Home Alone: the New Normal for Seniors

(Photo from futurity.org)

Being home alone is the new normal for millions of senior Americans:

More than 16 million people aged 65 and older in the U.S. live alone. That represents 28% of that age group, almost triple the share in 1950. Among the reasons: increased longevity, higher divorce rates among older adults and children more scattered than previous generations.

“It’s very likely most of us will live alone in old age,” says Elena Portacolone, professor at the Institute for Health & Aging at the University of California, San Francisco. Older adults with more financial resources have more care options, but even those with resources may find themselves hunting for in-home help.

Most people are unprepared to age alone. Only one-fourth of those living alone have someone who helps or would help with cooking, cleaning and getting groceries, and more than 80% haven’t planned for ongoing living assistance, according to an AARP 2023 report. At least one-fourth of older adults with dementia live alone.

Some crises take us by surprise. The growing alone-ness that has overtaken seniors is not one of these; it has been looming for years. Money can solve some of the problems, but it can't reverse the consequences of not having more children decades ago, or moving away from hometowns where siblings, cousins, and high school friends reside, or walking away from long-time marriages.

Although everyone can point to some things they are grateful for, too often they say that if they had to do it all over again, they would not change a thing. It's sad when people lie to others and even sadder when they lie to themselves.

Sibling Surrogacy

It's the plot secret in dozens of novels, movies, and TV series: your "aunt" is really your biological mother (21st century variation: or surrogate, not necessarily the same as biological mother).

Except now that fact is known and accepted by everyone from the beginning:

Emilee gave birth to her niece, the child of brother
Ben and wife Taylor (McGarvey / WSJ)

They Needed a Surrogate, So They Asked a Sibling to Do It

Having a surrogate give birth to your baby can cost as much as $200,000. Taylor and Ben Shinoskie found a cheaper womb to rent.

Ben’s sister, Emilee Shinoskie, gave birth to their healthy baby in May. Taylor and Ben, both 33 years old, saved money by taking on much of the administrative work themselves, though the birth still drained about $57,000 from their savings. The three of them, in Columbus, Ohio, navigated legal minefields and family dynamics that no contract could anticipate...

Surrogacy is often a last-resort option for couples struggling to have a biological child, and a common route for same-sex couples. It is typically the most expensive path to parenthood, and only a precursor to the massive cost of raising children. It combines the expenses of involving another person for nine months with the costs of in vitro fertilization, through which embryos are conceived in a lab.

Working with a friend or family member can be cheaper than hiring a stranger, but also messier. Taylor and Ben’s lawyer advised them to compensate Emilee, but she refused to be paid. After she wouldn’t deposit a $10,000 check, they bought her maternity clothes, paid for groceries and secretly replaced the tires on her car.

There were nearly 10,000 embryos transferred to surrogates in 2022, according to the latest data from the Centers for Disease Control and Prevention. Some women receive multiple transfers, and some types of surrogacy aren’t tracked.

The total embryo transfers to all surrogates, related or not, are just under 10,000 per year. Expect that total to increase as children become more highly valued by societies around the world.

Happy 102nd, Helen

Mother's Day, 2025

This evening we called to sing Happy Birthday to Helen to celebrate her 102nd birthday.

She said that it was a beautiful day in Honolulu, and we responded that the Bay Area was beautiful, too. It's been a cool summer, and air conditioning has been unnecessary in Foster City.

From her balcony on the hills above the University of Hawaii campus Helen likes to watch the planes take off.

Lately she's been humming Blue Skies, Irving Berlin's 1926 hit. She was delighted when we sang it to her over the phone, out of tune but with enthusiasm. At 102 very simple things give her pleasure.

Below is a nice rendition of Blue Skies by Norah Jones and Seth MacFarlane.

Accident Follow Up

The car landed on its roof (Trevino/LAT photo)

Last month we posted about a Memorial Day automobile tragedy. The Mercury News follows up:

Last month in Laguna Beach, while a 15-year-old girl was out on a driving lesson with her father, their car rolled through a fence and down an embankment from a closed grocery store parking lot to Coast Highway below. She was seriously injured but expected to survive.

Her father, a passenger in the car, did not.

The crash appears to have been caused by the teen confusing the gas and brake pedals, Laguna Beach police Lt. Jesse Schmidt said.

Crashes involving teen drivers are not uncommon. In 2022, 12% of all fatal crashes in California involved young drivers, according to the National Highway Traffic Safety Administration. And nationally, motor vehicle crashes were the leading cause of unintentional death in 2020 for people ages 15 to 24.

But fatal crashes involving 15-year-old drivers with permits are far less common.

While the Laguna Beach crash stunned the community, such tragedies are unusual — in part because these drivers are typically more cautious. Teens with permits are often freshly familiar with traffic laws, having just passed the written exam. It’s usually their first time behind the wheel, and they’re required to drive with a licensed adult over 25 — often a parent or professional instructor — which adds a layer of supervision not present for fully licensed drivers...

Driving instructors often recommend that new drivers begin in flat, wide-open parking lots, away from other vehicles, to practice basic skills without added pressure. Once teens are comfortable steering, braking and accelerating, they can move on to light traffic areas under supervision.

[CHP's Alex] Pereyda also recommends starting with lower-powered vehicles and emphasizes the tone parents set in the car.

“Try to be as calm as you can,” he said. “You want them to feel comfortable — but not too comfortable — so that they can learn in a healthy way. And make sure they know the responsibility of driving… your life could be taken or another’s could be taken.”

IMHO, the teenager's father displayed a genuine love for his daughter by teaching her how to drive, and the tragedy is more poignant in that she will have to live with the accident's consequences for the rest of her life. BTW, if it's unclear when a therapist advises a patient to "forgive yourself," this example can be Exhibit A.

The Days are Long, but the Years are Short

Today my father would have turned 100. He passed away nearly six years ago at the age of 94. (I had the privilege of delivering his eulogy).

I think of him often, treasure the moments that we had, and regret that I didn't have more of them.

That's the same sentiment that we have about our kids, that we're so busy making our way in the world that we don't pay enough attention, and in the blink of an eye they're grown and gone.

It all goes so fast, even when "it" is a hundred years.

Memorial Day 2025

The colombarium at the National
Cemetery of the Pacific, Punchbowl crater.

My father and his five brothers who wore the uniform during World War II are no longer with us, but I think of them often. Their stories are over, but they are not finished, in that what we consider is important about them has changed over time.

At 21 I had just moved to Palo Alto, while at that age Dad was about to complete his tour of duty in Yokohama. At 22 I was married, while Dad had yet to meet the woman to whom he would be married for 67 years. We can spend several pages more on comparing life milestones, but one thing Dad and his brothers will always--but I will never--have is their military service.

Paying respects to my uncles at Punchbowl

From 2011: Lately I've been thinking more about the generation that fought and won World War II. Today's problems are daunting, but they are nothing compared to what they faced--economic catastrophe and the destruction of nations. They secured the blessings of liberty for themselves and their posterity, in the words of the Constitution, and so shall we, if we remember our forefathers' example.

Mother's Day, 2025

On Mother's Day we had flowers delivered to my 101-year-old mother-in-law. Helen is a marvel. She is fully mobile, lives at home with one of her daughters, and texts us regularly about her day.

She wants for nothing material and is satisfied just hearing from us. I'm old school and like writing her physical letters. She says that she likes to re-read them, which one rarely does with electronic communications.

Happy Mother's Day, and many more.

Mom's Memorial Service

Yesterday was the Memorial Service for my mother, Doreen Yuen, who passed away at the age of 95 in December.

As with my father's ceremony in 2019, the sacrament of Holy Communion was held at Honolulu's St. Peter's Episcopal, the church she had attended all her life. Mom's service was livestreamed on YouTube, with relatives tuning in from Australia and the U.S. Mainland.

My brothers and I forsook a lengthy eulogy, and several speakers told stories about Mom. The length of the service was about an hour, and the crowd retired to the Parish Hall for lunch and fellowship while our family placed her urn next to Dad. Everyone seemed to enjoy the celebration of her life.

Her obituary is after the break.

Paia and Its Cemeteries

Paia Hongwanji Cemetery (Forrest and Kim Starr)

SFGate travel writer Eric Brooks stumbles upon abandoned graveyards. On the pathway to Baldwin Beach Park near Paia, Maui

There, just beyond some overgrown grass, was what looked like a group of headstones. Next to that, another 5 to 10 feet away, were more headstones. I rounded the corner to see an entire graveyard surrounded by sand and unmaintained brush. I estimated maybe 100 headstones in all...

Baldwin Beach Park and much of the surrounding land used to be owned by Maui’s Hawaiian Commercial & Sugar Company, or HC&S, a titan of the top industry in Hawaii for many years, according to Lucienne de Naie, author and docent at Hale Hoikeike at the Bailey House, a local history and art museum located in nearby Wailuku.

“The big boom in sugar cane came in the 1880s and 1890s,” de Naie told SFGATE.

That’s when plantation owners, keen to take advantage of the growing sugar cane business, began to import contract workers from countries like Japan, China, the Philippines and Portugal. “There were little camps of Japanese workers; the plantations tended to segregate their workers,” said de Naie, a resident of Maui since the 1970s who knows Paia very well. “The Chinese workers would live in another, the Philippine workers would live in another and so on. The camps had communal activities.”

...Citing a book called “Island of Maui Cemetery (Map & History) Directory,” de Naie was able to pinpoint the original name of the cemetery as the “Paia Hongwanji Cemetery.” It was associated with a Buddhist group called the Makawao Hongwanji, she added, which opened a temple in the area in 1908. The group moved not too far northeast to Upper Paia in 1917, later relocating about 7 miles southeast to Makawao in 1968, according to their website...

“Paia is the cemetery capital of Maui,” de Naie added. “For a small town, it probably has nine to 10 recognized cemeteries. It’s amazing how many cemeteries are there. Catholic, Protestant, Chinese and Mormon cemeteries. It’s a very easy place to dig, with the sand dunes. You put them where you can easily dig.”

Paia boy Fred, my father-in-law

My father-in-law (1922-2001) and his seven siblings were born in Paia. On a trip 35 years ago he showed us his old two-story house, now a tourist shop, and the old Maui High school buildings in a defunct sugar cane field. He regaled us with stories about the best fishing spots, the mischief he and his brothers got into, and life in old Paia town with Japanese, Chinese, Portuguese and Filipino children. (I won't use the names they actually called each other because they would offend modern sensibilities.)

Later we drove along the narrow cliffside rode to the Hotel Hana, where my inlaws honeymooned. Then we visited his half brother George in Kahului, and we flew back to Honolulu. Little did I know that it would be the last time I would visit central Maui.

Carpe diem.

LOLOCT7 Wasn't What Everyone Thought It Meant

(Photo from KABC LA)

Am antisemitic group complained about a personalized license plate spotted in Culver City:

the advocacy group StopAntisemitism shared a photo of the plate, “LOLOCT7,” spotted at a busy intersection in Culver City (Los Angeles County). The organization suggested that the plate celebrated the deadly terrorist attack [by Hamas on October 7, 2023], which it described as a “vile mockery” of the tragedy...

But the son of the car’s owner, who spoke anonymously to KABC-TV in Los Angeles, explained that the plate’s meaning had been misinterpreted.

He clarified that “LOLOCT7” was intended to reference “Lolo,” the Tagalog word for grandfather, “CT” for the Cybertruck model and “7” to signify the number of grandchildren the owner has.

The Filipino family said this explanation was shared with the DMV when the plate was first requested. The Cybertruck owner is in the process of getting new plates.

For most Americans the plate is likely interpreted as "laughing out loud" re "October 7", the date of a murderous terrorist attack. To the Filipino family the characters were an abbreviation for "grandfather." "Cybertruck," "7 [grandchildren]." The dispute was resolved quickly because the owner agreed to change the license plate.

In a multicultural society these misunderstandings can easily happen. Sometimes the dominant culture says or writes something that offends a minority group; in this rarer case the minority makes an expression that offends the dominant culture and the dominant culture cares. We are used to both sides being intransigent, and it's a relief that the "offending" side agreed readily to modify its material.

Chicken Feet

While shopping at 99 Ranch I passed the display of chicken "paws." The price was $5.49 per pound, and no, I didn't buy any.

My paternal grandmother used to get chicken feet free from the Honolulu Chinatown butchers. When one has to feed nine kids, no part of the animal is wasted.

Grandmother had several go-to recipes. What they all had in common was long hours of cooking. The feet are tough and require heat over an extended period to break down the cartilage.

My father never lost his childhood fondness for chicken feet and would always order a dish at dim sum restaurants. Nostalgia can be a powerful motivator.

Veteran's Day

Below is my post from 2013, slightly edited:

November begins on a personal note with my birthday. In recent years the celebration has been muted. (I'm at the age when I look back more than I look ahead.)

Dad, near Tokyo in 1945

Today, Veteran's Day, we remember my father and his five brothers, World War II veterans all, who have passed on. Dad's ashes are at the family church, while the others are interred at Punchbowl.

On November 19th the nation will honor the 161st anniversary of the Gettysburg Address, Lincoln's great speech in the aftermath of an horrific battle. And on November 22nd the nation will remember the life and death of John F. Kennedy 61 years after his assassination.

In a strange way revisiting traumatic events such as WW II, the Civil War, and the JFK assassination gives rise to hope. The obstacles that the nation overcame 61, 80, and 161 years ago dwarf those that it faces today, and there is no good reason why we shouldn't be equally--and ultimately--successful in solving our problems as well. © 2024 Stephen Yuen

Happy Birthday, Again

On my birthday I knocked over the dietary guardrails and ate a week's supply of beef, dairy (clam chowder and ice cream), and sugar.

The penalty will be short-term only (I hope), but the memory of this outing with the family will linger for months.

When I was a child, I liked opening presents and being the center of attention. After I grew up, birthdays came and went for 40 years with little recognition. Now I'm beginning to appreciate them more...

Another Group That is Falling Through the Cracks

Elena Portacolone (research gate photo)

We are used to hearing about vulnerable subsets of the American population who need a lot of help in taking care of themselves. Here's another one that numbers in the millions: [bold added]

]Sociologist Elena] Portacolone got to work and now leads the Living Alone With Cognitive Impairment Project at UCSF. The project estimates that that at least 4.3 million people 55 or older who have cognitive impairment or dementia live alone in the United States.

About half have trouble with daily activities such as bathing, eating, cooking, shopping, taking medications, and managing money, according to their research. But only 1 in 3 received help with at least one such activity.

Compared with other older adults who live by themselves, people living alone with cognitive impairment are older, more likely to be women, and disproportionately Black or Latino, with lower levels of education, wealth, and homeownership. Yet only 21% qualify for publicly funded programs such as Medicaid that pay for aides to provide services in the home.

Increased longevity is a societal good, but smaller families, that is, fewer relatives to check on a person, and the decline of churches and other community organizations have resulted in millions of aging, cognitively impaired adults falling through the cracks.

HENRYs

In 1980 the "young urban professional" (YUP-py) was identified as a significant cohort, and ensuing demographic acronyms have never stopped coming.

DINKs (double income, no kids), BOBOs (bourgeois bohemians), WEIRD (Western, educated, industrialized, rich, and democratic) all have had their place in the sun. Now there are HENRYs (high earner, not rich yet). [bold added]

Fifteen years ago if you’d told April Little that she’d make $300,000 a year, she would have pictured a life free of financial stress.

“The white picket fence—I have the whole visual in my head,” says Little, 38 years old, a human-resources executive turned career coach in Rochester, N.Y. “I don’t want to sound ungrateful, but when I got to that proverbial mountaintop I realized there’s a lot of expenses. And I still don’t own a home.”

So go the plush-but-not-too-plush lives of the Americans who qualify as HENRY—high earner, not rich yet.

Little makes multiple six figures running her own business but carries $90,000 of college and grad-school debt. Child care and education for her three children would be so costly that she and her husband decided the better option was for him to leave his radio job to parent and home-school full time.

New census data show 14.4% of U.S. households bring in $200,000 or more a year, a near record. Yet the money doesn’t have the buying power those earners wish it did, partly due to the rising prices hammering us all and partly due to the supercharged costs of things like houses and cars. HENRYs describe feeling stuck on a hamster wheel—a nice one that other hamsters envy—but running in place nonetheless.

Oh come on, you’re thinking. You’re asking me to feel sympathy for Audi-driving, Chase Sapphire-loving, Whole Foods-shopping consultant types with kids in private school?

Well…not exactly. But what they’re feeling is a version of what a lot of Americans at every income level face—making more money but not feeling like there’s a surplus. The essence of being a HENRY is feeling a gap between what you have and what you think you need to be comfortable.

What these high earners consider essentials might be termed luxuries (or nonsense) by the rest of us, but it’s also true that it takes more money to feel rich these days. And their great fear is becoming a HENRE: high earner, not rich ever.

The outlays for housing, private schools, transportation, and health care, not to mention education indebtedness, are often underestimated by 20- or 30-year-olds who think they have made it with a $200,000+ starting salary.

Even HENRYs whose futures look bright can't relax, since the loss of their high-paying job could be disastrous.

Speaking from the experience of being a previous generation's HENRY, I had visions of being able to quit when I was 40 but didn't achieve that psychological comfort zone until I was in my mid-60's. Hard work and technical abilities, while necessary, were IMHO not as important as finding a trustworthy life time partner and keeping one's health. (Having a little luck helps, too.)

The Laughing Heir

(For sale on Amazon): But will your cat take care of you?

We are personally acquainted with Bay Area millionaires who are over-60, never been married, and never had children. (They are millionaires primarily because of the houses they bought over 25 years ago.)

The recent growth in this demographic has resulted in the phenomenon of the laughing heir: [bold added]

Charities, distant relatives and even pets are benefiting from surprise inheritances. They can thank people without children.

Not having children is becoming more common, both among millennials and older people. A July Pew Research Center analysis found that 20% of U.S. adults age 50 and older hadn’t had children.

And many of these people don’t have wills. An AARP survey found half of childless people age 50-plus who live alone have a will, compared with 57% of others that age. Those without wills have less control over what happens to their money, which often ends up in the hands of people who don’t expect it.

This phenomenon of a surprise inheritance is common enough that it has a name: the laughing heir.

“All they do is get the money and go, ‘Ah ha ha, look at that,’ ” said Michael Ettinger, an estate lawyer in New York.

Having a significant estate when a childless person dies may be the result of rational decision-making:

Financial advisers say a far bigger concern than who gets what is making sure there is enough money and support for a comfortable old age, because clients without children can’t call on them for help...

Choosing an estate executor and who would handle money and health decisions on your behalf can be difficult when you don’t have children, financial advisers say. Using a promised inheritance as a reward for taking care of you when you are older isn’t a good solution, said Jay Zigmont, an investment adviser focused on childless people.

“Unfortunately, it is relatively common to see family members who are in the will decide to opt for cheaper medical care (or similar decisions) in order to protect what they will be inheriting,” he said in an email.

The old-age safety net, which many still subscribe to, is to have children who will have your best interests at heart. (I've seen enough murder mysteries to know that this is not always the case!)

The second-best option appears to be letting your distant relatives know they will be remembered in the will for some assistance today. The risk, as mentioned above, is that the aforementioned relatives may prioritize keeping the size of the estate as large as possible at the expense of the elderly person's care. And, as they collect their inheritance, they'll be laughing all the way to the bank.

A Financial Hit That Few Budget For

Christine Salhany spends about $240,000 a year
for 24-hour in-home care for her husband, Jimmy,
who has Alzheimer’s.(WSJ)

Everyone in my boomer circle of friends and relatives has been hit by the cost of caring for a loved one; it could be a parent, a spouse, or even themselves. It's a crushing financial burden: [bold added]

Americans want to grow old in their own homes. But pursuing that dream has gotten harder, and is putting huge financial and emotional strains on families.

In Nebraska, Christine Salhany spends about $240,000 a year for 24-hour in-home care for her husband who has Alzheimer’s. In Illinois, Carolyn Brugioni’s dad exhausted his savings and took out a home-equity line-of-credit to pay for home healthcare.

Traci Lamb closed her business to take care of her mom in Florida. And in California, Cheryl Orr delayed retirement to help pay for care and home modifications for her wife, who has dementia.

Soaring costs of in-home care, medical advances that extend lives but require ongoing help, and the growing ranks of older baby boomers are creating new pressures. Spouses, adult children and siblings are putting their lives on hold to care for relatives, wrestling with sleep deprivation and constant worry. Families are draining savings to hire help, pay for medical care, and modify homes...

The cost of paid in-home care has soared in recent years. The 2023 national median cost of a home health aide, hired through an agency, stood at $33 an hour, up from $20 an hour in 2015, according to Genworth, a long-term-care insurance company. Those needing round-the-clock in-home care can expect a median cost of about $290,000, which is more than double the annual median cost of a private room in a nursing home facility and four times the annual median cost of a private room in assisted living, according to Genworth.

Very few elderly have the nearly $1,000,000 in retirement savings to pay for long-term at-home care for, say, four years. Borrowing against, then selling the family home is an option if the patient is willing to move to assisted living.

I know three families that have tapped the value of their house; they were fortunate to have lived in the Bay Area, where suburban tract homes have appreciated by over a million dollars if held for at least 20 years. They have had to move away but consider themselves lucky to possess such a valuable asset.

If any politician can come up with a credible solution, he or she would win in a landslide.

Mixed Up Tape

(WSJ illustration)

My late father-in-law would often call any one of his four daughters by another daughter's name. Otherwise as sharp as a tack, he would make this mistake frequently, so we were left with a bunch of implausible explanations: his daughters were not important to him, he was expressing his disappointment that he didn't have a son, they looked alike, etc.

Modern neuroscience has another explanation. [bold added]

Names are especially hard for the brain to learn and recall, according to Samantha Deffler, a cognitive psychologist at York College of Pennsylvania. Most people recall faces more easily, and common nouns roll off the tongue more readily as well.

In an iconic experiment from the 1980s, participants were shown a series of portraits and told each person’s name and occupation. In a twist, words such as “cook” and “baker” were presented as occupations to some participants and as names—“Mr. Cook,” “Mr. Baker”—to others. In what came to be known as the “Baker/baker paradox,” participants recalled the jobs better than the names.

The brain remembers information by linking new bits of data with existing information of similar meaning or context. That makes proper nouns, which are arbitrary “nonsense words,” harder to learn, said Neil Mulligan, a cognitive psychologist who studies memory at the University of North Carolina at Chapel Hill.

Though it occurs nearly instantaneously, recalling a name is a multistep endeavor. A memory cue—perhaps a child’s backpack left on the couch—triggers a search for the child’s name. The memory system offers up multiple potential responses, then rejects all but the correct answer.

The ability to reject wrong responses gets worse with age, which is one possible reason older adults more frequently mix up names, Mulligan said.

Now that I'm in my 70's, I'm finding it increasingly difficult to remember names. What's also worrisome is that I had communicated regularly with some of these forgotten ones only two or three years ago.

I wish I could tell my father-in-law that I'm beginning to understand what he went through.

Helen at 101

Helen holds the newest twig on her family
tree, Hanzo, born June 3rd.

One year ago we gathered in Hawaii to celebrate Helen's 100th birthday.

This year, with most of the attendees traveling, we conferenced on Zoom. Everyone took turns reminiscing about favorite memories of Helen.

When talking with the nonagenarians and centenarians in my family, I've found that they are especially pleased when we mention moments that everyone, maybe even they, had forgotten. These moments are concrete evidence that they will be remembered after they're gone, proof that their lives had meaning.

May I be so lucky.

Five Years Ago

Five years ago July 4th was a day of personal sadness. The post is reprinted below:

Alfred, 20, in Fukuoka (1945)

My father died earlier this week.

Starting the sad process of notifications and filings, we looked high and low for his discharge papers. Then we opened his wallet. Miniaturized to the size of a credit card, they commemorated events of 72 years ago. He always carried them.

The greatest generation won a two-front war against the most powerful war machines in history, then battled a determined adversary for over 40 years, during which a misstep would have killed many millions. We owe them our independence and our very lives.

On this Independence Day we humbly give thanks.