"What we need is a radical reinterpretation of longevity that makes elders (and their needs) central to our collective pursuit of happiness and well-being."

I spent the first half of my working life serving as a physician, a geriatrician—a specialist in the care of the old. Years spent in the company of very old people helped me grasp a handful of deep truths about life, love, and happiness. These elders showed me how, given sufficient time, even the smallest changes can remake us. There are, in my opinion, few things more soulful than being a patient and faithful companion of the very old, the frail, and the infirm. My patients helped me accept who I was, who I am, and who I am becoming. - Dr. Bill Thomas

The use of a generational perspective can help us revise and extend the narrative that has grown up around the postwar generation. We all know the tale as it is most commonly told. It begins with the sweet innocence of 78 million children born in the aftermath of World War II and builds toward a “youthquake” that threatens the foundations of American society. At the last possible moment, the grown-ups regain control and work aggressively to restore and maintain social order. This sanitized narrative has a tumultuous beginning, a quiet middle, and an ending that is yet to be written.  

The postwar generation’s dim but growing awareness of aging is beginning to generate intensely private concerns that people are reluctant to discuss openly. The shame-based approach to aging is heavily reinforced by an American mediascape that loudly and insistently proclaims, “You are young. Young is always better than old. Adulthood can last forever, if you want it to.” In public, we tell each other, “You’re as young as you feel!” but in our most private moments we can feel the truth. We are aging. The 78 million people who make up the postwar generation are no longer young. If you are taking time to read this article, the odds are that you are no longer young.  

Admitting to the truth of aging is painful and difficult, but the admission must be made before we can begin our journey out of adulthood. The best place to start such an exercise in truth-telling is in front of a mirror. In their most honest moments, many people living in the late years of their adulthood can empathize with moments like this:

“She stood in the shower and let its hot rain wash the grime of travel from her body. It felt good to close her eyes. She was tired but knew that it would be a mistake to sleep. There was work to do. She wrapped her hair in a towel and palmed an opening in the misted mirror. Her face leapt into view and surprised her. Old. She pushed the word away and remembered the L’Oreal ad she’d seen on the plane. ‘Worried about wrinkles? We’ll help you fight back.’ Fight. She would fight.”
– Notes for a future novel written by Dr. Bill Thomas

Because our culture has conditioned us to focus on our flaws, we naturally concentrate on and worry about the wrinkles, creases, and imperfections we see in the mirror. Although it can seem hard to believe at first, it is within our power to look into a mirror, study what we see there, and acknowledge, without reservation, that we are no longer young. We can learn to read the story of our lives as it has been written around our eyes and mouth and across our foreheads and cheeks. We can begin to reinterpret the changes as signs of important signifiers or our unique journey through life.  

I realize that, for those who are trapped in deep denial, this claim sounds like pie-eyed nonsense. It’s also true that many others will confuse facing up to the reality that we are no longer young with “letting go” or “giving up.” No one wants to acknowledge the passing of youth, and it is human nature to want to look our best. More to the point, we live in an ageist society, and smart people know how important it is to obscure the signs of aging skin whenever possible. What I am proposing here goes much deeper than the merely cosmetic.  

You must have an intensely personal and private conversation with your own true, aging, self. The time has come to look into the mirror and, finally, make peace with the changes you see on your face and feel in your mind and body. You are not the person you were when you were 20 years old. You are not the person you were 20 years ago. The fact is that those people vanished a long time ago.  

The path to personal happiness and fulfillment I am offering to you has just two steps:

1. Stop pining for what is already gone.
2. Start searching for the person you are meant to become.

Relinquishing one’s claim on youth is a necessary precondition for exploring life beyond adulthood. One of the reasons that the Boomers’ passage into elderhood will be so much more challenging than their journey out of childhood is that millions of people now approach the end of adulthood with little or no understanding of what comes next. Far from its crude caricature as a second childhood “sans hair, sans teeth, sans everything,” elderhood contains a revolutionary and liberating developmental potential. Persistently and deliberately misinterpreted as mere decline, elderhood is actually the rich reward that goes to those who manage to outgrow the frenzied jangle of adulthood and enter voluntarily into a new and much more soulful way of being.  

The unyielding realities of biology, demography, and history are poised to incinerate the comforting illusion that “adulthood can last forever, if you want it to.” American society’s next great cultural challenge will revolve around the definition of and worth assigned to aging and elderhood. It is possible to envision an old age that ripples with beauty, worth, and meaning, but the realization of such a vision begins with and depends upon a solid understanding of the structure and function of human elderhood.  

The Boomers’ entry into adulthood offered a definite but contentious destination. Leaving adulthood, in contrast, will be a maddeningly vague and confusing task. Americans comprehend “life beyond adulthood” about as well as they understand the dark side of the moon. This ignorance represents a profound, and unacknowledged, loss. For most of human history, life’s third age, elderhood, provided a noble station within which a person could experience old age. Few members of the postwar generation currently recognize the word “elderhood.”  

Though we are taught to view respect for older people as a form of charitable forbearance, elderhood is actually a powerful instrument of culture. It has been protected, sustained, and nurtured because it is able to bind families, communities, tribes, and nations together. Powerful voices now claim, wrongly, that this precious endowment is an unaffordable luxury. In fact, we need elders precisely because they are extraordinarily useful. We need elderhood because it drives the wheel of intergenerational cultural transmission (see graph below).  

This graph offers a schematic representation of how this wheel works. This ancient and ongoing cycle of intergenerational assistance remains humanity’s greatest invention; it has shaped us, served us, blunted our worst tendencies and magnified our best. Given the terrible might of modern industrial society, it would seem that, more than ever, we need what it has to offer. While all but the most extreme anti-aging zealots accept that aging is inevitable, it is this capacity for transmitting culture across generations that makes aging essential.  

What we need is a radical reinterpretation of longevity that makes elders (and their needs) central to our collective pursuit of happiness and well-being. We have no word that describes the value of intergenerational interdependence, of living in a multigenerational society, of protective social structures and rituals. Because such a word would be useful, I coined the term “Eldertopia.”

Eldertopia / ell-der-TOE-pee-uh / noun: A community that improves the quality of life for people of all ages by strengthening and improving the means by which (1) the community protects, sustains, and nurtures its elders, and (2) the elders contribute to the well-being and foresight of the community. An Eldertopia that is blessed with a large number of older people is acknowledged to be “elder-rich” and uses this wealth to advance the good of all.  

The concept of Eldertopia can connect us to a life beyond adulthood that contains a rich array of human virtues and experiences. The most valuable of these experiences are unavailable to adults and children. Elders possess novel ways of approaching time, money, faith, childhood, and relationships. They are capable of uniting us all with our shared past and future. Furthermore, the extraordinary task of returning adulthood to its proper boundaries will require the emergence of a new generation of elders and the construction of a cultural bridge that connects them to society at large.   This will be the postwar generation’s last chance to right the wrongs that its unyielding embrace of adulthood have inflicted on our society and culture. We are deep within a global crisis that may well threaten our continued existence, and we need elders more than ever before. We will need elders in the scores of millions if they are going to save us from ourselves. How might such elders think about our collective future? Consider, for example, the worldviews of these elders:

>   Beatrice Long Visitor Holy Dance of the Oglala Lakota
>   The founder of the Earth Elders
>   Nelson Mandela  

Beatrice Long Visitor Holy Dance is an elder of her people and a member of the “Thirteen Grandmothers.” This group included the following as part of its statement of purpose:

We, the International Council of Thirteen Indigenous Grandmothers, come together to nurture, educate and train our children. We come together to uphold the practice of our ceremonies and affirm the right to use our plant medicines free of legal restriction. We come together to protect the lands where our peoples live and upon which our cultures depend, to safeguard the collective heritage of traditional medicines, and to defend the earth Herself. We believe that the teachings of our ancestors will light our way through an uncertain future.  

The founder of Earth Elders (a nonprofit organization) writes the following:

Although recently diagnosed with ALS, I do not fear my impending mortality, but I do fear for the fate of our home, Planet Earth, and for future generations whose lives will be impacted by the consequences of climate change, species destruction, and the general decline of the health of the planet. As an elder, I have a unique perspective to share with my peers and more importantly, with the generations that will follow me. I have decided to take on the mantle of Earth Elder, one who speaks and cares for Earth and future generations.  

The Earth Elders exist to connect midlife and older persons dedicated to a just, sacred, and sustainable future, to each other, and to the young. They remind us that “throughout history, in traditional cultures worldwide, elders shared their wisdom, vision, and earth keeping. Elders taught each new generation how to care for its people, Earth and all species. That heritage sustained life—up to now.”  

It is good to remember that an old man living with a degenerative neurological disease, a man who outgrew his adulthood, created the Earth Elders and gave it its life-affirming mission.  

With the help of Graça Machel and Desmond Tutu, Nelson Mandela has brought together a small, dedicated group of elders who, he believes, could contribute to resolving global problems and easing human suffering. According to a statement on The Elders’ website, the members of this guild have all “earned international trust, demonstrated integrity and built a reputation for inclusive, progressive leadership.” When Mandela announced the formation of The Elders in July 2007 (on the occasion of his 89th birthday), he described the mission of the group: “The Elders can speak freely and boldly, working both publicly and behind the scenes. They will reach out to those who most need their help. They will support courage where there is fear, foster agreement where there is conflict and inspire hope where there is despair.”  

It is within this passionate concern for others that we find the purest essence of human elderhood. This is where the road out of adulthood is meant to lead us.

William H. Thomas, MD
William H. Thomas, MD is an international authority on geriatric medicine and eldercare. A graduate of Harvard Medical School in 1986, he completed graduate medical training at the Highland Hospital/University of Rochester Family Medicine Residency. While pursuing a career in Emergency Medicine, a part-time position as the medical director of a small rural nursing home turned into a full-time and life-long passion for improving the well-being of older people. In the early 1990’s, he and his wife Judith Meyers-Thomas developed the Eden Alternative, now a non–profit organization with international reach, which includes affiliates in Japan, Australia, Scandinavia, Europe, Canada, the United Kingdom, and across the United States.




Dear Dr. Thomas, I found your blog after seeing your work at Roger Williams Medical Center. The elderly tell our story providing history and context to life's whY? Why are we here? Without which, it is impossible to know where we are going. May God bless your mission. HSLtW TL


wonderful article, gives me a new lease on life--Gail in Alabama


Hello Dr. Thomas, I am an avid supporter of your writing and work. Your words resonate with me strongly, and as you may be aware, I quote you all the time on Twitter. Thank you for what you are doing. You inspire me. Most especially, in this post, your quote: "Elderhood is actually the rich reward that goes to those who manage to outgrow the frenzied jangle of adulthood and enter voluntarily into a new and much more soulful way of being." How so beautifully put. How so very beautifully put. Jesse


Very well said! Speak freely and boldly Elders! We do need you now.


Dr Thomas is also author of What Are Old People For?, Life Worth Living and In the Arms of Elders available through Quick Publishing.


this is a wonderful article; it should be read by anyone old enough to know thatwe all were designed to age. The elder stage of life needs it's own celebrations, rites of passage, and meaningful contributions. Lets all unite,help Dr. Thomas by creating new revering the aging processwith a new culture thatleave no room, for infantilizing or trivializing our's about far more than Bingo, blue tinted hair, or bad jokes about decrepitude. it is life's crowning achievement and sacred purposeas models for achievement,for the young.


Thank you for sharing your wisdom for all of us. You give us a lot to think about. All the best, Valerie at Agile Aging


Hi Bill. Cathy Meyer from Eden in OZ & NZ here. I have read with interest how we have to broaden the message ,commenced by the promotion and education in the Eden Alternative. I now feel after reading this article that I will hand a mirror to all training participants and get them to ask the questions you point out. Somehow it has to come back to knowing oneself.... and so few do. In my case Im getting to know myself....!!!!!! Regards and keep up your efforts with passion. The tide is turning..


Dr. Bill Thomas blogs daily at Please join the conversation on changing aging.


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