This essay marks my thirty-fifth Substack for The Arc of Ageing.
I began writing on Substack earlier this year after more than two decades leading an international NGO in the field of ageing. Governments, intergovernmental agencies, civil society, academia, industry, and older people often shared the same space when they discussed ageing as both an opportunity and a challenge. Rarely as a structural reality already shaping how our societies function.
The essays written in 2025 reflect observations across my continuing career negotiating policy language, responding to crises, building partnerships, defending prevention budgets, and watching responsibility quietly migrate away from institutions and onto individuals and families.
Today’s final piece is not a personal reflection, but a position I have come to, shaped by proximity to decision-making, exposure to consequences, and sustained dialogue with those who design, fund, regulate, and deliver ageing policy.
I write plainly because euphemism has become a form of avoidance. I write publicly because what is normalised in closed rooms rarely changes.
Healthy Longevity Is Treated as an Exception
The failures we see in ageing policy today are not surprising. They are the predictable result of systems that continue to treat healthy longevity as an aberration, rather than as a defining feature of modern life.
Despite decades of evidence and public commitments, older age is still approached through the lens of ‘care’ and dependency. Prevention, participation, and the conditions of everyday living remain peripheral not because governments do not know better, but because the underlying design of our systems has changed little.
Health and social systems operate through classification, measurement, and eligibility. These are not neutral tools. When population ageing is considered primarily through the lens of decline, growing older is treated as a problem to be managed rather than a stage of life to be supported. This framing did not emerge by design, but through systems that defaulted to early life, working life, and episodic crisis.
This is not overtly intentional. It reflects systems designed around early life, working life, and episodic crisis, not longevity as a lived, ongoing condition. The result is a form of structural ageism that operates procedurally rather than rhetorically. Because it is embedded in routine practices and technical decisions, it is rarely named and even more rarely contested.
Care Is Absorbing What Systems Will Not
Health and social systems depend on unpaid and under-recognised care to function. And while the dependency varies by country, it is embedded in system design, though rarely reflected in funding decisions or accountability frameworks.
Language such as informal, familial, or private quietly removes it from the realm of public obligation. Respite becomes optional. Support is rationed, fragmented, or simply absent.
When someone is reclassified as ‘the caregiver,’ a relationship becomes a role, and a life becomes a function
This framing is also not neutral. It allows systems to offload cost, risk, and emotional labour while preserving the appearance of functionality. The moment someone is reclassified as “the caregiver,” something fundamental is lost. A relationship is converted into a role. A life is reduced to a function—often at the expense of income, health, and personal identity.
Ageing Policy Still Operates on Conditional Worth
Despite decades of rights-based language, ageing policy still operates on conditional worth. Older people are treated as assets when they remain productive, and as burdens when they require support. Both framings reduce human worth to economic utility.
These judgements are not evenly distributed. Older women remain systematically marginalised in health, economic, and rights agendas. Disability and dementia are treated not as conditions of human life, but as disqualifiers from full recognition. Rights narrow with age. Prevention is deemed inefficient. Investment is postponed or denied.
This is not demographic inevitability. It is a political and moral choice.
If care exposes design failure, prevention exposes moral failure. Adult vaccination, protection from extreme heat, food security, and infectious disease preparedness are repeatedly recognised as effective, yet persistently underfunded.
Rescue is visible and politically rewarding. Prevention is quiet, diffuse, and easy to postpone. Deaths are counted. Functional decline is not.
Evidence, Obligation, and What Comes Next
After almost living these patterns for a decade, it would be easy for me to conclude that change is unlikely. But despair assumes inevitability, and that is not where I am.
What the past year has revealed instead is unevenness. Alongside inertia, functioning alternatives already exist. Care models that recognise relational labour. Prevention strategies that reduce harm when funded and sustained. Advocacy structures that restore dignity within fragmented systems.
Hope, in this context, is not sentiment. It is evidence. Once workable alternatives are visible, inaction becomes a choice.
The question is no longer whether we know what needs to be done. We do. The question is whether institutions are willing to be held to account.
Ageing must be treated as a whole-of-society policy.
Care must be recognised as productive infrastructure.
Human worth must not be allowed to diminish with age, disability, or dependency.
Prevention must be funded not as an optional efficiency, but as an ethical obligation.
These are not aspirations. They are minimum conditions for credibility.
The arc of ageing is already visible. What remains unresolved is whether public systems will realign themselves with the lives they exist to serve.
The Arc of Ageing took shape with the steady encouragement of Darius Bashar. Artist’s Morning and the Writers Club offered not just structure, but companionship, community, courage, and a place to keep showing up to the page.
Thank you, Jane, for this powerful post that speaks the truth in strong, straightforward language.
Dear Jane,
Thank you for this powerful and urgently needed piece: "Longevity, policy design, and the cost of institutional delay." It cuts straight to the heart of one of the greatest mismatches of our time, we're living longer than ever, yet our policies, systems, and even cultural imaginations are still calibrated for a world where life ended decades earlier.
You lay out the costs so clearly: the human toll of waiting too long to redesign healthcare, housing, workplaces, financial systems, and social supports for a longevity era. Institutional delay isn't just inefficiency; it's a quiet erosion of dignity, opportunity, and potential across generations. Every year we postpone meaningful reform, we compound the price paid in isolation, unmet needs, strained families, and untapped contributions from millions of older adults.
I couldn't agree more. And what makes your argument even more compelling for me is the living evidence I see every day in my interactions with older people—80s, 90s, and beyond.
These aren't people fading into the background. They're sharp, curious, generative forces. There's the 88-year-old former engineer who now volunteers teaching coding basics to kids in his community center, bridging generations with patience and humor that no app could replicate. Or the 91-year-old woman who started a book club during lockdown that's now a thriving intergenerational gathering—her insights into literature and life leave everyone younger in the room humbled and inspired. I've watched a 79-year-old learn Spanish on Duolingo just to better connect with his grandchildren's friends, and a 94-year-old share war stories and life lessons with teenagers who hang on every word.
These everyday encounters are proof that longevity, when supported properly, isn't a burden—it's a gift. Older adults aren't "winding down"; many are more purposeful, resilient, and authentic than at any earlier stage. They have time for reflection, relationships, mentorship, creativity. Yet, as you so rightly point out, our delayed policies trap too many in systems designed for decline rather than flourishing: fragmented care, age-segregated living, inadequate pensions, workplaces that push people out too soon.
The cost of this delay is staggering, not just financial, but moral. We're squandering wisdom, experience, and contribution at a moment when society needs them most. Imagine if we acted with the urgency you call for: policies that incentivize lifelong learning, flexible work into later decades, age-inclusive urban design, integrated health and social care. We'd unlock a longevity dividend that benefits everyone.
Your writing in The Arc of Ageing consistently challenges us to think bigger and act faster. This piece is no exception—it's a clarion call. I'll be sharing it widely and reflecting on how I can advocate for the changes you outline in my own community.
Happy New Year 2026 to you, your family members and readers.
With deep gratitude and admiration,
Himanshu Rath
agewellfoundation.org