Writing this chapter at the turn of the twenty-first century is both an extraor-
dinary and disturbing experience. Without question, the lives of older persons reveal
significant gains and accomplishments, and this pattern is expected to continue. Over-
all, longevity is increasing, physical health is improving, chronic illness is declining,
and for many, financial status is improving. Healthier and longer lives provide addi-
tional opportunities for the creation of life's pleasure. At the same time, a large portion
of our older population, particularly women, ethnic minorities, and the oldest-old,
live lives of unnecessary hardship, hardship created and secured by our capitalist
economy. Without structural rearrangements and a more equitable distribution of so-
ciety's economic and social resources there is little hope that such deprivation will
decline.

Newer theories and burgeoning ideas provide invigorating opportunities to re-
examine valued beliefs and to develop new ways of thinking about older persons and
the society in which they live. Cultural, humanist, and critical gerontology bring wel-
come relief from the dominant medical paradigm that for so long has constructed our
vision of the aging experience. An emphasis on the meaning of aging and on creating
and sustaining meaning in life draw us away from our fixed view of older persons as
a medical problem to be solved. Resiliency theories point to the myriad ways older
persons successfully cope with a variety of stressors in their lives. The offering of
alternate ways of thinking about aging creates new pathways for working with older
persons in need of long-term care.

As exciting as the last decade of intellectual thought has been, there remains
cause for concern. At the heart of the controversies are profound differences concern-
ing how a responsive society should provide for older persons. Intellectual support

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