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A Better Future for Older Americans — If We Speak Up

Affordable housing and health care must be planned for now

By Robyn Stone

(Next Avenue invited our 2017 Influencers in Aging to blog about the one thing they would like to change about aging in America. One of the posts is below; we will be publishing others regularly.)

Credit: Adobe Stock

Americans approach aging with their eyes shut. That’s got to change, and fast.

Deep down, none of us really believes we’re ever going to get old. We won’t acknowledge the possibility that we might develop chronic conditions and frailties that could reduce our quality of life and quadruple our medical bills by the time we’re 80.

We don’t accept the likelihood that those medical bills, coupled with our shrinking post-retirement income, could trigger our move from a comfortable middle-class lifestyle to one that is far more modest and far less secure.

A Dangerous State of Denial About Aging

This dangerous state of denial about aging is shared by consumers, policymakers and leaders in the field of aging services.

We know that the number of Americans over 65 will grow rapidly in the coming decades, due mostly to the aging of the boomer generation. But we don’t understand that many of those boomers will be struggling to make ends meet. Some researchers have projected a 37 percent increase, between 2014 and 2024, in age 65+ households with annual incomes under $15,000. They expect at least 9.4 million older adults to have incomes below $30,000 within seven years.

What’s driving these dramatic trends?

Household incomes generally decline when retirees leave full-time employment. But these fixed incomes will soon come under more pressure than ever, because Americans are living longer and because fewer retiring Americans have access to secure pensions.

In addition, the number of non-white elders, who have had lower incomes throughout their lives, is expected to increase significantly in coming decades.

Under Strain: Government Programs for Older Americans

If these current predictions hold true, government programs designed to support Americans in their later years will soon experience significant strains.


Medicare has never paid for more than a very limited number of the non-medical services and supports that older people need to remain independent. Medicaid does cover some of these expenses for low-income elders, but it is already struggling to meet current commitments. Federal and local agencies provide some affordable housing for low-income elders, but current supplies can’t keep pace with growing demand.

The greatest financial burdens associated with aging may fall on middle-income elders. They won’t be wealthy enough to pay their own housing and health care expenses in retirement, but they won’t have incomes low enough to qualify for government assistance.

Your household may fit into this in-between category. If so, it’s time to open your eyes to the realities that could lie ahead — and then start making some noise.

How Do You Want to Grow Old?

Legislators and other government officials, as well as providers of health care and aging services, need to know how you want to grow old in America.

Then we all need to work together to develop more options for affordable housing, health care and services that will help you prevent frailty, promote health and enhance independence, whether you are 65 or 105.

We don’t have those options now. And we won’t have them until we do three things:

  • Get rid of our collective denial about aging
  • Get creative about designing housing and health care models that will help older people remain in their homes and communities even as their needs change
  • Get strategic about how to pay for these models

Affordable options for housing, health care and services won’t happen overnight. Designing, implementing and paying for them will be hard work. But the alternative — reaching our 80s only to find that life didn’t turn out as we had hoped — will be a much harder pill to swallow.

Robyn Stone As the senior vice president for research at LeadingAge, a national association for nonprofit aging services providers, Stone brings decades of research experience and senior level policy expertise to LeadingAge’s mission to inspire, serve and advocate for older Americans. Stone is the director of the organization’s Center for Applied Research, where she works to bridge policy and practice through applied research. Read More
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