Editor's note: This popular story from the Daily Briefing's archives was republished on June 5, 2023.

Almost a million older Americans are considered "kinless," with no immediate family members—a figure that is expected to grow as "[e]strangement, geographic distance and relatives' own declining health can render them unwilling or unable to serve as caregivers," Paula Span writes for the New York Times.

Nearly 1 million older Americans are 'kinless'

According to a 2017 study published in The Journals of Gerontology: Series B, an estimated 6.6% of American adults ages 55 and older do not have a living spouse or biological children. Of those, roughly 1% do not have a spouse or partner, children, or biological siblings. Among women over 75, that figure rises to 3%.

While these may not seem like high proportions, by 2019, this group grew to nearly a million "kinless" Americans.

"We assume that everyone has at least some family, but that's not the case anymore," said Rachel Margolis, a sociologist at the University of Western Ontario and co-author of the study.

The increase in "kinless" older Americans has largely been driven by shifting demographic factors among baby boomers, including lower marriage rates, higher divorce rates, and a higher number of childless individuals. According to Span, "[t]he rise of so-called gray divorce, after age 50, also means fewer married seniors, and extended life spans can make for more years without surviving family."

"All the pathways to singlehood have grown," said Deborah Carr, a sociologist and researcher at Boston University.

In addition, many older couples are living together instead of getting married—and those seniors are less likely to receive care from their partners than married couples. Meanwhile, older Americans who are in committed relationships that do not live with their partners are even less likely to receive care from their partners.

In addition, rates of "kinlessness" are very high among seniors who are Black, female, and have lower levels of wealth.

"The growing number of kinless seniors, who sometimes call themselves 'elder orphans' or 'solo agers,' worries researchers and advocates, because this group faces numerous disadvantages," Span writes.

Caring for America's 'kinless' seniors

In a study of middle-aged and older adults in Canada, researchers found that older adults who did not have partners or children self-reported lower levels of mental and physical health, and higher levels of loneliness. They were also less likely to participate in activities, including sports, cultural or religious groups, or service clubs, which serves as a predictor of cognitive impairment.

Typically, older adults who are "kinless" die earlier. According to Margolis and her co-authors, 10 years after they conducted their respondents' initial interviews, over 80% of older adults with partners and children had survived, compared with roughly 60% of those who were "kinless."

Researchers at Mount Sinai found that, at the end of life, seniors without partners and children receive fewer hours of caregiving each week and are more likely to die in nursing homes.

"Getting old is hard under the best of circumstances, and even harder if you're going it alone or with weak social ties," Carr said.

"Of course, having family is no guarantee of help as people age," Span writes. "Estrangement, geographic distance and relatives' own declining health can render them unwilling or unable to serve as caregivers."

Still, "our system of caring for the aged has functioned, for better or worse, on the backs of spouses and, secondarily, adult children," said Susan Brown, a sociologist at Bowling Green State University and an author of the study of sole family survivors.

While very few Americans can afford the costs of assisted living, many have incomes that are too high to qualify for Medicaid.

"Policies tend to lag behind reality," Carr said. "There was the belief in past decades that older adults would be married and have children; that's what the classic American family looked like. It no longer does."

With no broad public program in place to care for "kinless" seniors, experts suggest a variety of smaller solutions to support kinless seniors.

"Shared housing and co-housing, providing safety and assistance in numbers and community, could grow, especially with public and philanthropic support," Span writes. "The village movement, which helps seniors age in place, might similarly expand." In addition, "[r]evised family-leave policies and caregiver-support programs could include friends and neighbors, or more distant relatives like nieces and nephews," she suggests.

Ultimately, as "governments, community organizations and health care systems begin to address the issue, there's little time to waste," Span writes. Projections suggest that "kinlessness" will increase significantly as younger populations age.

"Younger people are less likely to marry and have children, and they have fewer siblings" as the size of the average family shrinks, Brown said. "How will they navigate health declines? We don't have a good answer. I'm not sure people are paying attention." (Span, New York Times, 12/5)