Approaching the New Year, I�m inspired to write a series of articles by a letter I received last week about an enduring problem. The writer has many specific questions and worries about growing old without kids. For example, what happens when one has no kids to provide care when elderly and frail, no one to make decisions about home health care or nursing homes? Also, the writer wondered if there are organizations and resources available for the childfree elderly.

Fear of growing old alone can become crippling, yet these are all very understandable anxieties and questions, and certainly ones that I�ve experienced. I looked back through years of MNK archives for more information and recognized three main categories of fear expressed by childfree people: Abandonment, social, and existential.

Abandonment fears inspire questions such as: whom will care for me when I become elderly and frail if I don�t have adult kids? Who make will decisions about my care? What if I am alone or lonely? What if I am isolated or can�t manage on my own?

Questions I have to ask in response are: Do we really want someone else making major life decisions for us? Are adult children always ready, willing, available, and able to make major decisions for their parents? Are many elderly parents, in Western cultures, actually being cared for solely by their adult children without other forms of aid? Is it moral and healthy to have children as a hedge against abandonment fears?

I know from experience with my family that adult children with the best intentions will end up making care decisions based on their own philosophies and needs. Those decisions may not be the right ones for their elderly parents.

My best suggestion for anyone, kids or no, is to plan, plan, and pre-plan for old age long before becoming incapacitated in any way. This isn�t always possible, but some pre-planning can be done in almost every situation. On her 40th birthday, my friend�s present to herself was a pre-paid reservation at an assisted-living home she was familiar with and liked. We all thought she was a little nutty. Now that I�ve experienced nursing homes and home health services through my parents, I realize the sense in my friend�s planning for the future.

Childfree, or not, it makes sense to visit nursing homes and assisted living facilities. There is a world of difference between these places. Each one is unique in social structure, religious outlook, and amenities. No one, even adult children, can make the best decisions about something so personal as choosing between the close, structured societies of elder care facilities.

It is also important to build enduring social support systems. Community involvement leads to strong support networks for old age. Some people consider it good karma to volunteer at nursing homes, hospices, and organizations such as Meals on Wheels. In a practical sense, connections and knowledge built by volunteering with the elderly can be a source of support as we move closer to old age ourselves.

A couple of Canadian studies show that unmarried childfree people build the strongest social networks. Married-no-kids couples tend to be the most isolated of all elders! They tend to rely on each other and don�t develop external contacts to meet their needs, so it is especially important for us to build connections outside of a marriage.

In most places, there are community resources for the elderly. It is a myth that we have to be abandoned, old and lonely if we don�t have kids and grandkids. Living in a community with a high percentage of older people, I witness the great services provided by local Councils on Aging. These are very active groups of older people helping other older people. Each town around here has a Council, and they provide legal advice and advocates for the elderly. In many case, the advocates make better decisions for the elderly than the adult children.

For example, in a couple of recent cases, elderly people who wanted to enter a nursing home were kept from doing so because the adult children were not willing to release the family home it to pay for nursing care! In the most extreme case, a grandmother was found living on a mattress on the floor of a chilly bedroom, without enough food and medical care, because her kids were all living in her home and wanted to keep it as their inheritance!

This unfortunate woman was in an extreme situation, but it serves to illustrate that you are always your own best keeper. Some degree of dependency on other people will probably be necessary for most of us if we are lucky enough to grow very old, but we can minimize and control it by pre-planning, taking care of ourselves, and building strong social connections. Bearing children, as insulation against loneliness and abandonment is much more self-centered than accepting responsibility for our own lives and care.