The “Happy Aging” Lie Was a Market Product, Not a Civic Design
For twenty years, America sold aging as a lifestyle category.
Independence, dignity, meaning, choice, optimism.
The lifestyle narrative was persuasive because it allowed people to delay the real problem:
the system needed to support late life was never built as infrastructure.
While the public was buying wellness, independence, and “aging in place,” the actual market collapsed underneath it — housing, workforce, Medicaid, rehab, discharge, and long-term care.
Most families are unaware of this collapse because they encounter the system late.
By the time they begin “looking at options,” the options they imagine no longer exist.
Families expect a consumer sequence:
independence → light support → assisted living → memory care → hospice
What actually happens now is closer to:
crisis → discharge → panic search → price cliffs → Medicaid bottleneck → staffing scarcity → churn → collapse
This mismatch isn’t emotional — it’s structural.
The old assumptions were:
supply will exist when we need it
retirement savings + home equity provide access
“we’ll get MaineCare when the time comes”
facilities compete for residents
quality is a choice
staffing is a feature
The real conditions are:
supply is constrained
private pay is a filter, not a solution
MaineCare isn’t a backup — it’s a bottleneck
facilities compete for labor, not residents
quality is rationed by capacity
staffing governs access
Most Mainers operate under the belief that MaineCare will be available when needed.
But eligibility is narrow, beds are scarce, timelines are punishing, and facilities that do accept MaineCare cannot absorb the volume.
Meanwhile, private pay exists at pricing that appears to offer choice but functions as exclusion.
It signals to the majority of families:
“you may enter the market, but you cannot stay in it.”
This is not choice.
This is filtering.
Families don’t experience this as market failure.
They experience it as disappointment, confusion, and “nothing seems to fit.”
In the early years of my work, I focused on warning families about these traps — Medicaid cliffs, care deserts, discharge accelerants, ownership structures, and pricing funnels.
All true.
All necessary.
But I’ve come to understand the deeper reality:
Families are unknowingly treating market collapse as a lifestyle decision.
Once I understood that, my role changed.
MAP no longer exists to help families “choose well.”
There is no consumer market to choose from.
MAP exists to help families operate in a collapsed market without destroying their finances, their relationships, or the remaining structure of their loved one’s life.
The public conversation needs to catch up to this reality.
We are not debating how to make aging nicer.
We are trying to keep the system from cannibalizing the people it was built to support.
If aging ever becomes dignified again, it won’t be because we used better language.
It will be because we treated it as infrastructure instead of optimism.
Author’s Note
Collapsing markets don’t announce themselves.
They continue operating — just with different rules.
Families are the last to discover those rules, and the consequences land on the elder.
