Donald Hammen, 80, and his longtime south Minneapolis neighbor, Julie McMahon, hit it off. Every morning, she checks to see if he has raised the blinds on his dining room window. Otherwise, she will call Hammen or come into his house to see what is going on.

Navigating Aging focuses on medical issues and counseling associated with aging and end-of-life care, helping America’s 45 million older adults and their families navigate the health care system.

If McMahon finds Hammen in bad shape, she plans to contact her sister-in-law, who lives in a Des Moines suburb. It is its closest relative. Hammen never married or had children, and his younger brother died in 2022.

Although Hammen lives alone, a network of relationships ties him to his town and community: neighbors, friends, former co-workers, fellow volunteers at a seniors advocacy group, and members of a group for single seniors . McMahon is an emergency contact, as is a former colleague. When Hammen was hit by a car in February 2019, another neighbor was doing laundry. A friend came to keep him company. Other people walked around with Hammen as he got back on his feet.

These bonds are certainly lasting. Yet Hammen has no idea who could care for him if he becomes incapable of caring for himself.

“I’ll cross that bridge when I get to it,” he told me.

These are fundamental questions for elderly people living alone: ​​who will be there for them, for big and small matters? Who will help them navigate an increasingly complex healthcare system and advocate for their interests? Who will take out the trash if it becomes too difficult to transport? Who will shovel snow in the event of a winter storm?

American society is built on the assumption that families take care of themselves. But 15 million Americans age 50 and older had no immediate family (spouse, partner, or child) in 2015, the latest year for which reliable estimates are available. Most lived alone. By 2060, this number is expected to reach 21 million.

Beyond that, millions of older adults living alone are not geographically close to adult children or other family members. Or they have difficult and strained relationships that prevent them from seeking help.

These elderly people must ask other people for help when they need it. Often, they turn to neighbors, friends, church members or community groups – or to paid help, if they can afford it.

And often, they simply go without it, leaving them vulnerable to isolation, depression and deteriorating health.

When older people living alone have no close family, can non-family caregivers be an adequate substitute? This has not been well studied.

“We are just beginning to better understand that people have a multiplicity of connections outside of their family that are essential to their well-being,” said Sarah Patterson, a demographer and sociologist at the University’s Institute for Social Research. . from Michigan.

What to remember from a remarkable published study by researchers at Emory University, Johns Hopkins University and the Icahn School of Medicine at Mount Sinai: Many older adults adapt to living alone by weaving together local social networks of friends, neighbors, nieces and nephews, and brothers and sisters (if available) to support their independence.

Yet finding reliable local connections isn’t always easy. And non-family caregivers may not be willing or able to provide constant, intense hands-on care if it becomes necessary.

When AARP investigated the people he calls “solo seniors” in 2022, only 25% said they could count on someone to help them cook, clean, buy groceries, or do other household chores if needed. Only 38% said they knew someone who could help them manage their ongoing care needs. (AARP defined single older adults as people 50 and older who are not married, have no living children, and live alone.)

Linda Camp, 73, a former city administrator in St. Paul, Minnesota, who never married or had children, wrote several reports for the Citizens League of St. Paul on growing old alone. Yet she was still surprised at the help she needed this summer when she had cataract surgery on both eyes.

A former colleague accompanied Camp twice to the surgery center and waited there until the procedures were completed. A relatively new friend took her to a follow-up appointment. An 81-year-old downstairs neighbor agreed to come over if Camp needed anything. Other friends and neighbors also contributed.

Camp was lucky: she has a large network of former colleagues, neighbors and friends. “What I tell people when I talk about solos is that all kinds of connections have value,” she said.

Michelle Wallace, 75, a former technology project manager, lives alone in a single-family home in Broomfield, Colorado. She worked hard to build a local support network. Wallace has been divorced for nearly three decades and has no children. Even though she has two sisters and a brother, they live far away.

Wallace describes himself as happily partnerless. “Mating isn’t for me,” she told me during our first conversation. “I need my space and my privacy too much.”

Instead, she cultivated relationships with several people she met in local groups for single seniors. Many became his close friends. Two of them, both in their 70s, are “like sisters,” Wallace said. Another, who lives a few blocks away, agreed to become a partner “we will help each other if needed.”

“At 70, single people are looking for support systems. And the scariest thing is not having any friends nearby,” Wallace told me. “It’s the local network that’s really important.”

Much less deliberate was Gardner Stern, 96, who lives alone on the 24th floor of the Carl Sandburg Village condominium complex just north of downtown Chicago. He never planned for his care needs in old age. He just thought things would work out.

This is indeed the case, but not as Stern predicted.

The person who helps him the most is his third wife, Jobie Stern, 75. The couple went through an acrimonious divorce in 1985, but now she goes to all his doctor’s appointments, takes him shopping, drives him to physical therapy twice a week. and stops every afternoon to chat for about an hour.

She is also Gardner’s neighbor – she lives 10 floors above him in the same building.

Why is she doing this? “I guess because I moved into the building and he’s really old and he’s a really nice guy and we have a kid together,” she told me. “I’m happy to know he’s doing as well as he can.”

For many years, she said, she and Gardner put their differences aside.

“I never would have expected that from Jobie,” Gardner told me. “I guess time heals all wounds.”

Gardner’s other main local connections are Joy Loverde, 72, author of books on elder care, and her 79-year-old husband, who live on the 28th floor. Gardner calls Loverde his “tell it like it is” friend – the one who helped him decide it was time to stop driving, the one who persuaded him to install a walk-in shower with a bench in his bathroom, the one who plays Scrabble with him every week and gives him practical advice whenever he has a problem.

“I think I would be in an assisted living facility without her,” Gardner said.

There’s also family: four children, all based in Los Angeles, eight grandchildren, mostly in Los Angeles, and nine great-grandchildren. Gardner sees most of the members of this extended clan about once a year and speaks to them often, but he cannot rely on them for his daily needs.

For that, Loverde and Jobie are one elevator away. “I have great people watching over me, a big screen TV and a freezer full of good frozen dinners,” Gardner said. “That’s all I need.”

As I explore the lives of seniors living alone over the coming months, I look forward to hearing from people who find themselves in this situation. If you would like to share your stories, send them to [email protected].

KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of the major operating programs of KFF — the independent source for health policy research, polling and journalism. This story also continued The Washington Post. This can be republished for free.