The Last Boomer

I’ve had more than one conversation this week with people who are experiencing emotional distress from not feeling as if they “belong.” I wish I could say this is uncommon, and that people who feel this way need only enter therapy, join a club, or find a useful nonprofit to volunteer for, but this discomfort rests on something more fundamental.

Humans have both a biological and a psychological need to be cared for, included, and nurtured; in a word, to belong.

These are all components of survival. If, as a baby, I am not fed, held, played with, and taught the rules of my tribe, I am at real risk of dying. If, as an adolescent, I have not learned basic skills in communication, collaboration, and cooperation, I will be ostracized and left without opportunities to meet a mate and propagate. If, as an elder, my frail body and impaired cognition are not accommodated, I will be unable to care for myself, at the mercy of the society I live in, and either left to be preyed upon or left to die.

There’s More to Life than Survival

The benefits of belonging are life-sustaining. Knowing I belong to someone or something, and knowing I am included without question, loved, and valued, all contribute to my well-being. Multiply that across the lifespan, and the full impact of belonging can be appreciated.

The joy of new life brings hope to the whole community. The investment of time and energy needed to protect that life and see that it grows is unquestioned. Watching the child become an adult requires patience and persistence, and its reward is the pride we take when the “launch” happens—when we see the fruits of our collective labors continuing the traditions we passed on to them.

And these benefits should accrue as we reach old age. At least, that is the ideal: a life well lived ends with tender care until death. For many people, historically, that was the trajectory, though not for everyone. Poor and childless elders in the nineteenth and early twentieth centuries often ended their days in almshouses and on county poor farms. But for most, growing old happened in the midst of family and community. It is only in the last century that being old has become so systematically segregated.

What Do I Mean?

Here in the United States, the first age-restricted retirement communities were built after World War II. Youngtown, Arizona, opened in the mid-1950s, and Del Webb’s Sun City followed in 1960. These were real estate developments marketed to people who were “retired”: communities built around post-work lifestyles that focused on activities such as golf and tennis, and that excluded children.

The consequence of this separation by age group was a bifurcation of what had traditionally been thought of as normal aging. Before this, people usually stayed in their communities, typically within easy distance of their families, and belonged to one or more groups within the community.

Retirement communities changed this. They became a new “club,” with their own expectations about who would “join.” You had to be of a certain age—50 in the early developments, and later 55, once federal fair housing law made that the standard. You were expected to be “retired,” which was the whole premise of the marketing. You were expected to have limited responsibilities toward younger generations—no full-time parenting or grandparenting. And, by design, you lived geographically separated from everyone else.

Culling the Herd

This culling of old people from mainstream community life showed up in other ways, too. The term “senior” became a descriptor for a group of aging adults who, on the one hand, were carefree, independent, and living the high life, and on the other, were technologically impaired, cognitively feeble, and hopelessly out of touch with modern trends.

Aging adults became like floating icebergs. No longer tethered to the “productive” groups in society, “seniors” drifted around, enjoying the “Golden Years” until death. That myth (and it was not much more than that) belied the very real experiences of too many older Americans.

Older adults were routinely excluded from clinical trials, so doctors treated heart disease, diabetes, and other chronic conditions in their older patients with little evidence to guide them, and ageist assumptions too often meant those conditions were under-treated.

And while Social Security and Medicare dramatically reduced poverty among older Americans during these decades, they could not cure isolation. As families scattered for work and opportunity, too many aging parents and spouses were left without anyone nearby to care for them.

Infrastructure

Alongside the rise of the retirement community came a second shift: the growth of the nursing home industry. Nursing homes expanded rapidly after Congress created Medicare and Medicaid in 1965, and in 1972 federal law formally defined the “skilled nursing facility.”

The move to shift recovery out of hospitals accelerated in 1983, when Medicare began paying hospitals a set amount per diagnosis rather than per day. Hospital stays grew shorter.

The hospital became the place where acute needs were met and managed. Once patients were stable, they were discharged to skilled nursing facilities to recover, and many who could not return home stayed on for long-term care.

On paper, this was efficient. In practice, it was often far from humane. Throughout the 1970s, congressional hearings and investigative reporting documented neglect, abuse, and profiteering in nursing homes.

It took until 1987, with the Nursing Home Reform Act, for Congress to set meaningful federal standards for resident care and rights. The system did give many people a place to rehabilitate and return home, or to die with care. But it also cemented an image many of us still carry: the nursing home as the place old people go to be warehoused.

The Boomer Bulge: Assisted Living and Continuing Care

The late 1970s saw the creation of the first assisted living communities. These were re-envisioned living spaces, where aging adults would be able to remain independent, maintain their own privacy, yet still have support in terms of meals, transportation, and availability of staff if something happened.

They gave the family relief knowing that “Mom” or “Dad” was being looked after, and gave the elder on-going autonomy with support and assistance close-by.

Unlike hospitals and nursing homes, however, there was no coverage from Medicare or Social Security. At first glance, the solution seemed to address a clear need. Now, almost 50 years down the road, it is clear that even these facilities are at capacity, and have further segregated elders within their own age group based on assets and functional ability.

That Was Then; This Is Now. What’s Changed?

The biggest change in the 21^st century is that we are living longer. Unfortunately, the places we are aging in—the 55+ communities, assisted living communities, and long-term care—haven’t aged as well. Aging adults keep getting funneled out of the mainstream, by choice or by circumstance, adding to this disconnection. But the places we are being funneled to no longer have the capacity to meet our needs.

We have become invisible because we are no longer seen as an integral part of the larger community. Except for “senior discount days”, we don’t interface on a regular basis with them. Because we have segregated ourselves, the communities we live next to have no sense of the vitality and experience we could offer to help solve problems common to all ages. Nor do they have a sense of urgency in meeting our needs for housing, transportation, healthcare, and community.

Changing Roles and Expectations

We exist outside of what were once commonly understood roles and expectations. Now, when we have finished with the stage of early retirement (travel, pickleball, downsizing), we find ourselves with little instruction on how to navigate the remaining stages: coming to terms with our mortality and filling potentially 10 to 20 years of life with purpose and meaning.

Too many of us no longer have a sense of belonging to family or community. We fear being warehoused in a nursing home, but we haven’t made plans for aging in place. We are fiercely independent, we have told our children so, and we intend to stay that way! Yet the implicit expectation that they will care for us remains.

A Harsh Truth

We have set ourselves up for this new stage of aging: disconnection and loneliness. The consequence of ageism—keeping “old” at arm’s length and worshiping youth—has left us under-prepared for the numbers of Boomers who now need community and seek belonging.

Too many of us have failed to consider what will give us a sense of worth when we are no longer able to be productive. Too many of us have stayed within “golden corrals” where peers die off, leaving those gifted (burdened?) with longevity behind. We don’t have the time or energy needed to re-connect to new communities.

I find it ironic that so many of us hate and even fear growing old while taking advantage of everything that extends life. We are living in an era when much of our healthcare is covered, and when medicines stave off the worst diseases or keep us alive through chronic illnesses that once would have killed us. We choose to remain ignorant of the gaps in care, assuming that someone will be there for us.

The Last Boomer

I’ve played around with the notion of what it might be like to be the last Boomer: to carry the memories of an entire generation that transitioned from the analog to the digital age, and even to the dawning of artificial intelligence. What will that individual think was the highlight of his or her lifetime? What will that individual want to make sure succeeding generations understand, so that they will not make the same mistake?

What would you say if you were the last Boomer?