专家说，对于独自衰老的人，要提前计划长期护理

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爱德华多·加尔文每周锻炼六天，每次至少锻炼一小时. 他饮食健康. And he's considering someday moving from his two-story condo in Ann Arbor, Michigan, 进入一层的生活空间, 因为虽然他现在59岁身体很好, one thing he doesn't have is someone to care for him should he lose it.

“我担心如果我出了什么事, 某种慢性疾病, 我可承受不了," said Galvan, a self-described "loner" who lives alone with no spouse or adult children and a family medical history that includes heart disease, 糖尿病和高血压. “这就是我经常锻炼的原因."

Childless, older adults are more likely to live alone than their peers who are parents, according to 2021年人口普查局的报告. 报告发现了15个.2 million – nearly 1 in 6 – adults 55 and older were childless, and 22.1 million lived alone, a trend that has been growing in recent years.

在美国，有超过27%的成年人是同性恋.S. living with multiple chronic health conditions – a number expected to grow substantially over the next two decades – experts say older adults will face a growing need for assistance. 随着健康状况的恶化, the ability for older adults to perform tasks such as basic home maintenance or daily activities such as meal preparation, 往返于医生的预约, 管理多种药物，甚至敷料, 洗澡和上厕所会减少.

“当你独自一人时，这些挑战会被放大。. 凯伦罗伯特, a university distinguished professor and senior fellow at the Virginia Tech Center for Gerontology in Blacksburg, Virginia. “安全是首要也是最重要的问题. 例如，有更大的坠落倾向. 如果你孤身一人，后果会很严重."

People typically turn to a spouse or an adult child for help, said Dr. Courtney Van Houtven, a professor in the department of population health science at Duke University in Durham, 北卡罗莱纳. “如果他们没有这些, finding someone who can enable them to remain in their home safely can be a real challenge. 这都是关于提前计划."

她说，大多数人不会这么做. 根据 U.S. 卫生与公众服务部, adults 65 and older have a 70% chance of needing some type of long-term care, whether it's in the home or in a care facility such as assisted living. But only 7.美国有500万成年人.S. – less than 3% of the population – carry long-term care insurance that would cover a home health aide or an assisted living facility. “他们认为这不会发生在他们身上，”范·胡特文说.

For those with very low incomes, Medicaid covers many long-term care costs, she said. 取决于国家, these can be either in a nursing facility or through home- and community-based services. 医疗补助计划是美国长期护理服务的最大资助者.S. But most people rely on unpaid caregivers, such as family or friends.

独自衰老的人, like Galvan, may be more likely to plan because they know they don't have anyone else to help them, 范·胡特文说.

"They sometimes come up with creative solutions that don't cost money," she said. "You hear more and more about people moving to be near friends so they can have support." Others turn to home sharing or may rent a room to a university student who can help with household tasks.

罗伯托说，保持社会联系是有帮助的. People who don't have strong social networks have fewer people to ask for help when they need it. 这是强有力的证据 将社会孤立和孤独与较差的健康联系起来, including higher rates of stroke and heart disease, and higher levels of stress and depression.

Friends, neighbors, church members or others in the community can provide support when there is no family to do so, Roberto said. "I can't say enough about the value and importance of friendships to physical health and well-being. 如果你独自一人，重拾旧友谊或结交新朋友. 如果你大半辈子都是独来独往, 这一点在你70多岁的时候可能不会改变, 但你不需要有最好的朋友. 你只需要与社区保持联系."

Roberto recommends people without support take an inventory of the type of services available in their community, 以及所涉及的成本, 在他们需要之前. 老龄问题地区机构, 老年活动中心, 教堂和其他组织可以提供交通工具, meals, 家用医疗设备, homemaker assistance and other types of support that allow someone to stay in their home more safely.

“你不可能为每一种情况都做计划, 但是你可以了解你的社区,罗伯托说. "People often don't think about needing help until they really need it."