This position statement, developed by the American Geriatrics Society (AGS) Ethics Committee, outlines new guidance on care and decision-making for a unique and growing group of older adults: the “unbefriended.” As an update to earlier guidance released in 1996, the AGS Ethics Committee developed these new recommendations in collaboration with the AGS Clinical Practice and Models of Care Committee and the AGS Public Policy Committee with additional input from the Committee’s Ethnogeriatrics Liaison.