To Age Not Alone

Aging can be seen through the lens of decline and loss or through the lens of growth and expansion, and our Jewish sources lean into the latter. In Pirkei Avot’s description of the life cycle, fullness and strength come not before but after old age sets in: “At sixty, old age; at seventy, fullness of years; at eighty, the age of “strength” (5:21). The Hebrew word for old — zakein — is interpreted by some as an acronym for ze kanah chokhma, one who has acquired wisdom.

America’s attitude toward aging and the elderly is the opposite of what Judaism teaches. Our productivity-focused society is, reasonably enough, organized around the youthful wage-earning years of life. But the side effect of this is the marginalization of America’s aging population. Whereas loneliness is not uncommon among older adults globally, the prevalence of it in North America is the highest on earth. The reality for America’s older adults is exactly counter to what we pray for frequently during the High Holiday season: “Do not cast me off in old age; when my strength fails, do not forsake me” (Psalm 71).

What does it feel like to be “cast off” or “forsaken” in old age? That the psalmist gives voice to these fears indicates how rational, common, and deeply human a fear it is. We are social creatures whose lives revolve around one another in all sorts of ways. Our need for sociality and community, both for their own sake and for the material resources they generate, does not disappear once we stop working for a living. One of the first insights God articulates in Genesis about the nature of human beings is that, for them, being alone “is not good.” We often think about this in relation to Adam and Eve and marriage, but it applies to all forms of connection and the need for affection and emotional and physical support, and it doesn’t go in only one direction. A wonderful midrash posits that Adam and Eve went so far astray in the Garden of Eden because they didn’t have any elders to guide them. To forsake the elderly is to be bereft of their wisdom.

And sometimes that wisdom is unintentional. One of us, Sara, used to serve a community in which one of the elderly congregants would mispronounce a phrase in the Shabbat morning liturgy — often singing it at the top of her lungs because of hearing impairment. Instead of saying ki l’olam chasdo, she would say bi l’olam chasdo, changing the meaning from “God’s mercy endures forever” to “in me is God’s mercy eternal.” It was an accidental teaching, calling on us to realize God’s mercy through our personal honoring of and reverence for elders. The way to do that is to manifest that reverence in the policies and programs we create to support each and every person as they age.

The Jewish tradition has always treated elders as central and essential community members. In mishnaic times (70–200 ce), there was a culture to gather the elderly in the place of worship so that whoever arrived and needed a quorum for prayer could recite their full prayers with the elders as their community. This practice hints of what Robert Putnam, Lewis Feldstein, and Donald Cohen would discover many generations later and write about in their 2023 book, Better Together: Restoring the American Community: When communities include people of all ages and create opportunities for interaction and contribution, individuals and the community as a whole are both stronger. One illustrative case study is Experience Corps, a program in which retirees assist in tutoring and mentoring roles that “reconnect isolated seniors with schools, students, and community life.” The program exemplifies how older adults can play active, valued roles in civic life rather than being sidelined.

The collective term for the nodes of social involvement like the one this program facilitates is society, and American society would benefit greatly from Jewish teachings in this regard. Jewish teachings about caring for and incorporating elders into community can and should become a template for how American society organizes itself.

What might this look like?

One promising model of a place where this puzzle was solved is Israel. If you think elder care is unaffordable in a wealthy country like the United States, imagine what it was like in the early days of the kibbutzim. These communities were full of smart, capable people without capital. Their sense of communal cohesion derived from the fact that each person was needed for the collective to function. As Rabbi Abraham Joshua Heschel observed, older adults need more than to be healthy and supported; they must have the opportunity to be needed: “What a person needs is not only a sense of belonging but also a sense of indebtedness.” Communities, whether specifically elder or retirement communities or communities where elderly people live, should encourage volunteering of some kind in accordance with each member’s physical or mental talents and capacities.

In the elder community that Amy runs, 10 hours of volunteering per week are required of all residents, and the results have been phenomenal. What began as a way to save money on staff and overhead costs quickly morphed into a central defining feature of life in that community. The requirement disproportionately attracted people who have a penchant for community-building. They began building community before the facility even opened, starting their own WhatsApp groups and Google chats and sharing forums that have continued to nurture that community now that they’ve moved in. Like Heschel, Rabbi Lord Jonathan Sacks argued that a person only really dies from not having something to contribute. Treating the aging population with dignity means treating them like other members of the community, with something to offer.

The importance of community in the later decades of life also helps to dispel a common misconception: that living in a senior community is some kind of failure. The American ethos maintains a fixation on “independence” — personal as much as national — defined by one’s ability to live on one’s own with literally no dependence on others. This rather narrow vision of societal values correlates to imagery of American success: pulling oneself up by one’s own bootstraps, not depending on anyone. But it can lead to what is often referred to as the “independent isolation paradox,” the false notion that staying at home is what maintains independence. The statistics suggest otherwise. An aging person’s commitment to living alone can too often result in a person becoming a prisoner in her own home and losing physical and mental function. The data show that being lonely increases by 59 percent the rate at which one loses one’s ability to perform what’s referred to medically as “activities of daily living (ADLs)” — the scientific measure of independence. Loneliness actually accelerates the difficult parts of the aging process. Making new friends and connections slows down deterioration, so it is essential that older adults are in environments where there’s opportunity for human connection as long as possible.

If community is the key to an end of life that’s well lived, one goal our society should set for honoring our elders should be to make community both available and affordable for as many elders as possible. Both of these — availability and affordability — are notable challenges. But they are not insurmountable by any means, and it’s important to think of the two in tandem. The fact of the matter is that most things are available to people who can afford them. The aging population includes those of high net worth, for whom optimal medical care in a strong community is affordable and available. What these elders and those caring for them should prioritize is living in environments with opportunities for social engagement. In old age, people will have outlived a significant number of their friends or will no longer live close to friends, since they’ve moved closer to their younger family members caring for them. With their physical and medical needs being attended to, their mental well-being will be enhanced by the ability to make new friends and new connections for social interaction.

But those in the low- and moderate-income categories generally have a harder time finding affordable quality care in the context of a community. Whereas all Americans age 65 and older are eligible for Medicare, Medicare coverage does not include assisted living or home care or long-term care of the sort that’s often required in old age and that, in some facilities or multigenerational contexts, can come with a community of peers. Our society needs to come up with ways to help all older Americans become part of communities where their increasing medical needs will be taken care of as well.

There are several promising policy pathways to make this happen. For example, in 2024 Massachusetts Governor Maura Healey set up a Special Commission on Senior Housing “charged with studying strategies to create affordable, healthy housing for seniors.” The commission’s recently published “Building for Aging” report outlines a series of recommendations that would be game-changing for older adults in her state, including streamlining the development of affordable housing units for older adults. The report is worth reading to understand the role that state government can play in senior housing for those who can’t afford expensive long-term care, and it specifically highlights the need “to promote the advantages of aging in community to attract more moderate-income older adults.”

With more older adults joining these housing communities, costs for their care can be made more efficient through what the report calls a Place-Based Services Pool Fund that “could combine multiple new and existing funding sources, including an investment from health plans, housing providers, and the Commonwealth.” Both the public and private sector can play a role in this place-based services optimization, and this kind of innovative thinking should be adapted in additional states.

It is not uncommon to encounter a backlash, even within the Jewish community, for providing public funds to support older adults.

Support for elders is often sidelined in favor of support for young people. People critical of government funding for elder care might readily support government allocations to Jewish private schools, in which a pupil might learn the following passage from the Shulchan Arukh, considered the most authoritative Jewish legal text, requiring a child to support his parents in old age: “If the parent does not have [the means] and the adult child does have [the means], we force the adult child to fulfill the needs of the parent according to what the child can afford” (Shulhan Arukh, Yoreh De’ah 240:5). While the Shulchan Arukh also sets limits to protect the work life and standard of living of the adult child, in doing so, the text stresses two components: 1) the need to care for one’s parents as a basic obligation, and 2) the need for one to care for oneself at the same time.

What if our society were more sensitive to both factors? Social policies are needed to ensure that family caregivers have the means to assist elders, including perhaps legal dispensations and protections for those caring for elderly family members. This will allow and even encourage people to create an integrated society that cares for its elders without destroying the health or stability of caregivers.

The Torah could not be any clearer about the honor to be accorded to all elderly people: “You shall rise before the aged and show deference to the old” (Leviticus 19:32). The Shulchan Arukh is even more precise, defining the person in question as anyone age 70 or older, “even if he is an ignoramus, provided he is not wicked.”

The specificity of the obligation and its focus on proximity are instructive. We are obligated to rise before those elderly who are within our sphere of perception, and not to look away. What if our society as a whole were to internalize this moral teaching? How might we rise for the generation who brought us into this world?