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Rooted in core palliative care values, the Iyashi Care team creates strong connections with patients based on their unique diagnosis, goals of care, support system, and more. Over the past seven years, Iyashi Care has provided over 500 patients and their family members with an extra layer of support, each with their own stories, needs, and backgrounds. One of the common demographics that the Iyashi Care team serves is solo agers. Keiro spoke with Yuichi Edwin Yanami, MD, and Kanako Fukuyama, LCSW, MSW, to gain insight on how Iyashi Care can support solo agers navigating serious or chronic illness.
Common Situations of Iyashi Care Solo Agers
The Iyashi Care team is well equipped to address the unique needs of their patients, especially solo agers. Some common examples of the solo ager Iyashi Care patients that the team has seen are those who live alone, are single, and have no children. Although most of them are not truly alone, many of the solo ager patients lack a traditional support system. Oftentimes, they may have a distant relative or a friend, but having limited support poses a new set of challenges such as not having someone to call in an emergency or not knowing who to designate as a medical power of attorney (MPOA) or durable power of attorney (DPOA).
Another commonality among these patients is that much of their extended family lives a significant distance away, in other states, or even in Japan, which means they cannot necessarily support the patient in ways that are needed. Dr. Yanami shared that “most of the solo ager patients in Iyashi Care are Shin Nisei [the children of Japanese immigrants who migrated to the United States after World War II]. That’s the problem. If they grew up here, maybe there is somebody we can ask to help, but in cases where most of their family members are in Japan, it is almost impractical.”
Many solo ager patients are the ones to reach out for more information about Iyashi Care because they know they need extra support, often before their health issues become more serious. “Solo agers in our program reach out to us because they’re worried about their future, especially because many want to stay home as long as possible. I would say they’re more aware that they’re on their own, and they are worried about what might happen to them,” Kanako explained.
Building Trust and Providing Support
In the initial visit with an Iyashi Care doctor, one of the first things that the team establishes with the patient is trust. The doctor will spend time with the individual to get to know them, building a relationship by asking questions about their medical history, support system, and more. Based on this, the team will help identify areas that the patient can work on to improve their quality of life.
Here are common areas for solo agers that the Iyashi Care team can help support:
Future Planning
“In the early stages of the patient’s time with Iyashi Care, future planning is of the utmost importance, especially for solo agers. Because they don’t have that strong family support system, I usually tell them that if something happens, they may be assigned a public guardian or conservator who may not know how to take care of them. So we will help them with that process of making those decisions early, filling out their advance health care directive, and so on,” shared Dr. Yanami.
Medical and Durable Power of Attorney
The team will work with the patient to see if there is a friend or a relative who could potentially take on this representative role. In some cases, a patient may hire someone to help with their aging and/or medical journey, such as a private patient advocate or fiduciary. When these representatives are declared, the Iyashi Care team will work with them to ensure that the patient is properly being taken care of. When naming your MPOA or DPOA, it is ideal that you name someone younger than you, because someone in a similar age group may be experiencing similar life stages as you.
Safety
Because many solo ager patients live on their own, there are common items that the team may recommend to ensure their safety at home. “I often suggest to my patients who are living alone to either have a personal emergency response system or have a process with a neighbor or friends so that somebody can call or visit to regularly check in,” Kanako said. Another area of high concern is driving, which the team may help find potential alternatives based on the patient’s situation.
Getting Creative with Your Support System
Additionally, the Iyashi Care team can help you with defining your support system and connecting with others. The team will help the patient understand the important role the community has in supporting older adults as they age. For example, Kanako may encourage them to attend senior centers, churches, temples, or kenjinkais as a first step to connecting with those around them. It is also important to start finding friends or distant relatives who you can trust to be your medical and durable power of attorney and emergency contact.
Both Dr. Yanami and Kanako emphasized how necessary it is to have support as you age and navigate your illnesses. Dr. Yanami said, “No matter what we may believe, we should not be ending our lives alone. When you’re born, you need help, and when you’re nearing the end of life, you also need help. A lot of patients say that they don’t want to be meiwaku [bothersome or trouble]. However, I tell them, ‘I’m sure you’ve helped many people in the past, and now it’s time for you to receive help.’ And Iyashi Care is here to help provide that support.”
For additional information about Iyashi Care or to enroll, please contact 213.873.5791 or [email protected].