Veterans and Nonveterans' Risk and Protective Factors for Becoming Elder Orphans: An Exploratory Study

Background and Purpose:  Carney (2016) defines elder orphans as, “aged, community-dwelling individuals who are socially and/or physically isolated and have no known family member or designated surrogate available to them” (p.1).  It is estimated that more than 1 in 5 Americans over the age of 65 are at risk of becoming an elder orphan. A recent review described the topic of elder orphans as an “underdeveloped area within gerontology and health disciplines.,” (p.3). Although more women live alone than men, older men are at greater risk of social isolation than older women because they typically have fewer nonfamily social contacts. Because veterans  experience conditions associated with social isolation at higher rates, such as posttraumatic stress disorder, traumatic brain injury, and substance use disorders, they may have heightened vulnerability. The aim of this study was to explore the differences in risk factors associated with becoming an elder orphan among veterans and nonveterans older adults (55+) and factors that may buffer the negative impact of being an elder orphan. Specific risk factors previously identified include not having contact with children or children not living nearby, living alone, not having friends or relatives to call for help.  Protective factors include discussing medical care with family and friends and having advance directives.

Methods: Using the University of Michigan Health and Retirement Study Core Final longitudinal dataset (2014) we analyzed a subsample of community-dwelling male veteran (n=2,935) and nonveteran (3,076) respondents, age 55-99. Veterans were respondents who answered "Yes" to the question "Have you ever served in the active military?" in any wave of the HRS study since 1992. 

Results: Veterans were more likely to be White (80.1%) compared to nonveterans (70.2%).  They were significantly less likely to be coupled/partnered (73%) compared to nonveterans (77.1), (χ2(1) = 42.4, p < .001).  There was a significant association between having an advance directive for veterans (69.6%) compared to nonveterans (30.4%), (χ2(1) = 42.4, p < .001). Veterans were also significantly more likely to discuss their medical care with friends or family (67.5%) than were nonveterans (32.5%), (χ2(1) = 24.3, p <.001).  However, there were no significant differences between veterans and nonveterans for living within 10 miles of children or relatives, living near friends, or having close friends or relatives to call upon for assistance with activities of daily living for an extended period of time. 

Conclusions and Implications:  Although older male veterans were less likely than nonveterans to be coupled/partnered, a known risk factor for elder orphan status, they actually had more protective factors than nonveterans, such as having advance directives and discussing medical care with family and friends. Having advance directives and discussing medical care with family and friends are protective against life challenges and buffer the impact of being an elder orphan.