Most of us instinctively measure ourselves and others by work, achievements, and reputation. We ask what people do, admire titles, and judge how we are perceived. These markers shape our culture but become blinders. When we link human worth to productivity and social standing, we mistake these as measures of value. They are not.
This distortion becomes most visible in the lives of older adults and people with disabilities. For much of life, identity is reinforced by profession and productivity. But when circumstances change—through retirement, disability, or aging—those markers fade. People begin to describe themselves in the past tense: “I used to be…” Identity becomes anchored in what was, rather than what is. The consequences are not merely personal; they are structural. When society measures worth by productivity, those who fall outside that frame are easily diminished. Older adults are labeled “past their prime.” People with disabilities are seen through the lens of limitations rather than possibilities. Over time, these judgments are internalized. What begins as social bias becomes self-perception.
Age-Friendly Can Limit Thinking
This is the quiet, persistent force of ageism. Unlike other forms of discrimination, ageism often goes unnamed and unchallenged. Jokes about aging remain socially acceptable. Policies routinely marginalize older people. And perhaps most tellingly, the frameworks we use to guide policy rarely confront ageism directly. Instead, we have embraced a softer language: age friendly.
At first glance, this seems like progress. The global age-friendly movement, advanced by institutions such as the World Health Organization, has encouraged cities and communities to consider transportation, housing, social participation, and accessibility for older residents. By institutional standards, it has been a success. But success at doing what, exactly? The word “friendly” reveals the limits of our thinking. Friendliness is something a host extends to a guest. It is voluntary, conditional, and rooted in goodwill. Justice, by contrast, is something a citizen claims as a right. It is enforceable, structural, and rooted in power. This distinction is not semantic; it is foundational.
The word “friendly” reveals the limits of our thinking. … It is voluntary, conditional, and rooted in goodwill. Justice, by contrast, is something a citizen claims as a right. It is enforceable, structural, and rooted in power.
A community can be age-friendly even when older adults lack affordable housing, transportation, or healthcare. It can offer amenities but fail to ensure real participation, autonomy, or rights. Friendliness can coexist with inequality. The age-friendly model often avoids naming the issue: ageism. Naming ageism means naming responsibility across systems and institutions. It demands accountability, not just accommodation. Many policies still focus on older adults remaining “independent” and “functional,” upholding an ableist hierarchy. Those with the greatest needs are least served. This is clearest in long-term care.
Roughly 1.2 million older Americans live in nursing homes, yet these settings are often treated as peripheral to community-based aging frameworks. This situation is both empirically incorrect and morally indefensible. The lived reality in many facilities, with residents excluded from meaningful care planning, personal preferences overlooked, and autonomy diminished, is not an exception. It is the structural outcome of a system that places institutional life outside the boundaries of justice. We have, in effect, designed a system that, in theory, welcomes older adults while, in practice, marginalizes them.
The disability rights movement shows a clear alternative. Activists rejected charity in favor of rights, declaring exclusion a civil rights violation. This led to enforceable protections such as the Americans with Disabilities Act. Aging policy has too often settled for inclusion or hospitality rather than insisting on rights and accountability. That must change.
Shitfting to an Age-Just Society
What is needed is not a more refined version of age friendliness, but a fundamentally different paradigm: an age-responsive—and ultimately age-just—society. An age-responsive society moves beyond welcome to action. It designs systems such as housing, transportation, healthcare, and long-term care that recognize aging as a universal human experience and respond to it with intention and investment. It ensures that older adults can participate fully in community life and that long-term care prioritizes dignity, autonomy, and independence. But an age-just society goes further still.
It recognizes ageism as a form of structural discrimination and works actively to dismantle it. It replaces voluntary frameworks with enforceable rights. It brings long-term care into the center of public accountability. It ensures co-governance, where older adults, including those with disabilities and those living in institutional settings- hold real decision-making power over the policies that shape their lives. At its core, this transformation requires a shift in how we understand human value.
Dignity is not tied to productivity; it does not decline with age or disability.
Dignity is not tied to productivity; it does not decline with age or disability. Human worth is inherent. Older adults consistently contribute wisdom, care, and leadership in ways that transcend economic value. Policies must reflect this. The goal is just institutions, not merely pleasant communities—ones that recognize value, protect rights, and urgently meet needs. A just society is measured by whether its oldest and most vulnerable citizens control the conditions of their lives.
This moment demands more than incremental change; it calls for bold resolve. Justice for older adults is not a distant aspiration; it is an imperative. Let us act now, with persistence and conviction, to create an age-just society worthy of everyone’s dignity, power, and purpose. We must actively advocate for policies and systems that recognize the rights, dignity, and agency of older adults. Let us commit to naming ageism, demanding accountability, and ensuring that older adults have real decision-making power to shape our society. The transformation to an age-just society begins with each of us taking responsibility. Now is the time to act.
James A. Lomastro, PhD, brings more than 40 years of experience in long-term care administration, healthcare policy, and disability advocacy, including his work with Dignity Alliance Massachusetts, which has secured more than $200 million in policy victories for older adults and people with disabilities.
Richard T. Moore served in the Massachusetts State Senate for 22 years, including as Chair of the Joint Committee on Health Care Financing, and has been at the center of aging and long-term care policy in the Commonwealth for decades.
