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Hastings Center News

What Does It Mean to be a Good Citizen in an Aging Society?

That question was the focus of  “Long Term Care in New York City, circa 2030,” a panel discussion hosted by the New York City Bar Association on May 3 that included Hastings research scholar Nancy Berlinger. In 2030, one million New Yorkers will be age 65 or older. This trend is consistent worldwide in wealthy societies with developed health care systems and declining fertility rates.

Berlinger, the co-principal investigator of a planning process at The Hastings Center to determine how the field of bioethics can best respond to the challenges of population aging. She explained that everyone who lives in an aging society, regardless of age, is a member of that society. Habits of referring to older adults as “the elderly” or “seniors” or to population aging as a “tsunami” or “crisis” make it hard to identify with aging as a normal part of human life, or with the interests of older adults in a society.

Berlinger offered these examples of ethical questions for aging societies and citizens who aim to improve the lives of older adults:

  • What makes a good life in late life? What hinders a good life?
  • How should we support fellow New Yorkers living with frailty and dementia?
  • How should we support fellow New Yorkers who are family caregivers or paid caregivers?
  • Do we need more choices, or stronger systems?

Berlinger noted that while it is common to think in terms of health care systems to meet care needs resulted from age-associated conditions, older adults, like those of other members of society, also depend on a society’s investments in housing, nutrition, transportation, and the needs of caregivers. While activities such as advance care planning are important, “planning does not create options,” she told the group, mindful that 70% of costs associated with dementia care are not covered by Medicare or reflect unpaid family caregiving. She underscored the importance of attention to socioeconomic disparities in wealthy societies. “Gerontologists and urban planners have drawn attention to how disadvantages accumulate over a person’s life, how aging can lead to poverty,” she said. “The benefits of knowledge of how to make communities ‘age-friendly’ should be accessible to low-income communities.”