context.

Do you think solo aging exposes

something

we just don't like to admit that

independence only works

until life requires someone else

to step in?

Hmm.

That's an interesting way of

putting that.

Life only works.

Well, yes.

I guess you could look at it that

way.

There's so many different lenses

through which you can look at this

life.

You know, I have to say,

I think solo aging is probably a

little easier

for those who are kind of

naturally gregarious.

Those of us who are extroverts,

who have put ourselves out there

and gather around us a group of

people

that we love and trust throughout

our lives,

even if that group has morphed and

changed over the years.

Mine certainly has.

But if you have made it through

this lifetime

as more of a loner,

then I think it's a heavier lift

to set these things up for

yourself.

It just is.

One question that comes to mind

when I was thinking about our

upcoming discussion today

is do you think that solo aging

will actually be different as an

experience

between the baby boomers,

Gen Xers, and millennials?

Well, for one thing,

I think we're blazing some

territory here

that's going to be well-trod in

successive years

because the birthright now is,

in Canada, in Western Europe,

it's well below replacement level.

anyway, let's just keep the

conversation at that

and not go into the issue of

immigration.

But, well, I kind of have to in a

way.

At any rate, yes,

I think we are,

the programs that we can set up

today,

the life plan guidance that we can

set up today

is going to be extremely helpful

for people behind us

because, as we know,

medical science

is keeping people alive a lot

longer.

You know,

there's a lot being written about

longevity,

longevity, longevity.

Well,

longevity is,

is good

as long as you're also healthy and

happy

and enjoying life.

A lot of longevity comes with

complexity.

Yeah,

it sure does

because all those conditions

that used to end our lives,

now medical science

has made it possible

for us to continue living with

those conditions.

And I'm, you know,

talking about heart disease

and cancer

and things like Parkinson's

disease.

Millions of people are living with

them,

which, of course,

means that

there are billions of caregivers

spending millions of hours

taking care of them.

So,

you know,

to a great extent,

the best thing solo agers can do

is take as good a care of

themselves

as they possibly can,

which means all the things

that we all get tired of reading

about

and hearing,

getting exercise,

eating right,

taking,

making sure that we are leading

as healthy a life as possible

so that we will need less care

as we get older.

overcoming and avoiding frailty

and maintaining meaning

and human connection

probably will be the best

common denominator,

I think,

and I think the studies are out

there

to prove it

and they've been consistent.

Yeah,

I think so too.

I think that's exactly right,

Mark.

Well,

Sarah,

you're a solo ager yourself.

And when you stop being the expert

at the podium for a moment

and simply become Sarah,

what part of your own future

are you still working through?

My husband and I have,

we decided many years ago,

actually before I even got into

this,

because this is not my first

career,

but long before that,

we had my husband's father

father who lived in a lovely

retirement community

in Florida

and was,

you know,

the thing they had determined

they weren't going to be a burden

to their children.

Well,

they weren't.

They put themselves in the hands

of wonderful caregivers

when they needed it,

but mostly they lived a lovely

independent life there.

so my husband Chuck

and I looked at each other

and said,

you know what?

That's our future.

We're going to have to plan

for that financially

because there's nobody

coming up behind us

to take care of us.

So that is what we are doing.

We recently made a commitment

to move into a community

not far from where we live,

and they are doing

an expansion right now,

so they're actually building

our unit,

and we've put a down payment

on it,

and we,

you know,

barring any sort of catastrophe

with the building of it

or in our lives,

we'll be moving in there

in about two and a half

or three years.

So that's one thing we've done,

just looking at our own

private lives.

We,

again,

we had to plan carefully

for that financially,

starting when we were

in our 50s.

We also have

long-term care insurance,

which we purchased

in our 50s.

we also have talked

to a number of fiduciaries,

and that's,

it is a fiduciary

that will now take the place

of what is currently

in our estate plan

that involves a younger,

a younger cousin of mine.

But within the recent,

recent years,

unfortunately,

that younger cousin

has had two bouts of cancer.

So,

you know,

even the 15 years younger

that she is,

might not be the right answer.

So,

the next time we do

an estate plan,

it will be with a fiduciary

on that top line.

So that's the reality for me.

Again,

my husband and I

don't know

which one of us

will go first.

Right now,

we're both healthy

and thriving.

so,

but,

you know,

that can change

in a phone call.

You're right.

It can change

with one medical test.

I'm in my mid-70s now,

so,

we just don't know.

I'd like to thank you

for your authentic stories today

and your authentic advice.

I think coming from a solo age

or yourself,

it's really meaningful

to our listeners

and is just

chock,

so full of advice.

We're going to include

your book

in the show notes

because I

do recall

having been really well received

and

unique at the time.

Thanks for being here today.

This was a really important

and meaningful conversation

and

whether

you're

a solo wager,

no matter what

type

or size

you are

in

what's becoming

a much broader

swath

of solo

wagers,

I think the advice

you gave us today

applies broadly

and

we're grateful

for it.

Well, thank you, Mark.

I appreciated the opportunity

to share that.

That wraps up

this week's episode

of the Caregivers Podcast.

I'm your host,

Dr.

Mark Ropaleski.

Thanks for being here

and we'll see you next time.

Sarah,

thank you for helping us

talk about something

that's easy to avoid

until the moment

it becomes urgent.

I think one of the

clearest reminders

from this conversation

is that independence

is not the same thing

as a care plan.

You can be capable,

thoughtful,

organized,

and deeply independent

and still need people,

documents,

authority,

backups,

and support in place

before a crisis happens.

For anyone listening

who's aging

without reliable

family support

or who loves

someone who is,

I hope this conversation

doesn't leave you frightened.

I hope it leaves you honest

because the goal

is not to panic.

The goal is to ask

the hard questions now,

name the roles

that need to be covered,

and put support in place

before the emergency arrives.

Before you go,

please subscribe

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Thank you for listening

and we'll be seeing you

next time.

Before we wrap up,

I wanted to remind you

of something important.

The conversations you hear

on this podcast

are here to inform,

to support,

to spark reflection.

You're not a substitute

for professional medical advice,

care, therapy,

or crisis services.

Listening to this podcast

does not create

a doctor-patient

or caregiver-client

relationship between us.

If you're facing

a medical concern,

health challenge,

a mental health challenge,

or a caregiving situation

that needs guidance,

I encourage you to reach out

to a qualified professional

who knows your story.

If you're ever in crisis,

please don't wait.

Call your local emergency number

or recognize crisis hotline

right away.

You deserve real-time

help and support.

The views you hear

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whether from me

or my guests,

are our own.

They don't necessarily

reflect any organizations

we work with,

are part of,

or have worked with,

or been part of in the past.

This podcast is

an independent production

and it's not tied

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university,

or healthcare system.

Thank you for being here,

for listening,

and most of all,

for taking the time

to care for yourself

while you continue

to care for others.

I look forward to hearing from

you.