AGING OUT: An Exploration of Caregiving, Community, and How Americans Grow Old, by Lucy Schiller
In the world of longevity science, the question of whether getting old should be classified as a disease is a subject of ongoing debate. A view of the aging process as pathological, some biogerontologists have argued, would open pathways for clinical research on its mechanisms, and how they might be slowed.
To examine the biology of aging may be to head off age-related disease. But when “old age” was proposed as a replacement for “senility” in the World Health Organization’s 2022 International Classification of Diseases, central to the outcry that followed was the fact that so much of the world already treats aging, and the elderly, as a pox of the highest order.
The United States, in particular, has elevated youth worship and a corresponding death denial to the status of religion, a development inextricable from that of an individualist, image-obsessed, consumerist society ruled by perpetual capital growth. The shock of a global pandemic that killed 1.2 million Americans caused this country’s wellness economy to surge, especially among younger cohorts, as public health infrastructure and health care funding entered parallel crises. That such a cataclysm produced no larger reckoning with how we live, age and die would seem tied to the fact that more than 75 percent of our Covid-19 victims were over the age of 65.
In her first book, “Aging Out: An Exploration of Caregiving, Community, and How Americans Grow Old,” Lucy Schiller finds herself compelled to step into the void where that reckoning should be. When her paternal grandmother, Anita, died after contracting Covid from a home health aide, Schiller’s confusion about the loss was bound to a wider context: “In the gap between my grandmother’s death by Covid and ‘normal’ death, I became unsure of how to think of what happened,” she writes. “I could not tell if her death had been natural or unnatural. … If I could answer that question, I felt, I could figure out how to grieve.”
Schiller’s writing about a woman she avoided knowing in life — when the pandemic hit, she spent several months as a live-in caregiver for her other grandmother — comprises some of this book’s most cogent and moving passages. Elsewhere, the personal material designed to serve as both engine and binding agent creates more of a drag on a story that combines reporting on the long-term care industry and companion care services for the old; portraits of figures like the activist and Gray Panthers founder Maggie Kuhn; and critiques of the public and private entities preying on their elderly constituents and clientele.
Still in her 30s, Schiller suffers, she tells us, from a tendency toward “a kind of diffuse sallying through the world,” the sort of hovering existence whose limitations a writing career not only can hide but can subside upon. She claims intimate knowledge of conditions we associate with old age: invisibility, precarity, isolation. Schiller’s experience of herself as fragmented and unreal informs her observations about the need for “a larger, clearer and collective understanding of reality … if we are to actually believe in our own oldness, our own futures, as things to enter.” But our sense of her predicament doesn’t deepen or evolve, and its abstractions often sit in awkward juxtaposition with the various urgencies and injustices Schiller encounters in her reporting.
A subcurrent runs beneath Schiller’s eddying swirl of personal and political: That so many of her subjects are women reflects the extent to which aging is a female-coded phenomenon, and old age is a predominantly female experience. Women live longer than men but hold far less wealth; they fill the majority of nursing home beds and make up even more of the elder care work force. “Aging Out” charts the exploitation of both parties in this equation, and the social and cultural atrophy that has allowed it to progress unchecked. Though a lifelong feminist, Maggie Kuhn, who emerges here as a fascinating and complex figure, centered her movement on racial and economic justice; she founded the Gray Panthers in 1970, after being forced to retire at age 65.
Today, as Schiller notes, staying “productive” is considered not just a right but a hallmark of “successful aging.” The best way to avoid the abyss in this scenario is to continue working; a convenient turnabout, given that so many Americans now have little choice.
Toward the end of “Aging Out,” Schiller meets with a present-day Gray Panther, and describes his resistance to discussing “younger people’s antipathy toward older people, the flood of antiboomerism that I imagined Maggie, if she were around today, would find both flabbergasting and sadly understandable.”
Kuhn’s greatest insight remains resonant: Any fight for the dignity and welfare of the elderly must be intergenerational, connecting the young to the fully human old age that only the luckiest of us will live to see.
AGING OUT: An Exploration of Caregiving, Community, and How Americans Grow Old | By Lucy Schiller | Flatiron | 261 pp. | $29.99
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