There was a heartbreaking story in the Washington Post this week about an elderly man in China named Han Zicheng who tried putting himself up for adoption. His wife had died years earlier, and his adult sons lived far away and rarely called or visited. At 85, Han posted a flyer on a neighborhood bus shelter seeking a family to care for him. It read: “Lonely old man in his 80s. Strong-bodied. Can shop, cook and take care of himself. No chronic illness. I retired from a scientific research institute in Tianjin, with a monthly pension of 6,000 RMB [$950] a month. I won’t go to a nursing home. My hope is that a kindhearted person or family will adopt me, nourish me through old age and bury my body when I’m dead.”
Aging alone
Han’s plea is painful to read, yet it reflects a growing reality in China, the United States and other industrialized countries: many seniors live alone without a dependable family or social support system. A century ago, multigenerational households were common. Families often lived and worked together on farms, with older relatives helping raise children and younger adults caring for the infirm. At the same time, average life expectancies were much lower; in 1900 a man in the United States could expect to live about 46 years and a woman about 48.
Since the Industrial Revolution, society has moved away from agrarian lifestyles. Young adults typically leave the family home for education and career opportunities, frequently relocating far from their hometowns. Simultaneously, advances in medicine, nutrition and workplace safety mean people are living much longer—today a 65-year-old in the U.S. can often expect to live another two decades.
Those two trends—longer lives and more geographically dispersed families—create new challenges for seniors and their communities.
A widening gap
As families become geographically scattered, older members often shoulder the consequences. Many seniors now face a care “gap”: a mismatch between the supports they need and the personal, family-based help that used to be more common. That was Han Zicheng’s situation. He had a modest pension and could likely afford paid services, but he sought something more personal and enduring—a family connection to fill the emotional and practical void in his life.
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Elder orphans
Dr. Maria Torroella Carney, chief of geriatrics and palliative medicine at North Shore-LIJ Health System in New York, calls people in Han’s position “elder orphans.” Their situation raises urgent questions for individuals and communities:
- Who will care for us if we are alone as we age?
- How will we stay socially engaged to avoid isolation and loneliness?
- What responsibility does society have to close the care gap confronting many seniors?
These issues touch a broad spectrum of people. About one-third of Baby Boomers are single—many never married or are divorced—and a notable share of middle-aged adults have no children or live far from their offspring. Others have aging friends or relatives who face declining support networks.
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Options for care at home
There are practical solutions for elder orphans who want to remain in their homes but lack family caregivers. Home care providers—also called personal care aides—can help with household tasks and personal care. Home health aides and visiting nurses deliver medical care at home for those who need treatment for illness or injury, with the goal of helping seniors regain independence.
However, at-home care often comes with challenges. The caregiver industry experiences high turnover—around 60 percent—driven by low wages, difficult working conditions and limited benefits, which can make consistent care difficult to secure. Costs also add up: in-home care can be expensive, and additional services such as bill-paying assistance, equipment and home upkeep may add several hundred to a few thousand dollars per month. Beyond cost, living alone can still leave seniors vulnerable to loneliness and social isolation, which have harmful effects on health.
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A CCRC may be the answer
For some elder orphans, a continuing care retirement community (CCRC), also called a life plan community, can be an effective solution. CCRCs typically offer a continuum of care from independent living to assisted living and skilled nursing, which helps address both current needs and future changes in health. They also provide organized activities, social opportunities and amenities that promote physical and mental engagement—factors that support overall wellbeing.
CCRCs can be costly, so it’s important to research contract types, entrance fees and refund policies before choosing a community. Understanding exactly what services are included and the long-term financial implications can help seniors and families decide whether this model fits their needs.
An individual and societal issue
Han Zicheng’s story could unfold in many modernized countries. While options exist—home health workers, assisted living, CCRCs—society must also develop better systems to support aging populations. As thousands of Baby Boomers enter retirement each day, the need to address the care gap grows more urgent, with financial, ethical and social consequences that demand thoughtful, sustainable solutions.