Estrangement is a different situation from simply not having family nearby — the people exist, phone numbers might even still work, but the relationship doesn't function as support, and hasn't for a long time, or ever really did. That's its own kind of weight to carry into aging, separate from the practical planning gap it creates, and it deserves to be named honestly rather than folded into a general "no family" category as if it were the same thing.
You don't owe anyone an explanation
Whatever led to the estrangement — and estrangements happen for every reason, from abuse and addiction to a slow drift neither person quite chose — you are not required to justify it to a lawyer, a hospital, a friend, or anyone else in order to plan around it. Naming a trusted friend, rather than an estranged relative, as your power of attorney or health care proxy is entirely valid and legally straightforward. The law doesn't require you to name next of kin by default, and an attorney helping you set this up doesn't need the backstory — only your clear decision about who you want.
Some practical wrinkles worth knowing about
Estranged family can sometimes surface in ways you don't expect: a relative you haven't spoken to in years may still be listed as a beneficiary on an old life insurance policy or retirement account if you haven't updated it, or may have some legal standing to contest a will if your estate planning isn't clear and current. Reviewing and updating beneficiary designations, your will, and your named decision-makers is one of the most concrete things you can do — not because reconciliation is required, but because outdated paperwork is what actually gives an estranged relative standing, not the estrangement itself. See Writing a Will With No Children as Heirs and Power of Attorney When There's No Obvious Person to Ask for how to do this cleanly.
Grief without reconciliation
It's entirely common to grieve the relationship you wish you'd had — the parent, sibling, or child who should have been there and wasn't — while still being completely confident in your decision not to reach out or rely on them. Those two things aren't in conflict, whatever anyone else might imply. You're allowed to miss an idea of family without that meaning you owe the actual people anything, and you're allowed to build your real support system entirely outside of them without that being a failure or something that needs fixing before you can move forward.
Building the support you're actually building
Once the plan is separated from any pressure to reconcile, the practical work looks like it does for any solo ager: naming decision-makers who aren't the estranged family member, building a smaller trusted circle of friends or chosen family, and making sure the people who will actually show up are the ones with legal authority to do so. See Building a Care Team With No Children or Spouse for a starting framework, and don't feel obligated to include estranged family in it just because they're technically related to you.