Be careful what you wish for?

Feeling grateful for this silver tsunami

You’ve likely seen the flow of articles investigating the cause of inflation. The finger has been pointed in various directions. Maybe it's corporate greed, maybe it's our just-in-time supply chain, maybe it's the silver tsunami.

Sometimes it seems fair enough that we blame things on our increased longevity. Getting old is expensive and requires a lot of different supports.

There’s a lot of finger pointing at the elderly. There are too many elderly people and not enough people of working age. Or maybe elderly people are working longer and thus it’s harder for young people to enter the workforce. Elderly people vote against services for younger people, from school funding to sustainability. Elderly people gum up the public housing and rent control systems, since they stay in oversized apartments long after their kids have grown up and moved out, while young families linger on waiting lists or in tiny apartments. Elderly people refuse to give up their car keys — or their senior roles in the workforce or access to their own bank accounts — and make disasterous decisions. Elderly people use a ton of expensive medical services, especially in the last year of life.

And, of course, the big accusation: more elderly people need more care for longer. It’s the tidal wave of those pesky old people and their needs that’s threatening our entire society.

I’m skeptical about some of these claims, which are tricky to fact check since they’re so vague and the statistics are spotty. Still, it’s clear that changing norms for the elderly are shaking things up. There’s been a major demographic shift and we’re struggling to adjust.

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What else has dramatically shifted society? The massive drop in infant mortaility. While it’s suprisingly tricky to pull up hard numbers to show that there are more elderly people who require caregiving support, it’s simple to show that way way more kids are making it to their sixth birthday.

According to the CDC:

“The decline in infant mortality is unparalleled by other mortality reduction this century. If turn-of-the-century infant death rates had continued, then an estimated 500,000 live-born infants during 1997 would have died before age 1 year; instead, 28,045 infants died.”

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You know what else is super expensive? Kids. All those routine doctors visits. Childcare. Education. All those special clothes, mobility aides, and learning tools.

That’s a lot of money, some of which comes out of the pockets of parents and some of which comes through government services and subsidies. There were 471,955 extra kids born in 1997 who lived to 1998. That surplus is happening every year.

This incredible drop in the death rate of children is what makes the life expectancy such a misleading figure. Of course the average life expectancy is pulled way down when in some US cities 30% of kids in 1900 were dying before they turned one.

Apologies for really hammering the point, but wow did a lot of kids die:

“In our long history, how likely was it that our ancestors died as children? Historical studies suggest that around one-quarter of infants died in their first year of life and around half of all children died before they reached the end of puberty. It’s only in the very recent past that we’ve seen dramatic improvements.”

The increased survival rate for children is incredible. Think of all those extra sneakers, coats, meals, soccer uniforms, piano lessons, acne medications, and tuition bills that parents today face.

Back when only half of kids survived to adulthood, child labor was legal. Parentifying kids by expecting them to contribute to running a household, work on the farm, or work in the family business was expected.

Kids are contributing less and demanding more than ever before.

And this has happened more or less during the same time as we were making incredible advances to extend the lives of the elderly. We’ve made far less progress pushing back mortality at the end of life than reducing mortality at the very beginning.

We don’t have a pithy phrase for this deluge of babies destorying society with their needs, though.

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Okay, you’re probably making the excellent point that there are fewer children as a share of the population today than there were 100 years ago. And, like a snake digesting a mouse, the baby boom has forced us to shift resources through the course of their lives.

Perhaps you’re making the excellent point that childcare is also in crisis. Both the childcare and eldercare systems in the US are a mess. We have the public school system and Medicare. Beyond that, there are patchy and complex systems to navigate, with a terrible effort to reward ratio.

More adults of retirement age has not led to a boon in families being able to take care of their kids. Instead, it’s led to the sandwich generation.

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Can we all agree that depicting our elders as a natural disaster is an awful image?

Let’s stop framing advances in public health and modern medicine as a morality tale that we should be careful what we wish for.

The answer isn’t to go back and undo our progress. No one using the term silver tsunami really wants to take back those wishes. We don’t want people to die from disease, accidents, and malnutrition at historic rates.

We want to make that third wish and build a society that provides the support we all need. Those advances in public health and modern medicine didn’t happen by magic. It took a lot of work and a lot of missteps to get where we are. It’s work that will never be complete.

The daily slog of caregivers and advocates is building that world. It may be harder to depict on charts, but it’s happening. It’s taking those extra lives and extra years and treating them as the miracles that they are.

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I’m glad there isn’t some clever phrase to frame the drop in childhood mortality as something coming to destroy everything in its path. Without this phrase, it’s harder to frame children themselves as a burden. Headlines about childcare don’t subtly suggest that their recently improved odds of making it to adulthood is the problem.

It’s easy to use language without thinking about its implications, even as it subtly changes how we view the world. It’s time to let the silver tsunami get lost at sea.

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Have you seen the Caring Across Generations #CareCantWait billboards in Times Square? If you’re interested in being featured it’s not too late to get up there! You can share your story with Caring Across Generation and be included in the project.

PACE has been overlooked for a long time. This could be its moment to shine…and expand. There are also many self-organized communities of care, like the Village to Village movement, that are expanding.

In the US, 3 million people owe more than $10,000 in medical debt. People who are old enough to qualify for Medicare are less likely to have medical debt. Given the bills I’ve seen people get, I’m pleasantly shocked by how low that number is.

I wonder how many friendships end because caregivers experience jealousy. It's easier to be annoyed with someone who "doesn't get it" because they're out continuing to enjoy their life while yours is falling apart than to deal with the complicated emotions we're drowning in. The NY Times offers up some general tips on noticing when changing friendships trigger jealousy.

North Carolina is working to use Medicaid funding to address the social determinants of health. Other states are sitting on stockpiles of unused welfare funding, rather than distributing it or using it to improve quality of life.

James Greig finds some agency in a mental health landscape determined by trauma and capitalism.