This paper examines the deterioration of traditional family care for the elderly in America, arguing that elder abuse and neglect are symptoms of broader social and cultural breakdown. Drawing on sociological, political, and economic perspectives, the paper traces a pattern of age discrimination beginning around age 50 in the workplace and connects it — through labeling theory — to increasingly severe neglect and abuse as individuals age. The paper reviews theoretical frameworks including ecological, exchange, feminist, and social learning models, evaluates their limitations, and calls for more comprehensive, case-specific research. Comparative examples from Japan and the developing world reinforce the argument that the marginalization of elderly people is a global phenomenon rooted in shifting family structures, economic pressures, and changing cultural values.
The paper demonstrates critical synthesis: rather than simply summarizing each source, the writer evaluates competing theoretical frameworks (ecological, exchange, feminist, social learning) against one another and against the empirical data cited, then argues for a more comprehensive approach. This technique — using sources to build and test an argument rather than merely support a thesis — is a hallmark of graduate-level academic writing.
The paper opens with a historical narrative establishing the shift from extended-family care to institutionalization, then introduces personal and political voices to frame the stakes. The central body is divided between a review of family-caregiving data and a critique of theoretical models for elder abuse. The final substantive section introduces the original contribution: linking age discrimination in the workplace to the later trajectory of elder neglect via labeling theory. The paper ends mid-argument, suggesting it is an excerpt of a longer work.
In America, especially early in its history, it would not be unusual to walk into a family residence and find extended generations living under the same roof — including first-generation immigrant parents well into their final years, surrounded by family members who shared in their care. Much of this pattern had to do with the expansive country that was to be populated over the following decades and centuries since the arrival of the early colonists.
In the beginning, parents arrived with their families to a wide space of untamed wilderness, and the hardships of that wilderness took their toll. Families stayed together out of necessity — to contend with the challenges presented by the wilderness, to sustain themselves, and to increase their personal land wealth. Large families were commonplace, because it took many people and many hands to clear and work the land: first to achieve self-sufficiency, and then to produce income that would help sustain those large families.
In America today, large families are very much a thing of the long-forgotten past, along with the mule and plow. As technology advanced and untamed space disappeared, the American family shrank in numbers. Today, the meaning of "single-family home" tends to be defined by the exclusion of all but the immediate family. There are no extended families living in single residences — no grandmothers, grandfathers, brothers-in-law, or sisters-in-law, at least not on a permanent, long-term basis. Most noticeably absent is the elderly family member, who today maintains independent living until the time comes to downsize to a smaller and more manageable space reflective of age, agility, and general health.
There has been a radical change in family lifestyle in today's busy world of competing demands. The plight of the elderly has taken a back seat to more immediate family concerns. This has created a void in which the elderly family member often becomes lost to the institutionalized care of strangers, absent the familiar support of extended family. It is not a healthy situation, and it is a social condition that is being experienced in other countries around the world as well.
On the elderly in America, Lillian B. Rubin (2007), in her book 60 and Up, puts it into perspective by quoting a writer from Time, Cathy Booth: "It has become the baby boom generation's latest, and in some ways most agonizing life crisis: what to do when the parents who took care of you can no longer take care of themselves." Rubin cites Booth further, quoting her as describing the plight of American elderly as having "descended into elder-care hell, when my mother, then sixty-nine, was found to have Lou Gehrig's disease" (Rubin, p. 111).
Rubin has chosen Booth as a summation of the plight of the elderly — someone who expresses genuine conscience about the situation of her loved one, and who perhaps felt helpless to make any choice other than one that equated to elder-care hell. There are many elderly who are surrendered in the twilight years leading to their final hours, physically and emotionally abandoned by their families. Something has gone very differently as Americans have evolved to the present — something disturbing that is a comment not just on American society, but on society around the world.
Japan offers a striking parallel. Before World War II, the elderly were held in high esteem, valued for their life experiences, knowledge, and contributions to their families, and they remained a part of family life until they passed on. Today, Japan finds itself in a very different cultural moment, in which the elderly are no longer the valued members of a traditional and culturally inherited family way of life. This stark change in postwar traditional values was summed up in 1972 by a minister of labor, K. Hara, quoted by Takeshi Ishida (1989) in his book Japanese Political Culture: "that if old people had to live in public homes for the elderly, it was their own fault" (p. 33).
The comments cited here offer perspectives from both sides of the social plight of the elderly around the world today — political and emotional family insights. This paper explores the plight of the elderly, focusing on American society as it exists today. It is an issue that receives little attention, because the elderly have weak voices, and commentary on their lives and needs is expressed largely through institutional settings with corporate leadership focused on profit. These corporations have more power and influence than any one American family, but the American families that surrender their loved ones to these institutional settings bear a share of responsibility too — they face tough choices, choices that profoundly impact the lives they have built for themselves with their immediate families.
This essay examines whether the American elderly have, like much else in America today, become disposable in the lives of the American family, and what role government and economics play in the consignment of elderly people to elder-care hell. It also argues that elder care abuse begins much earlier than some studies suggest — at around age 50, with age discrimination — and that elder abuse arises out of social breakdown and labeling theory, manifesting in increasingly intense neglect and abuse as the person ages and experiences the processes of dying.
Harold V. Cordry and Leslie Foster Stebbins (2001), in their book Work and Family in America, write that just as child care emerged as a national need some thirty years ago, so too has elder care emerged along that same line of family urgency and priority (46). Cordry and Foster Stebbins distinguish the level of care and the caregivers providing it along class lines:
"Although very wealthy families are able to purchase high-quality services for their relatives, and families with very low incomes can receive institutional care, for middle-class families there are few alternatives between informal home care and institutional care (England 1989) (Cordry and Foster Stebbins 46)."
This leads Cordry and Foster Stebbins to conclude that during the 1990s, an estimated 22.4 million households in the U.S. were providing care to a parent, relative, or friend over the age of 50 (citing Harrington 1999, Cordry and Foster Stebbins 46). They calculate further that 65% of disabled people in the 1990s lived at home or with a relative, and that the primary caregiving for those elderly family members came from family, with minimal government support (46).
While Cordry and Foster Stebbins may accurately have defined these populations with supporting statistics, the figures do not describe the quality of care being given, nor do they confirm that the care was being delivered in a nurturing family setting. This same population also gives rise to concern about reports of elder care abuse, as well as about abuse occurring in institutional settings.
Cordry and Foster Stebbins cite Neal et al. (1993), arguing that it is a myth that adult children no longer provide care for their elderly parents and relatives as was once the tradition. However, the problem of elder abuse in different countries around the world is on the rise, as reported in the Cambridge Handbook of Age and Aging (Johnson, Bengston, Coleman, and Kirkwood 2006, 324). The handbook's authors state:
"The socioeconomic breakdown has created an unexpected and inadequate way of living within a family, which promotes conflict when facing the new intergenerational exchange. These new forced living arrangements have generated a reversal of roles between family members that were culturally defined, structured, and programmed (WHO/INPEA 2001a, 2001b) (Johnson, et al. 324)."
This description, drawn from studies conducted in South America, Africa, and other regions of the world, can plausibly be applied in logic and theory to aging, death, and dying in American society. Especially at this moment in American history — when we are witnessing an economic breakdown that adversely impacts all of the class groups identified by Cordry and Foster Stebbins — it follows that we will see a rise in elder care abuse in America.
The problem with attempting to better understand elder care abuse from a clinical and social perspective is that there are not enough studies drawn from contemporary times to provide the insight needed to develop a clinical approach to protecting the elderly from abuse, or to identify and intervene with at-risk elderly people. Johnson et al. describe elder abuse as interpersonal violence that, beginning in the latter part of the twentieth century, came to be identified as violence against an age-specific segment of the population (325). It is, they say, a problem that has drawn focus on the same plane as human rights, gender, equality, and population aging (325). This focus is timely, because in the next decade there will be an unprecedented number of elderly people worldwide — and especially in America — as the baby boom generation becomes the elderly population.
Johnson et al. note that researchers in developed countries have created a situational model of elder abuse, attributing it to overburdened caregivers (325). They describe the range of theoretical approaches:
"a dependent elder (exchange theory), a mentally disturbed abuser (intra-individual dynamics), or as learned behavior (social learning theory) (Bennett, et al. 1997). Others have used the imbalance of power within relationships (feminist theory) and the marginalization of elders (political economic theory) to explore this issue (Whittaker 1997). Early on, elder-abuse researchers realized that a single theory could not accommodate such a complex, multi-faceted phenomenon. For child abuse and more recently domestic violence, a similar realization has led to the adoption of the ecological model as a means of explaining interactions across systems (Johnson et al. 325)."
The ecological model is consistent with Cordry and Foster Stebbins's identification of class distinctions related to family care and primary caregivers across class spectrums in America. It is the most recent and prevailing theory that helps experts explain the problem of elder abuse (Johnson et al. 325). However, because it aligns with Cordry and Foster Stebbins's focus on the number of primary family caregivers, it tends to overlook the potential for a family member who is a primary caregiver to also be an abuser.
The weaknesses of any of these theories — especially one that treats the care of elderly as benign simply because a primary caregiver is an immediate family member — is that there continues to be a lack of extensive and clinically useful data to prevent elder abuse. The dynamics of elder abuse are therefore best explained using the ecological theory, which encompasses socioeconomic factors, but even that framework may overlook the medical factors that come into play when an immediate family member is the primary caregiver. How immediate family caregivers arrive at the choices they make on behalf of an elderly parent who suffers from Alzheimer's, dementia, or other debilitating conditions is not adequately explained by any of the theories offered. Even the ecological theory seems inadequate in cases that might involve assisted termination of the elderly person's life by a family member.
This is a complex problem in which no individual theory is sufficient, and each case must be examined on its own specific criteria. Perhaps this is the biggest obstacle, because we cannot group the vast number of case dynamics across the class structures identified by Cordry and Foster Stebbins under a single theoretical framework. Existing literature must therefore be examined closely, and cases in the literature weighed carefully, to better define the directions from which abuse is being directed at elderly people. These theories fall short, probably because there is insufficient research to understand the problem on a larger scale. We must look across a broader spectrum — as broad as the class lines cited by Cordry and Foster Stebbins — to gain a fuller understanding of the problem.
That the elder abuse problem is widespread and increasing is indicative of age discrimination, social breakdown, and labeling theory. The problem must be discussed with this theory in mind, because elder abuse at the end stages of life is the culmination of a pattern of discrimination that begins at around age 50. None of the theories discussed thus far have adequately taken into consideration this pattern of discrimination, or its connection to the culmination of elder abuse.
The evidence reviewed in this essay points to a deeply troubling pattern in American society and beyond: the elderly are increasingly marginalized, beginning with age discrimination in the workplace at around age 50 and progressing through social neglect and institutional abandonment to outright abuse in the final years of life. No single theoretical framework — ecological, exchange, feminist, or social learning — is sufficient to account for the full complexity of this phenomenon. What is needed is a more comprehensive, case-sensitive approach that takes into account the full spectrum of social, economic, medical, and cultural factors at work. Until more extensive and clinically grounded research is conducted, and until American society confronts the cultural values that have allowed the elderly to become disposable, the plight of aging Americans will remain a quiet crisis — one that speaks to the character of the society we have collectively built.
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