BioMed
Aging well depends on care systems, housing, money, connection, and protection from abuse.
Society worked hard to add decades to the average life, but paid far less attention to making those extra years livable. Life now outlasts health by about a dozen years on average, so far more people will need care for longer than ever before.
We want the people we love kept safe, but we want freedom over our own lives. Older adults keep the right to make risky choices about money, driving, sex, friends and where they live. Some of those choices can lead to poverty or danger, so protection always has to be weighed against the right to decide.
Loneliness and cognitive decline leave older people open to scams and abuse. About one in ten Americans aged 60 and over is abused, neglected or exploited each year, and the rate is far higher among people with dementia. A person's growing inability to manage money can go unnoticed until savings meant for housing and care are already gone.
People mistreat the old partly because they dislike aging and often dislike older people. That same fear and shame keeps people from thinking about their own aging or planning for it. The attitude is bad for people's health and bad for society.
Most care for older people comes from spouses and grown children who are not paid. The cost does not disappear. It moves onto those relatives as lost time, lost income, lost jobs and worse health, estimated at hundreds of billions of dollars a year in lost earnings in the United States.
Getting older adds to the disadvantages people already carry. Older women face sexism on top of ageism, and older people from minority groups face racism and economic discrimination. Minority residents also tend to get worse care in institutions, which showed in who died of Covid-19 in nursing homes.
When there is little public support for care, people blame themselves for coping badly with growing old or with looking after someone who is. Often they are not failing at aging or caring. The society around them is failing them.
Nursing homes and court-appointed guardianship were built to protect older people, but they often harm the people in their care instead. Many of these systems were designed for other problems and were never built for the needs they now serve.
Aging is not only a health problem. It involves family, money, law, housing and social services all at once. Fixes that stay inside a single field miss most of what decides whether later life goes well.
Most older adults live either among people their own age or alone in their own homes, often lonely. Keeping the generations apart feeds both isolation and the fear and disgust a culture feels toward aging.