title: Elder Orphans Hiding in Plain Sight: A Growing Vulnerable Population.
abstract: Adults are increasingly aging alone with multiple chronic diseases and are geographically distant from family or friends. It is challenging for clinicians to identify these individuals, often struggling with managing the growing difficulties and the complexities involved in delivering care to this population. Clinicians often may not recognize or know how to address the needs that these patients have in managing their own health. While many such patients function well at baseline, the slightest insult can initiate a cascade of avoidable negative events. We have resurrected the termelder orphanto describe individuals living alone with little to no support system. Using public data sets, including the US Census and University of Michigan's Health and Retirement Study, we estimated the prevalence of adults 65 years and older to be around 22%. Thus, in this paper, we strive to describe and quantify this growing vulnerable population and offer practical approaches to identify and develop care plans that are consistent with each person's goals of care. The complex medical and psychosocial issues for elder orphans significantly impact the individual person, communities, and health-care expenditures. We hope to encourage professionals across disciplines to work cooperatively to screen elders and implement policies to preventelder orphansfrom hiding in plain sight.
authors.affiliation: Long Island Jewish Medical Center, Northwell Health, Hofstra Northwell School of Medicine, New Hyde Park, NY 11040, USA.
authors.forename: Maria T
authors.identifier: 0000-0001-6726-4025
authors.initials: MT
authors.lastname: Carney
authors.affiliation: Long Island Jewish Medical Center, Northwell Health, Hofstra Northwell School of Medicine, New Hyde Park, NY 11040, USA.
authors.forename: Janice
authors.initials: J
authors.lastname: Fujiwara
authors.affiliation: Long Island Jewish Medical Center, Northwell Health, Hofstra Northwell School of Medicine, New Hyde Park, NY 11040, USA.
authors.forename: Brian E
authors.identifier: 0000-0002-3148-6918
authors.initials: BE
authors.lastname: Emmert
authors.affiliation: Long Island Jewish Medical Center, Northwell Health, Hofstra Northwell School of Medicine, New Hyde Park, NY 11040, USA.
authors.forename: Tara A
authors.initials: TA
authors.lastname: Liberman
authors.affiliation: Maimonides Medical Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY 11219, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Paris