By Richard Eisenberg
How far has our nation progressed in the way it treats its oldest residents?
That's the provocative question asked at the start of the new, one-hour documentary, "
Aging in America: Survive or Thrive."
It begins airing on PBS stations on Thursday, May 1, and continues
throughout May, which is Older Americans Month. It also starts streaming
May 1 and was recently shown at the On Aging 2025 conference organized
by the American Society on Aging.
To
answer the question about how the United States is treating its elders,
filmmaker Neil Steinberg uses as his lens the Pulitzer-prize winning
book "Why Survive? Being Old in America"
written by the pioneering gerontologist Dr. Robert Butler 50 years ago.
Steinberg met Butler in 1986 while producing the video series, "Caring
for an Aging Society."
A Boom in People 65 and Over
At
the time Butler wrote "Why Survive?" there were fewer than 23 million
Americans over age 65. Now there are more than 55 million, of whom over
17 million are economically insecure, the documentary says.
When Butler died in 2010, AgeWave CEO and founder Ken Dychtwald
— a consulting producer for the film — wrote: "Every now and then, in
the course of human history, an individual emerges who changes the
course of everything. There is no question that Bob Butler was such a
man."
In his book, Butler described the
treatment of older adults this way: "In America, childhood is
romanticized, youth is idolized, middle age does the work, wields the
power and pays the bills, and old age, its days empty of purpose, gets
little or nothing of what it has already done. The old are in the way."
He called nursing homes "houses of death."
A psychiatrist and activist dubbed the "father of geriatrics," Butler founded the first department of geriatrics
in a U.S. medical school — at New York City's Mount Sinai Medical
Center — and in 1975, became founding director of the National Institute
on Aging (NIA), part of the National Institutes of Health (NIH). At
NIA, Butler presciently made Alzheimer's disease a national research
priority and debunked the myth of the inevitability of senility as a
part of growing older.
At NIA, Butler also worked to prevent older adults from being excluded from clinical trials, Terry Fulmer, president of the John A. Hartford Foundation, says.
Coined the Term 'Ageism'
Butler
famously coined the word "ageism" as a shorthand for discrimination
against older adults. He first used it in a 1968 interview with a cub
reporter at The Washington Post named Carl Bernstein.
At
73, Butler co-founded the Age Boom Academy at Columbia University, a
program where journalists learn about aging and ageism (I'm a proud
former Age Boom Academy Fellow). It is now part of the Robert N. Butler
Columbia Aging Center.
Steinberg says he made "Aging in
America" as a way of "looking at where we've been over the last 50
years, the improvements we've made and how far we still have to go."
Rather
than offer a how-to-live-better-as-you-get-older film, Steinberg says,
he wanted to shine a spotlight showing that "this is society's
responsibility."
To tell the story, the documentary intersperses video clips of Butler with new interviews of experts such as Dychtwald and UCLA professor Fernando Torres-Gil;
Butler's wife and daughters and poignant stories of older adults like a
Wyoming woman named Brenda caring for her husband Michael who has
Alzheimer's.
Older Adults Who Need Help
One
thing Steinberg learned making the film, he says, "is that a lot of
people who really need help are strong, vital, terrific people who just
got hit with something out of nowhere."
One
of those in the documentary is Connie, a 60-year-old nurse. She
explains that when she got cancer, "I was depleted emotionally,
financially and physically." She lived in a van for 11 months before the
Serving Seniors nonprofit helped her find a home.
"Why is it a fight to give people their basic humanitarian needs?" Connie asks.
Fulmer,
of the Hartford Foundation, was a close friend and colleague of
Butler's and suggested the documentary idea to Steinberg.
"I
just said: 'How could this go unmarked, a Pulitzer prize-winning book
from a man who was way beyond his years and vision?'" Fulmer recalls.
Her foundation provided major funding for the documentary.
Achievements That Help People Age
The
film spotlights a few impressive achievements now helping Americans age
well as more and more of them live into their 80s and 90s.
One is the Age-Friendly Emergency Department
at UCSF in San Francisco, staffed by geriatricians assisting older
adults. "Breaking your arm at 17 is one thing, but breaking your arm at
87 is a whole 'nother situation," Steinberg says.
Another example cited is the federal government's small PACE (Program for All-Inclusive Care for the Elderly)
initiative, providing medical and social services to older adults who
are eligible for nursing home care but prefer living at home.
"
'Til this came along, I was in my house by myself," says an Indiana
resident at a local PACE center. "This way, I get to meet people."
The
documentary also discusses ways some older Americans are using the
second half of life to reimagine themselves and find new meaning.
What Is the Same — or Worse
In
the film, Dychtwald says: "What's awakening now is the realization that
you might have new purpose at 50, you might have 30 years of life after
your main career is over. So, people are doing a lot of scratching
their heads thinking, 'Who can I be next?' "
But much of the documentary shows how
little has improved for older Americans since "Why Survive?" came out a
half-century ago — and what's gotten worse. For example, older adults
are now the fastest growing group of homeless Americans.
"It's
sad for me to think that he identified these problems so many years ago
and we're not anywhere near where we should be," one of Butler's
daughters, Cynthia, says in the documentary.
Although
Fulmer doesn't think Butler would be disappointed by the amount of
progress the country has made in improving aging in America over the
past 50 years because "he was an eternal optimist," Butler's oldest
daughter Christine, a retired nurse, thinks her father would be "in a
lot of ways, devastated."
Steinberg and Dychtwald believe Butler would be "disappointed."
Dychtwald thinks Butler would be "horrified" by the Trump administration's reported plan to cut the budget of the National Institutes of Health
by over 40% and its firing of 1,300 NIH employees. (The NIA's budget is
just one-tenth that of its parent NIH; aging experts think it may be on
the chopping block.)
Work Still to Be Done
Ageism insidiously pervades beauty-product advertisements and TV commercials for everything from burgers to brokerage accounts.
"We have a lot of work to do, still, because of ageism," says Fulmer.
Butler
hoped the nation would, in time, be filled with geriatricians serving
older adults. But there are only 7,400 geriatricians in the U.S. today.
By comparison, there are 60,000 pediatricians. The American Geriatrics
Society says the U.S. will need 30,000 geriatricians by 2030.
Butler also wanted geriatrics to be "a
giant new field of medicine," says Steinberg, "but it never quite took
off the way he had hoped."
The "Why
Survive?" author also wanted geriatrics to become a standard part of
medical school. It isn't. While 96% of medical schools require pediatric
rotations, just 10% do for geriatric rotations, Dychtwald said at On
Aging 2025.
Compensation may be one
reason we haven't seen more geriatricians. The median salary in
geriatrics is $275,000, which is significant but far below the $500,000+
salary of plastic surgeons and neurosurgeons, according to the 2024 Physician Compensation Report from Physicians Thrive.
The Filmmaker's Reflections
Steinberg hopes viewers will rethink aging after watching his documentary.
"A
major population of older people is a blessing and something to be
celebrated. But we also have to see what we can do to support these
people," he says. "We need to give people the opportunity to live their
later years in dignity."
And, he
adds, "I don't want [aging in America] to be a bleak story. But I don't
want to sugarcoat how dire some of the challenges are."
Full Article & Source:
New PBS Documentary Takes a Tough Look at Aging in America
