Since 1945, new medical techniques have extended active life for many Americans, while the proportion of older people in the population has increased and earlier systems of elder care have eroded. These changes have given older Americans new choices and powers, but a continuing cultural privileging of youth still marginalizes and endangers the aging.

The 1950s and 1960s saw efforts to develop ethical and affordable ways of housing and caring for seniors outside of families. With Social Security providing reliable retirement income, elders began moving away from established family homes into new Sunbelt apartment, retirement communities, some of which actively discouraged younger families from locating nearby. Even without relocating, many elders still had fewer family members to care for them. Family size was shrinking, either by design as safe, reliable birth control became available, or, especially among poorer or newer Americans, through the exigencies of mobility, immigration and high mortality. Moreover, more frequent divorce and remarriage could multiply the size of the kin group, making young families responsible for more elders than ever before.

Elders have increasingly used new political and cultural powers based on their numbers in the population to claim care from the whole society. Since the 1970s, activist organizations, like the American Association of Retired Persons (AARP), the American Society on Aging, and the Gray Panthers, eventually supported by the large and aging postwar baby-boom generation, have lobbied successfully for Social Security benefits, medical rights and legal protections for older Americans.

Wide-spread anxiety including feminist concern, about intrusive and expensive healthcare, the disproportion of poor women among the elderly unethical nursing-home practices and indignities surrounding death in hospitals have spurred movements for public regulation of care facilities, greater physical independence for elders and respect for age itself, and hospice and homecare programs for the terminally ill. The 1990s especially saw a revitalized Right-to-Die movement, dramatized by the assisted-suicide campaign of Dr Jack Kevorkian.

Wealth and family background strongly shape the expectations of aging. Affluent, especially white, elders seek “independence,” and plan their finances, activities and choice of retirement home so as to avoid “burdening” their children. Their wealth and leisure time has supported new consumer markets in special safety equipment, exercise plans and machines, medical innovations and plastic surgery. By contrast, less affluent seniors, including many non-whites, more often seek to avoid sundering community ties, and tend to rely on their children, neighbors and church community to assist and protect them. This preference varies less with wealth among non-white seniors than among whites; Asians in particular are shocked by the isolation of the elderly.

Neither has offered a perfect solution. While independent seniors can suffer from isolation or emptiness, seniors who stay rooted in their communities also sometimes endure neglect, danger, or financial loss in securing needed care. The new opportunities for American seniors have not erased the society’s persistent discomfort and impatience with the late stages of human life.