In 2050 83.7 million Americans will be over 65 years old.  This emerging population is referred to as the “gray tsunami” or baby boomers.  These are people born in the United States between 1946 and 1964.  Because of this growth, one out of five people will be elderly.  With aging comes functional decline, cognitive impairment and a growing need for health and social support.  Most caregiving is supplied by family, usually a middle-aged daughter.  When elderly people are unmarried with no family or friend network, they are referred to as “elder orphans.”