This series is my attempt—forty-two years after that encounter in Nicaragua, forty years after beginning elder chaplaincy, and now from inside the experience of aging myself—to finally learn what that woman tried to teach me:

Liberation theology must be done WITH the oppressed, not FOR them. It must start from the margins, not the center. It must honor survival as resistance and recognize that those half a block off the plaza often see more clearly than those in the spotlight.

So this isn’t a series ABOUT elders. It’s a series BY elders, FOR elders, centered on elder voices and elder liberation.

I’m not thrusting a microphone anymore. I’m not a chaplain observing from outside (though pastoral care remains part of who I am). I’m sitting at a table with five other elders—Christian, Buddhist, Muslim, secular humanist, interfaith seeker—and we’re doing theology together.

We’re deconstructing the lies that justify ageism. Building alternatives rooted in multiple wisdom traditions. Organizing for collective liberation while practicing contemplative resistance. Claiming our right to autonomy, dignity, and voice. Refusing to disappear quietly.

This is liberation theology for elders. Not from above. From the alley. Half a block off the plaza. Where we’ve been surviving as best we can—and where we’re finally finding each other and building something that might make a difference in our lives.

Not someday. Not for the next generation. Now. For us.

Because we’re not waiting for someone else’s revolution anymore. We’re creating our own.

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Who We Are: The Circle of Six

This series emerges from conversations among six elders who’ve become a community over the past several years. We meet weekly at a community center in Chicago, and less formally in each other’s homes. We bring different wisdom traditions, life experiences, and perspectives. But we share one commitment: elder liberation—spiritually, politically, bodily.

A note about these characters: The six elders in this series—Agnes, Joan, Helen, Grace, Kenji, and Amara—are composite characters drawn from real people and real conversations over forty years of chaplaincy and years of leading interfaith elder circles. Their stories, struggles, and wisdom reflect dozens of actual elders I’ve known, served alongside, and learned from. While no single person is exactly “Agnes” or “Kenji,” everything they say and experience in these pages comes from lived reality. I’ve combined, condensed, and crafted their narratives to protect privacy while honoring truth. They are fiction in form, testimony in substance.

Let me introduce you to the six people who’ve become my teachers, co-conspirators, and friends:

Sister Agnes (91)

Former Roman Catholic nun who left her order after fifty years. Trained in classical theology at a time when few women had access to advanced theological education. For decades, she taught what she now calls “the five sacred lies about aging”—that aging is punishment for sin, that suffering is redemptive, that elders should withdraw from the world. Now, at ninety-one, she’s dismantling everything she taught and building something truer. Agnes is our theological anchor—deeply read, fiercely intelligent, increasingly radical. She’s a Tillichian mystic who, late in life, discovered liberation theology and became dangerous because of it. Agnes taught me that it’s never too late to admit you were wrong and start again.

Joan (72)

Working-class organizer. No theology degrees, no academic credentials—just four decades of showing up for people. Joan’s radicalization came through witnessing her friend June die in a hospital, untreated pain and medical neglect justified by ageist assumptions that “old people always hurt” and “at her age, what can you expect?” Joan knocked on Sister Agnes’s door eight months after June’s death and asked, “Why does theology justify this?” That question launched this entire series. Joan is our convener—the one who brings people together, asks the questions no one else will, and keeps us grounded when theology gets too abstract. She reminds us constantly: “What does this mean for the elder in the nursing home who can’t even choose when to eat lunch?” Joan taught me that organizing is love made public.

Helen (81)

Retired research scientist. Secular humanist. Jungian. Sharp mind, sharper tongue, no patience for sentimentality or theological hand-waving. Helen became a death-with-dignity advocate after watching her husband die slowly, in pain, denied the peaceful death he’d requested because doctors couldn’t let go. She brings bioethics rigor, psychological depth (she’s studied Jung for thirty years), and fierce commitment to elder autonomy. Helen challenges our theological assumptions, refuses to let us spiritualize away material suffering, and insists that you don’t need God to have ethics. She’s proof that liberation theology can be secular. Helen taught me that non-theistic wisdom is still wisdom, and sometimes the clearest moral vision comes from outside religious frameworks.

Grace (79)

Progressive Protestant pastor (retired). Perpetual seeker. Grace holds her Christian identity lightly, always exploring Buddhism, Sufism, Hindu practices, Indigenous wisdom. She facilitates our weekly interfaith circle, leads rituals that draw from multiple traditions, and creates space for questions without demanding answers. Grace is our bridge-builder—able to translate between traditions, find common ground without flattening real differences, and hold paradox without needing to resolve it. She teaches art classes at the community center, leads dream circles, and brings beauty into everything she touches. Grace taught me that faithful seeking is more valuable than certain answers.

Kenji (86)

Japanese-American Zen priest. Soto Zen lineage, trained in Japan. Kenji was three years old when his family was sent to Manzanar internment camp—barbed wire, armed guards, everything stolen. He carries that trauma with the lightest touch I’ve ever witnessed. After decades of rage and shame, he found Zen Buddhism at twenty, trained as a monk, and became a teacher. Now he teaches Wednesday night zazen at his small apartment, leads occasional retreats, and brings Buddhist wisdom on impermanence, non-attachment, and death as natural transition. Kenji is our contemplative teacher—embodying presence, stillness, and the possibility of integrating trauma without being defined by it. He’s proof that spiritual practice can transform suffering without erasing it. Kenji taught me to sit still long enough to notice what’s actually happening beneath the noise.

Amara (83)

Somali Muslim. Sufi-influenced. Retired nurse. Refugee. Amara fled Somalia’s civil war in 1992 at age fifty, lost her husband to political violence, was separated from her children, spent six months in a refugee camp before resettlement in Chicago. She rebuilt her life—learned English, recertified as a nurse, worked in nursing homes where she witnessed every form of elder neglect. Now she lives with her daughter and grandson, remains active in her mosque’s women’s group, and brings Islamic ethics of communal care and Sufi mysticism to our conversations. Amara quotes Rumi like he’s a close friend, brings cardamom tea to every gathering, and refuses to let us forget that liberation requires community, not just individual enlightenment. Amara taught me that mysticism and activism aren’t opposed—they feed each other.

These six voices—Christian, working-class, secular, interfaith, Buddhist, Muslim—are woven throughout this series. We don’t always agree. We hold different theologies, different politics, different relationships to aging and death. But we’ve learned to think together, to let our differences sharpen rather than diminish our collective wisdom. This series is the fruit of our conversations, arguments, prayers, and organizing.

How I Approach Theology: A Mertonian Framework

I need to be clear about where I stand theologically, because it shapes everything in this series.

I am a Methodist minister trained in liberation theology. That’s my foundation. Liberation theology—developed by Gustavo Gutiérrez, James Cone, Rosemary Radford Ruether, and others—insists that theology must begin with the experiences of the oppressed, analyze the structures that cause suffering, and work toward concrete liberation. It’s theology from below, not above. Theology that sides with the marginalized against the systems that marginalize them.

But my theology has evolved beyond traditional Christianity. Like Thomas Merton—the Trappist monk and contemplative who engaged deeply with Buddhism and recognized truth in multiple traditions—I’m rooted in Christian practice while recognizing profound wisdom in Buddhism, Islam, Hinduism, Indigenous spirituality, and depth psychology.

Some call this “perennialist” or “universalist.” I’m uncomfortable with both labels because they can flatten real differences between traditions. But I do believe this: All authentic spiritual paths point toward the same Ultimate Reality. Christians call it God. Buddhists call it Emptiness or Buddha-nature. Muslims call it Allah. Hindus call it Brahman. Carl Jung called it the collective unconscious. Paul Tillich called it the Ground of Being.

Different words. Different practices. Different cultural expressions. But the same moon.

Here are the theological premises that shape this series:

1. God is the Ground of Being, not a being. God doesn’t “allow” or “disallow” things like a supernatural interventionist. God is the ontological ground in which all existence participates. I’m more Tillichian than traditional theist.

2. The Holy Spirit is best understood through Jung’s collective unconscious. The Spirit that moves through humanity, connecting us across time and space, carrying archetypal wisdom—this is what Jung was describing psychologically and what mystics describe theologically.

3. Shadow is real and requires integration. Evil isn’t just the absence of good. It’s ontologically real. We each carry shadow—denied, repressed parts of ourselves. Aging brings the shadow to the surface. Integration, not eradication, is the goal.

4. Humans have genuine free will, including over our own deaths. Life is a gift, but it is our gift to steward. That includes choosing when and how we die, within ethical bounds and in accordance with community accountability.

5. The greatest sin is the exploitation and diminishment of persons. Not disobedience to divine commands, but treating people as objects instead of subjects. Ageism is a sin because it strips elders of personhood.

6. We have collective responsibility for each other. Autonomy is relational, not isolated. We are interdependent. Community is not optional—it is how we humans exist.

7. The modified Golden Rule: Treat others as THEY want to be treated, not as you think they should be treated. This honors difference, respects autonomy, and prevents paternalism.

These premises may be controversial. Traditional Christians may find them heretical. Secular humanists may find the theological language unnecessary. That’s okay. I am not claiming this is the only way to approach elder liberation. I am offering one framework, shaped by forty-plus years of ministry, four decades of chaplaincy, and my own experience of aging.

Take what is useful. Leave what is not. Add your own wisdom.

My Formation: Garrett-Evangelical and the South Side

To understand where these premises come from, you should know where I was formed.

I attended Garrett-Evangelical Theological Seminary from 1979 to 1983, at a pivotal moment in American progressive theology. It was there I encountered the teachers and traditions that would shape everything that follows.

Dean McBride, Professor of Old Testament and scholar of ancient languages and pre-Christian traditions, whose rigorous work on comparative mythology led me to discover Joseph Campbell on my own. Through both, I learned that biblical wisdom wasn’t unique truth but one expression of perennial human spiritual insight—preparation for the interfaith perspective I would later develop.

Rosemary Radford Ruether, whose feminist theology taught me to see how patriarchy, racism, classism, and imperialism interlock—preparation for recognizing ageism as another strand in the same oppressive web. She modeled prophetic scholarship grounded in lived struggle.

Paul Rademacher, Professor of New Testament, who was himself a mystic, showed me that contemplation and scholarship aren’t opposed, that rigorous exegesis can lead to mystical insight, that intellectual rigor and spiritual depth are companions, not competitors.

A lecturer and pastor at Second Baptist Church in Evanston (whose name I’ve regrettably forgotten but whose prophetic witness I haven’t) who brought Jesse Jackson to campus, connecting theology to organizing in real time, showing that faith produces action.

Jesse Jackson’s presence at Garrett during my seminary years taught me—before it became a political slogan—that “I am somebody” is a theological claim about human dignity. This shaped my later conviction that elder dignity is a theological claim, not a demographic issue.

The Black church tradition that shaped my understanding of liberation theology as lived practice, not just academic theory. I worshiped at Liberty Baptist Church, St. Mark’s United Methodist Church, and Trinity United Church of Christ on the South Side of Chicago, where I heard Jeremiah Wright’s prophetic preaching—a witness that theology emerges from struggle, preaching is resistance, and the church exists to challenge power, not sanctify it.

Georgia Harkness, Methodist theologian and mystic whose work I encountered (though not as a direct student), whose integration of social concern and contemplative depth modeled what faithful theology could be. Her hymn, “Hope of the World,” became an anthem for all of us in the chapel and is a personal favorite to this day.

Hans Küng, whose courage to challenge ecclesiastical authority, whose work on world religions and global ethics, and whose insistence that theology must serve humanity rather than defend institutions—all encountered in those formative seminary years—shaped my later comfort with interfaith engagement and questioning inherited authority. It is he whom I heard say, “There is a church from above and a church from below. But despite the attitude of the Holy See, there is no in between.”

By 1982, when I was ordained, I had learned:

From McBride and then through Joseph Campbell, that ancient wisdom traditions point toward perennial patterns.

From Ruether: to understand that Christ is not bound to maleness but as a liberating, dynamic reality in which the maleness of Jesus has no ultimate salvific significance. The same is true of Christ’s “race,” color, or age.

From Rademacher: Mysticism, scholarship, and presence belong together.

From the Black church and Jesse Jackson: Theology is only real when it produces justice.

From Wright and Küng: Prophetic witness sometimes requires breaking with convention and institutions.

Then came Nicaragua in 1983, which crystallized it all.

What Makes This Series Different

There are many books about aging. Most fall into a few categories:

· Medical guides: How to manage chronic conditions, when to move to assisted living, and financial planning

· Self-help spirituality: “Aging gracefully,” “finding purpose in later years,” accepting decline with serenity

· Policy advocacy: Defending Social Security, improving nursing home regulations, expanding Medicare

· Memoirs: Individual stories of aging, often by privileged people with resources

This series is none of those—and all of them.

Here’s what makes our approach different:

1. We Name Ageism as Structural Sin

Not “aging is hard” or “we need to be kinder to elders.” Ageism is a system of oppression parallel to racism, sexism, and classism. It has theological justifications, economic drivers, and political consequences. It kills people. And it must be dismantled, not just softened.

2. We Center Elder Voices

Not experts talking ABOUT elders. Not well-meaning advocates speaking FOR elders. Elders speaking for ourselves. The six of us write from inside the experience, not observing from outside. We’re not objects of study—we’re subjects creating our own theology.

3. We’re Genuinely Interfaith

Not “Christianity with token interfaith gestures.” We bring Buddhist, Muslim, Christian, secular, and interfaith perspectives into real dialogue. We let them challenge each other. We don’t flatten differences, and we don’t pretend one tradition has all the answers.

4. We Hold Contemplation and Activism Together

Liberation theology can become grimly political—all analysis, no wonder. Spiritual practice can become escapist—all meditation, no justice. We refuse that split. Mysticism fuels activism. Action requires contemplative grounding. Both/and, not either/or.

5. We’re Practical

Every article includes practices you can actually do—meditation techniques, organizing strategies, ritual templates, and document samples. This isn’t abstract theory. It’s a toolkit for liberation.

6. We’re Honest About Hard Questions

When do elders have the right to refuse treatment? To choose the timing of death? How do we distinguish autonomous choice from despair? What about dementia—does personhood remain? We don’t shy away from complexity.

7. We Build Community, Not Just Individual Spirituality

You can read this series alone. But it’s designed for circles—study groups, Base Ecclesial Communities, interfaith gatherings. Liberation happens collectively, not just individually.

How This Series Is Organized: A Roadmap

This series contains seventeen articles organized into six parts. You can read them sequentially, or jump to topics that speak to your immediate needs. Each article stands alone while contributing to a larger argument.

PART I: FOUNDATIONS (Articles 1-3)

Article 1: Nicaragua 1983: Half a Block Off the Plaza
The encounter that launched this series. Liberation theology, Nicaragua, and learning to listen from the margins.

Article 2: Structural Ageism in Healthcare and Society
Names the systems that harm elders. Tells June’s story—medical neglect as structural violence.

Article 3: Aging as Transformation Beyond Decline
Reclaims aging as sacred lifecycle stage, not decline. Sister Agnes’s journey.

PART II: THEOLOGICAL DECONSTRUCTION & RECONSTRUCTION (Articles 4-6)

Article 4: Deconstructing the Five Sacred Lies
Deconstructs traditional theology about aging: Aging as punishment, body-soul dualism, redemptive suffering, elder invisibility in scripture, otherworldly focus.

Article 5: Reconstruction and Teaching
Builds alternatives from liberation theology, Buddhism, Islam, Hinduism. Sister Agnes’s seminary lecture. Includes major section on mysticism and awe—elders as natural mystics.

Article 6: Testing The New Theology
Putting the reconstructed theology into practice. The work of integration, walking with Bernadette, institutional pushback, and Sister Agnes looking back and forward.

PART III: INNER WORK (Articles 7-8)

Article 7: Shadow Work and Integration in Elderhood
Jung’s shadow applied to aging. Confronting regrets, unforgiven acts, unlived lives. Integration, not repression.

Article 8: Mental Attitudes Toward Aging and Death
Contemplative practices: meditation, prayer, dream work, death preparation. Cultivating awe.

PART IV: AUTONOMY, DYING & JUSTICE (Articles 9-11)

Article 9: Dignity, Autonomy, and Agency in Dying
Medical aid in dying (MAID), voluntary stopping eating and drinking (VSED), hospice, palliative care. The B.R.A.I.N. framework for decision-making.

Article 10: Claiming Agency at Life’s End
Privilege and possibility at life’s end. Samuel’s story, practical tools for claiming agency, and the fear that keeps elders silent.

Article 11: Justice and End-of-Life Autonomy
Systemic injustice in end-of-life care. Samuel and Rosa’s contrasting mornings, the five injustices, and the mandate for collective liberation.

PART V: COMMUNITY & COLLECTIVE ACTION (Articles 12-13)

Article 12: Base Ecclesial Communities and Rituals for Elder Liberation
How to form elder circles. Christian BECs, Buddhist sanghas, Islamic ummah, secular mutual aid. Rituals for aging, dying, remembering.

Article 13: Digital Legacies, Technology and Resistance
Digital legacies, community archives, and technology as tool for liberation or control. Whose stories get preserved?

PART VI: PROFESSIONALS, VISION & MOVEMENT (Articles 14-17)

Article 14: Intersectionality and Elder Liberation
Compound marginalization made visible. Carlos’s hospital story, ten testimonies witnessing intersectionality, the matrix applied, and elders as agents of change.

Article 15: For Professionals—Walking with Elders Through a Liberation Lens
Three professional stories of transformation. Guidance for pastors, chaplains, healthcare workers, social workers, death doulas.

Article 16: The Elder Liberation Manifesto
Ten demands. Concrete policy and practice changes we’re fighting for.

Article 17: Community Voices Respond
Elders from the broader community respond. Where do we go from here?

In addition to the seventeen core articles, this series includes Bonus Articles responding to specific conversations, publications, and events in the elder liberation space. These companion pieces will be published as they arise and linked to the relevant core articles.

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Who This Series Is For

Primary audience: Elders ourselves. If you’re aging—and if you’re alive, you are—this is for you. Whether you’re sixty-five or ninety-five, whether you’re thriving or struggling, whether you’re isolated or surrounded by community. This series affirms: You are not declining. You are becoming. And your liberation matters.

Secondary audiences:

Progressive Christians open to interfaith dialogue and willing to question traditional theology

Spiritual seekers (spiritual-but-not-religious) looking for wisdom beyond single traditions

Healthcare and eldercare professionals (doctors, nurses, social workers, administrators) who want to serve elders, not just manage them

Death doulas and hospice workers seeking theological grounding for end-of-life accompaniment

Families and caregivers of elders navigating hard decisions about care, autonomy, dying

Academics in gerontology, theology, religious studies, medical ethics

Organizers and activists working for elder justice

Who this is NOT for:

Those seeking “aging gracefully” platitudes that avoid naming injustice

Those wanting medical advice (consult professionals)

Conservative Christians looking for biblical literalism or traditional dogma

Anyone who thinks elders should be grateful, quiet, and wait for heaven

How to Use This Series

If You’re Reading Alone:

Read sequentially for the full arc, or jump to topics speaking to immediate needs

Try the practices—don’t just read about meditation or shadow work, DO them

Journal your responses, questions, resistance

Consider forming a circle (see Article 12) to do this work collectively

If You’re Reading in a Group:

One article per gathering (they’re long enough for deep discussion)

Use discussion questions provided at end of each article

Try practices together—meditate, do ritual, draft documents

Share stories—every elder has wisdom; make space for it

Organize for change—don’t just discuss; act

If You’re a Professional:

Start with Articles 2 and 15 (structural ageism + guidance for professionals)

Use this in training (staff education, seminary courses, nursing programs)

Challenge your institution’s practices using this framework

Join or form professional learning communities around elder liberation

Content Considerations:

This series addresses trauma, death, suffering, and structural violence. Some articles include:

Stories of medical neglect and elder abuse

Discussion of aid-in-dying and choosing death

Personal trauma histories (internment, war, displacement)

Challenging of religious beliefs readers may hold dear

Please practice self-care. Take breaks. Find support. If content triggers trauma, step back and return when ready.

An Invitation

Forty-two years ago, a woman in Nicaragua taught me that liberation must come from the margins, not the center. For forty years, I witnessed elders saying the same thing she said: “Nothing will make a difference in my life. I’ll simply survive as best I can.”

But survival alone isn’t enough. We deserve liberation.

This series is an invitation:

To elders: Claim your voice. Refuse invisibility. Organize for collective liberation. You are not burden, not decline, not waiting room for death. You are wisdom-keepers, prophets, mystics, organizers. The world needs what you carry.

To allies: Listen to elder voices. Challenge ageism in your institutions, families, communities. Support elder autonomy even when choices make you uncomfortable. Show up.

To all of us aging (which is all of us): Join the work. Form circles. Practice contemplation. Organize for justice. Build the world where elders are honored, not warehoused; heard, not silenced; free to live and die with dignity.

The revolution hasn’t reached the alleys yet. But we’re not waiting anymore. We’re building it ourselves.

From half a block off the plaza, where we’ve been all along, we’re finally finding each other.

And we’re dangerous now.

Welcome to liberation theology for elders. Welcome to the circle. Welcome home.

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—A Methodist Minister, Age 72
Ordained 1982
Garrett-Evangelical Seminary, 1979-1983
Chaplain to Elders, San Francisco & Oakland, 1983-2023
Kensington, CA, 2026

A Note on Language and Method

Throughout this series, you’ll notice certain choices:

Composite characters: The six elders—Agnes, Joan, Helen, Grace, Kenji, and Amara—are composites drawn from real people and conversations. While each character is fictional, everything they say and experience comes from actual elders I’ve known. This method allows me to honor privacy while telling truth, to synthesize wisdom from multiple sources while maintaining narrative coherence, and to create teachable moments while remaining grounded in lived experience.

“Elder” not “senior” or “elderly”: We reclaim “elder” as a term of respect and wisdom, rejecting infantilizing or diminishing language.

“God” and other terms: I use “God,” “Ultimate Reality,” “Ground of Being,” “Allah,” “Emptiness” somewhat interchangeably, depending on context. This reflects my conviction that different traditions point toward the same Reality.

“We” not “they”: I write as an elder, from inside the experience. This isn’t observation—it’s testimony.

Theological rigor with plain speech: I’ve tried to be academically responsible (citations, careful arguments) while remaining accessible. If I’ve failed in either direction, forgive me.

Practices included: Liberation theology is praxis—action and reflection together. Every article includes something you can DO, not just think about.

Acknowledgments

This series exists because of:

The elders who taught me over forty years of chaplaincy—especially those whose names I never learned but whose words shaped my theology. The six characters in this series are composites of real people whose stories I carry with permission and gratitude.

The woman in Nicaragua whose answer still guides me.

The interfaith elder circles I’ve participated in and facilitated over the past two years in Chicago—where conversations like those in this series actually happened, though not with these exact people in these exact configurations.

My theological formation at Garrett-Evangelical Theological Seminary (1979-1983), a crucible of progressive theology at a pivotal moment:

Dean McBride, Professor of Old Testament and scholar of ancient languages and pre-Christian traditions, whose rigorous work led me to discover Joseph Campbell on my own, teaching me that biblical wisdom is one expression of perennial human spiritual insight

Rosemary Radford Ruether, whose feminist theology showed me how oppression interlocks and prepared me to recognize ageism

Paul Rademacher, Professor of New Testament and mystic, modeling the integration of scholarship and contemplative insight

The Reverend Dr. Hycel B. Taylor, the head of the Church and the Black Experience at G-ETS and pastor at Second Baptist Church in Evanston, was also the head of Jesse Jackson’s organization, Operation PUSH. Dr. Taylor taught us, collectively and firsthand, how to connect theology to organizing and activism. For me, personally, it was Dr. Taylor who made it clear that not everyone belonged on the front lines; there was both room and need for those behind the scenes to make a movement successful. Movements require people attacking institutions from within and from the outside to be successful. It was Dr. Taylor who gave me my marching orders.

The Black church tradition of the South Side of Chicago that shaped my liberation theology as lived practice:

Liberty Baptist Church, St. Mark’s United Methodist Church, and Trinity United Church of Christ, where I heard Jeremiah Wright’s prophetic witness that theology emerges from struggle

My mentors in liberation theology: Gustavo Gutiérrez, James Cone, Ada María Isasi-Díaz, Joanne Carlson Brown, Miguel De La Torre—whose work gave me language for what I witnessed in Nicaragua and nursing homes.

My feminist/womanist teachers beyond Ruether: Elisabeth Schüssler Fiorenza, Delores Williams, Katie Geneva Cannon—who taught me liberation from the perspective of those most marginalized.

Georgia Harkness, Methodist theologian and mystic, whose integration of social concern and contemplative depth modeled faithful theology.

Hans Küng, whose courage to challenge ecclesiastical authority and work on world religions shaped my interfaith engagement.

My contemplative teachers: Thomas Merton (whose journey from monastery to Buddhist dialogue mapped my path), Meister Eckhart, Julian of Norwich, Teresa of Avila, Rumi, Hafiz, Thich Nhat Hanh, Pema Chödrön—mystics who taught me that justice work requires contemplative depth, that mysticism without justice is escapism, and that the deepest spirituality emerges when both are held together.

Process and philosophical theologians: Paul Tillich (whose “God beyond God” freed me from theistic literalism), Pierre Teilhard de Chardin (whose evolutionary mysticism showed me cosmic liberation), Alfred North Whitehead, Charles Hartshorne, Catherine Keller.

Depth psychologists: Carl Jung (whose collective unconscious became my language for the Holy Spirit), James Hillman, Marion Woodman, John Sanford—who taught me that shadow work is spiritual work and integration is the goal.

The Methodist tradition that ordained me in 1982 and formed my understanding of social holiness, personal piety in service of justice, and the insistence that faith produces works—even as I’ve wandered far from Methodist orthodoxy into perennialist territory.

And the elders reading this: Your liberation is the point. Everything here is in service of your flourishing, your voice, your freedom.

Let’s begin.

Support This Work

Paul is 95 years old. He is sharp enough to know what he wants, clear about his values, and still determined to handle his own affairs. What he no longer has is a world that will let him act on those decisions without a translator.

When Paul wants to change his insurance policy, he does what any responsible adult of his generation was taught to do: he writes a careful letter, addresses it properly, and mails it. Then nothing happens—no response, no acknowledgment, no human being on the other end. I have to explain, gently and repeatedly, that the address still exists, but the conversation has moved on. “They don’t answer letters anymore, Paul. It’s all done in the app.” For him, that sentence might as well be in another language.

I drive Paul‘s Cadillac because he prefers his own car. When his car breaks down 25 miles from where I am driving to pick him up, Paul does exactly what he has been told to do for decades: he calls AAA. He has paid his dues faithfully; he knows the script. But in 2026, a phone call is no longer enough. Without a pinned GPS location in the app, the promised roadside assistance does not materialize. It takes a friend driving him back to the disabled car and me logging into his account on my phone to drop the precious little digital pin that finally summons a tow truck. Paul did everything “right.” The system changed the rules without telling him.

At the post office, the humiliation is smaller but no less real. Paul hands me cash to mail something important. I have to tell him that the local branch no longer accepts cash at the counter—only cards. The government service he has trusted his entire life will not accept the legal tender in his wallet from a 95-year-old man standing before a federal employee. No sign says, “We have redesigned this place for people with credit cards and smartphones.” There is only the quiet, bewildering experience of being told, again, that what he has to offer no longer counts.

Paul is not incapable. He is being systematically locked out. In every one of these situations, the only reason his intentions become actions is that I am there to translate: to speak to the app, to navigate menus, to enter passwords, to sit on hold. Paul can afford this. Most elders cannot. That is not a story about individual aging. It is a story about a system that has decided it no longer needs to speak the language of the old, because it assumes someone like me will always be there to interpret—or that it doesn’t matter if no one is.

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When Autonomy Exists Only on Paper

On paper, Paul remains in charge. Every institution requires his authorization. They want his verbal consent on the call, his signature on the form, and his “yes” before any change is made. That is good and right. We have come a long way since the days when decisions were routinely made over the heads of elders.

But the way we have built “authorization” in the digital age quietly strips away that autonomy.

To change a policy or resolve a problem on Paul’s behalf, I enter a labyrinth. I call and navigate a phone tree designed for younger ears and quicker fingers. I enter his account number, then his date of birth, then the last four digits of his Social Security number. A recorded voice warns, “Some options have recently changed,” as if that helps. I am on hold. When a person finally answers, they insist on speaking to Paul, even if he is frail or hard of hearing, to ask security questions he may or may not remember answering last year.

If we’re dealing with an online account, the gauntlet is even more absurd. A one-time passcode is sent by text to a phone Paul doesn’t really use or to an email he doesn’t check. Security prompts refer to “devices you’ve logged in on recently,” as if the last 12 months of his digital life were stored in his head. Often, I end up borrowing his presence like a prop—holding the phone to his ear so he can say “yes, I authorize her,” feeding him the information the system requires, and translating back and forth as fast as I can.

I am grateful that companies do not simply take my word for it—Paul’s consent matters. What I resent is that they have built a consent model that assumes a certain kind of user: tech-literate, hearing intact, and comfortable juggling passwords, texts, and apps across multiple devices. The system says, “Paul is the decision-maker,” but only if Paul can perform a set of digital tasks that have nothing to do with his moral or cognitive capacity.

His autonomy now depends on my availability and technical fluency. If I am sick, traveling, or simply too exhausted to spend another hour on hold, his decisions sit in limbo. In theory, he is in control. In practice, the world has made him dependent on someone like me to exercise the rights that are supposedly his.

That is not autonomy. That is dependency dressed up in the language of consent.

The New Class Line: Who Gets a Translator?

Paul’s situation is revealing not because it is unique, but because he is, in some ways, lucky.

He has enough money to pay for my time. He has a car, friends with cars, and a social network he can mobilize when he is stranded. He has me, and I have the skills and patience to sit on hold, reset passwords, and argue politely but firmly with representatives whose scripts were never written for ninety-five-year-olds.

Imagine another elder who is just as sharp as Paul but poor and alone. No adult children nearby. No funds for a private caregiver-advocate. No pastor, chaplain, or neighbor who can afford to spend their afternoons navigating phone trees for free.

Nowhere is this more obvious than in health care. Clinics and hospitals increasingly route everything through “MyHealth”–style patient portals: test results, appointment requests, prescription refills, even basic questions for a clinician. For an elder like Paul, these portals might as well be locked doors. He cannot navigate the app, struggles to read on a smartphone, and cannot remember yet another username and password. So every lab result becomes a phone call to me, every refill becomes an hour on hold, every “simple” message to the doctor becomes a multi‑step relay. The system congratulates itself on empowering “patients” while quietly assuming that somewhere, offstage, a caregiver is doing all the actual portal work.

When that elder’s letter goes unanswered, there is no follow-up call from someone like me. When their car breaks down, AAA never arrives, and the membership becomes effectively unusable. When the post office stops accepting cash, they may walk home with their letter still in hand.

When Medicaid sends a confusing notice or a Medicare Advantage plan requires prior authorization, the form sits on the table until the deadline passes. Services are recorded as “declined.” Coverage is terminated for “failure to respond.” The chart notes read “non-compliant,” as if the problem were stubbornness rather than a system that moved all the doors without providing a map.

We have quietly created a new class line in old age: elders who can afford a translator and those who cannot.

Those with money and networks hire intermediaries to make the apps and portals work on their behalf. Those without are blamed for not keeping up. Their suffering appears in our statistics as “unmet need,” “missed appointments,” and “avoidable hospitalizations.” Rarely do we name the true cause: a system that has decided the burden of adaptation belongs entirely to the elder, no matter how old they are or how many times the rules have changed.

For those of us who care about elder liberation, this is not a side issue. It is a core injustice. A just society does not make access to basic services contingent on having a personal assistant.

Caregivers as Unpaid Administrative Infrastructure

For every Paul, caregivers are shouldering an invisible layer of work that our language about “care” barely acknowledges.

When we picture caregiving, we tend to think of very physical tasks: lifting and transferring, bathing and toileting, preparing meals, managing medications, and sitting vigil through the night. These are real and exhausting. But layered on top of them now is a second shift: the work of serving as an administrative interface between elders and the world.

Caregivers become de facto IT support, updating phones, installing apps, resetting forgotten passwords, and troubleshooting portals that malfunction. They become benefits navigators: reading letters from insurers, deciphering government notices, comparing plans, and filling out forms that could easily overwhelm a law student. They become financial administrators: setting up online bill pay, monitoring accounts, spotting suspicious charges, and contesting errors.

Most of this labor is unpaid or grossly underpaid. It is taken for granted by systems that assume someone will always be there to “help Mom with the website” or “handle Dad’s benefits online.” When policymakers and executives design new digital tools, they rarely budget for the caregiver hours required to make those tools usable for elders. Those hours come out of someone’s life—usually a daughter’s, a spouse’s, or an underpaid home care worker’s—and are treated as a free resource.

I have spent countless hours on the phone on Paul’s behalf, resolving issues that, in theory, I could have handled in seconds in an app if the system had been designed with him in mind. But because the app assumes he will be the one using it, and because the security protocols assume a particular kind of user, I am forced back into the slow lane. I am grateful that his authorization is required. I am also exhausted by how that requirement is implemented—perplexing, fragmented, and profoundly insensitive to the realities of old age.

Caregivers like me are not just companions and helpers. We have become an unpaid infrastructure propping up systems that would otherwise collapse under the weight of their own inaccessibility. Any serious conversation about caregiver burnout must address this administrative burden. Any serious vision of elder liberation must ask why we have designed a world that functions only if a hidden class of translators is always on call.

Elder Liberation: A System That Speaks Their Language

Elder liberation is not just about more programs, more funding, or more services—though we desperately need them. It is also about the deeper question of who systems are built to serve and in what language they expect people to speak.

A liberating system would be grounded in some simple principles.

First, it would offer multiple real channels for action, all treated as legitimate. If an elder wants to communicate by letter, there should be a clear, honored path for that, with a human obligated to respond. If they prefer the phone, a live person should be reachable without an obstacle course. If they—or their caregiver—use an app, that app should augment, not replace, other forms of access. Digital tools should be additions, not gated entrances.

Second, elders themselves would be at the table when new systems are designed. Before an insurance company retires a mailing address or a public agency stops accepting cash, they would ask people like Paul what those channels mean to them. They would test their new processes with actual elders, not just with thirty-something staff in a conference room, and they would treat elders’ confusion not as a personal failing but as a design flaw.

Third, caregivers would be recognized as essential infrastructure, not an afterthought. The administrative work we do on elders’ behalf would be acknowledged, compensated, and supported, rather than assumed. Systems would be built to minimize unnecessary steps, shorten hold times, and provide direct caregiver access with clear, elder-approved permission—so that respecting an elder’s autonomy does not have to mean exhausting everyone involved.

Finally, and most fundamentally, we would recover a moral vision in which elders are not treated as outdated users of a modern world but as bearers of wisdom and dignity whose ways of relating to institutions still matter. A society that claims to honor its elders cannot be content with a world where a 95-year-old man who has survived almost a century is told, in effect, that his money is not money, his letters are not communication, and his phone calls are not enough.

Paul’s stories are not anecdotes; they are case studies of a quiet form of exclusion. For elders like him, the so-called “annoyance economy” is not merely irritating—it is disabling. Without a translator, most will not “get with the times.” They will stop asking the system for anything. They will give up on changing policies, appealing denials, and claiming what they have paid for and what they need to live.

In a companion piece, I take up Annie Lowrey’s description of America’s “annoyance economy” and ask what it looks like through Paul’s eyes. For now, it is enough to say this: elder liberation will require more than teaching ninety-five-year-olds to use apps. It will require insisting that our systems once again speak the language of the old—and that when they change that language, they do not leave elders behind.

This essay was sparked by Annie Lowrey’s recent article in The Atlantic, “America’s Annoyance Economy Is Growing,” which examines the rise of friction and “time taxes” in American life. Her analysis helped me see more clearly how the same dynamics play out in elder care—and how, for older adults and their caregivers, what looks like mere annoyance from afar often becomes a matter of dignity, access, and survival.

Annie Lowrey is right: America has built an “annoyance economy” that runs on phone trees, fine print, and deliberate friction. It wastes our time, nudges us into subscriptions we don’t want, and uses bureaucracy as a quiet profit engine. For many middle-aged, tech-savvy people, the primary feeling is irritation.

For elders and their caregivers, it is much darker.

What seems like an inconvenience with a laptop can become a barrier to survival when you are 85, hard of hearing, and living alone. For a 95-year-old like Paul, the annoyance economy is not about subscription fatigue at all. It is about being structurally locked out of his own life unless a caregiver steps in. Without a translator, most elders in Paul’s position don’t “adapt”; they give up—on appealing denials, on changing policies, on accessing services they have paid into all their lives.

This is where elder liberation and the annoyance economy most sharply intersect.

From Irritation to Injury

Lowrey describes a world in which companies and institutions have discovered that friction can be monetized. Make it hard to cancel. Make it tedious to complain. Make it confusing to reach a human being. Over time, people will stop trying. The profits show up quietly in a few extra months of charges and a few fewer successful claims.

But elders are not just one group among many in this landscape. They are particularly vulnerable.

In my previous piece, I wrote about Paul, a 95-year-old who can no longer change an insurance policy, call for a tow, or mail a document without someone like me translating his intentions into action. For him, every “modern convenience” becomes another test he cannot pass on his own. The letter that no one answers because “we don’t handle that by mail anymore.” The roadside assistance that never arrives because he cannot pin his location on an app. The post office that no longer accepts cash.

Paul’s experiences are not quirky anecdotes from a man “behind the times.” They are case studies of how the annoyance economy treats the old: as people whose time, confusion, and humiliation are acceptable collateral damage. And when you overlay this with deliberate policy choices—such as those made by the Trump administration—the annoyance economy stops being background noise and becomes a primary mechanism of harm.

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Administrative Burden: The Technical Term for What Caregivers Feel

Policy scholars have a term for the invisible work that Lowrey describes: administrative burden.

• Administrative burden has three parts:

• Learning costs: determining which programs exist, what you are eligible for, which forms you need, and which deadlines apply.

• Compliance costs: completing applications, gathering documents, attending required appointments, and navigating recertifications and renewals.

• Psychological costs: the stress, stigma, anxiety, and sense of helplessness that come from dealing with opaque systems and the fear of making a mistake.

For older adults, these burdens are especially heavy. As people age, they are more likely to:

• Interact with multiple systems at once (Medicare, Medicaid, Social Security, housing, SNAP, and energy assistance).

• Experience sensory and cognitive changes that make complex forms, phone trees, and portals harder to use.

• Live with chronic conditions that sap the time and energy needed to navigate red tape.

Researchers have documented that administrative complexity explains why many eligible older adults do not enroll in programs like SNAP or lose benefits they qualify for because they miss a renewal notice or cannot complete recertification. The burden is not an unfortunate side effect. It is built in—and it falls hardest on people with the least capacity to bear it: the sick, the poor, the isolated, and the old.

From this perspective, the annoyance economy is not just about poor customer service. It is a way of governing through exhaustion.

“Connected” on Paper, Isolated in Practice

Tech optimists often point out that older adults are “more connected than ever.” There is some truth to that. Surveys show that a large majority of adults over 65 now use the internet, and many own smartphones or computers. On paper, the digital divide appears to be closing.

But the reality behind those averages tells a different story.

There are significant income gaps in device ownership: wealthier seniors are far more likely to have smartphones and home broadband than low-income elders. Owning a device is not the same as being able to use it effectively. Many older adults:

• Need help setting up and learning to use new devices.

• Have trouble reading small text, keeping track of multiple passwords, or managing two-factor authentication codes.

• Struggle with hearing or cognitive changes that make long, automated phone menus or video visits overwhelming.

For someone like Paul, the “connected world” is visible but not accessible. He sees commercials promoting patient portals and telehealth. He hears people talk about apps that make everything “easy.” Yet when he tries to navigate those systems on his own, he cannot cross the threshold. Someone else has to enter the passwords, interpret the screens, and decide what to click.

This is where caregivers come in—not just as companions, but as the human interface between elders and the annoyance economy.

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Health Care as the Annoyance Economy’s Front Line

Lowrey notes that health care is one of the worst offenders in the annoyance economy. That is an understatement.

In health care, annoyance is the policy: friction is built into every step of accessing care.

Patient portals—“MyHealth” apps and their cousins—have become the default way to:

• View test results.

• Request appointments.

• Refill prescriptions.

• Ask clinicians questions.

For many older adults, these portals are unusable without help. They may not have a computer or only have a basic phone. They may be unable to read small text or navigate drop-down menus. They may forget their login credentials or be confused by security questions that assume a particular kind of digital life.

In practice, every portal task becomes caregiver labor:

• The caregiver logs in, reviews results, interprets medical jargon, and explains it verbally.

• The caregiver requests appointments, schedules rides, and coordinates around work.

• The caregiver refills prescriptions on time, catches errors, and follows up when the system fails.

On top of this, prior authorization has become a central tool in the annoyance economy. Before a test, medication, or treatment can proceed, an invisible bureaucracy must approve it. Doctors and nurses spend hours filling out forms, faxing documentation, and waiting on hold. Patients and families wait, worry, and sometimes abandon care when the process becomes too confusing or slow.

For elders, prior authorization is often the difference between timely treatment and deterioration. For caregivers, it is yet another gauntlet to run—time spent at kitchen tables and on lunch breaks calling insurers, tracking reference numbers, and trying not to cry in front of the person they love.

This is the context in which the Trump administration has introduced its own “innovation”: the WISeR model.

When Friction Becomes Policy: Trump’s Annoyance Agenda

The Trump administration has not only tolerated the annoyance economy in elder care; it has cultivated and expanded it.

One of the clearest examples is the WISeR model—a six-year pilot that introduces prior authorization into Traditional Medicare for certain outpatient procedures, using artificial intelligence and third-party vendors. Under WISeR, companies are effectively paid to identify and prevent “wasteful and inappropriate services”—a phrase that sounds technocratic but, in practice, means more layers of review, more opportunities for denial, and more hoops for elders and their doctors to jump through.

I explored these policy moves in more detail in my recent pieces on how the administration is weaponizing the system against elders and caregivers.

Physicians, advocates, and lawmakers have raised alarms because they have already seen how prior authorization works in Medicare Advantage and private insurance: it delays and denies care that clinicians believe is necessary. Extending that model into Traditional Medicare, with AI as an additional layer of opacity, would multiply the administrative burden on providers and patients alike. It would take an already complex system and add a new axis of annoyance—one that is difficult to contest because the decision-maker is an algorithm behind a corporate firewall.

At the same time, the administration has worked to weaken the very programs designed to help elders and caregivers cope with this burden:

• Cutting or eliminating State Health Insurance Assistance Programs (SHIPs), which guide older adults through Medicare choices.

• Dismantling Aging and Disability Resource Centers (ADRCs), which serve as one-stop hubs for long-term care navigation.

• Zeroing out Lifespan Respite Care, the only federal program dedicated to giving family caregivers a break.

• Proposing cuts to public health and aging services that provide information, outreach, and support.

The pattern is clear: increase the complexity and friction of access while removing the people and programs that help elders navigate it.

Layered on top of this is the administration’s broader agenda: massive Medicaid cuts that force states to tighten eligibility and reduce home- and community-based services; immigration crackdowns that drive away the immigrant workforce that provides much of the hands-on care; and wage rollbacks that keep home-care workers poor and turnover high. Each of these moves increases the time, energy, and emotional strain required for elders and caregivers to secure basic care.

This is annoyance weaponized—friction repurposed as a tool of control.

The Caregiver as Translator—and Shock Absorber

In this landscape, caregivers become the shock absorbers of the annoyance economy.

They are the ones who:

• Spend hours on hold with insurers, billing departments, and government agencies.

• Learn to navigate three or four patient portals, each with its own quirks and login systems.

• Translate every letter, notice, and denial into plain language.

• Sit with elders in the aftermath of yet another bureaucratic humiliation.

For someone like Paul, his life only “works” because a caregiver is willing and able to perform this translation. His desires are intelligible. His decisions are coherent. What he lacks is the ability to perform the digital and administrative tasks that the system now treats as prerequisites for being taken seriously.

Most elders are not so lucky. They do not have a paid caregiver who can spend hours on the phone. They do not have adult children who live nearby and have flexible schedules. They do not have a chaplain with the stamina to run the gauntlet over and over again.

Without a translator, they do not “join the digital age.” They quietly fall away. They miss deadlines. They stop refilling medications that now require portal access. They live with untreated symptoms because they cannot manage another call. They accept denials they might have successfully appealed because the process is too confusing or demoralizing to attempt.

The annoyance economy depends on this. It depends on people stopping insisting.

From Annoyance to Sin

Lowrey is right to argue that the government should protect people from an economy built on friction. It is not enough to scold individuals for being impatient or inattentive when the real problem is systems calibrated to wear them down.

But for elders and caregivers, “annoyance” is too mild a word.

From a liberation theology perspective, what we are witnessing is a form of structural sin: a system that quietly treats elders’ suffering as an acceptable cost of doing business. It is the deliberate organization of economic and administrative life so that time, confusion, and humiliation serve as tools of control. The annoyance economy shifts the burden of functioning onto those with the least margin—older adults, disabled people, low-income families, and overworked caregivers—and then blames them when they falter.

The Trump administration’s policies do not merely exist within this economy; they deepen it. By expanding prior authorization, cutting navigation supports, and making cost-saving an overriding goal even in elder care, they make it harder for elders to access the care they need and easier for institutions to say “no” without ever having to say it out loud.

In theological terms, this is a violation of the dignity of aging. It treats elders not as bearers of wisdom and memory but as administrative problems to be managed, discouraged, or quietly dropped.

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Elder Liberation in an Annoyance Economy

What would elder liberation look like amid an annoyance economy?

At minimum, it would mean:

• Rights without punishment: If an elder has a right to a benefit or service, claiming it should not require superhuman persistence. The default should be simplicity, not obstacle courses.

• Burden on institutions, not individuals: Agencies, insurers, and corporations should absorb the complexity, not outsource it to 95-year-olds and their caregivers. Processes should minimize learning, compliance, and psychological costs for elders.

• Multiple real access paths: Digital tools must be paired with fully functional non-digital options—mail that is actually answered, phone lines that reach humans, in-person offices that still accept cash. Apps should be one doorway among many, not the only entrance.

• Honest accounting of caregiver labor: The administrative work caregivers do should be recognized, supported, and, where appropriate, compensated. Policies should be evaluated not only on budgetary savings but also on the hidden time taxes imposed on caregivers and elders.

• Naming and resisting structural sin: Faith communities, advocacy groups, and policymakers must name the annoyance economy for what it is when it targets elders: a system of slow violence that erodes dignity and shortens lives.

Paul’s life only works because he has a translator. Most elders do not. If we are serious about elder liberation, we cannot be satisfied with teaching a few more people to use apps. We must insist on systems that do not require a permanent translator in the first place—and we must call out any political project, including the Trump administration’s, that treats the exhaustion of elders and caregivers as an acceptable price to pay.

The annoyance economy may be growing. It will become the horizon of possibility only if we let it.

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The Brennan Center coined the term “deportation-industrial complex” to describe the enforcement machine created by the One Big Beautiful Bill Act: $75 billion for ICE, $45 billion for detention facilities, $65 billion for CBP—all built on long-term contracts with for-profit prison companies, rapid hiring of 10,000 new officers, and financial incentives that create constituencies invested in perpetuating deportation at scale​. This apparatus poses an existential threat to America’s elder care system, and its harms fall disproportionately on caregivers of color and the seniors who depend on them.

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The Workforce at the Center of the Crisis

The direct care workforce that provides 80% of hands-on elder care services in the United States is overwhelmingly composed of women of color and immigrants​:

• 67% of home care workers are people of color, though people of color make up only 38% of the overall U.S. workforce.

• Black women are the most overrepresented group: they constitute nearly 30% of all home health aides while making up only about 6% of the labor force.

• Hispanic/Latino workers make up 26% of home care workers, and Asian workers account for another 9–14%.

• Immigrants make up 28% of the overall direct care workforce and 32% of home care workers specifically​. That share has been growing, up from 24% in 2018​.

• 42% of home health aides are foreign-born, more than double the national workforce average of 19%.

• Among unauthorized immigrant health care workers, 43.2% work in long-term care settings, compared to 22% of U.S.-born health care workers​.

• An estimated 15% of immigrant home care aides are undocumented, meaning thousands could be directly removed from the labor pool under intensified enforcement.

In short, elder care in America runs on the labor of women of color—disproportionately Black, Latina, Caribbean, and immigrant women working low-wage jobs with few protections.

How the Deportation Machine Directly Threatens Caregivers

Mass Deportation and TPS Revocation

The One Big Beautiful Bill funds the deportation of up to 1 million immigrants per year​. The Trump administration has simultaneously moved to end Temporary Protected Status (TPS) for immigrants from Haiti, Cuba, Honduras, Nicaragua, and Venezuela—stripping work authorization from roughly 350,000 Haitians alone as of February 2026.

The impact on elder care facilities is already tangible:

• Sinai Residences in Boca Raton, Florida—home to 500 seniors, including Holocaust survivors—is losing 9% of its staff due to TPS terminations for Haitian workers. Residents have offered to hide workers in their apartments. Some elderly residents, drawing on their own histories of persecution, are attending ICE protests.

• A nursing facility in Massachusetts fired 10 Cuban and Haitian workers after TPS ended and anticipates losing another 28 Haitian workers, representing about 9% of its total workforce. The facility raised wages by 10% to attract replacements, with the costs passed on to residents.

• Laurel Ridge Rehabilitation and Skilled Care Center in Boston expects to lose up to 10% of its workforce from certified nursing assistants with TPS. Its director said, “I’m not confident that I can fill those positions”​.

• One senior living director told the Jewish Telegraphic Agency: “There will be no caregivers in this country if our isolationist policies are all enforced”.

Rescission of Sensitive Locations Protections

On January 20, 2025, the Trump administration rescinded the protected areas policy that had shielded hospitals, nursing homes, schools, and churches from ICE enforcement since 2011. ICE can now conduct arrests inside healthcare facilities without restriction.

This has direct consequences for elder care:

• ICE has raided assisted living facilities, detaining residents and creating panic among both staff and patients.

• The Gray Panthers described an ICE raid at an assisted living facility as “a shocking display of cruelty” that violates the ethical obligation of healthcare providers to “do no harm”.

• Clinics in Southern California reported cancellations of up to one-third of medical visits and half of dental appointments due to fear of ICE.

• The Medicare Rights Center reports that immigrant workers—including those with green cards and naturalized citizens—are avoiding their workplaces due to fear of enforcement actions.

The Chilling Effect on Legal Workers

The deportation-industrial complex not only affects undocumented workers. It radiates fear outward to documented immigrants, naturalized citizens, and U.S.-born workers of color:

• LeadingAge, the association for nonprofit aging services, reports that foreign-born workers feel threatened even when working legally, creating “a chilling effect throughout the workplace”​.

• A certified nursing assistant born in the U.S. told NPR: “What difference does it make that I was born here? It boils down to your skin color and your surname”.

• Workers in mixed-status households—where some family members are documented, and others are not—are leaving formal employment entirely, either going underground into gray-market care or exiting the workforce.

• Providers report that some workers have simply stopped showing up, not because they lack papers, but because of fear.

• Some workers are “self-deporting”—leaving the country voluntarily rather than living in terror.

The Cascading Impact on Elders

Abandonment and Neglect

When caregivers disappear—whether through deportation, self-deportation, or fear—elders are left without essential daily care. The consequences are life-threatening:

• One home care worker described a client who, after losing her caregiver, “was left alone for so many days that she was wrapped up in her clothes with her own feces.” The woman was hospitalized. She told her caregiver she didn’t want to live anymore, and shortly afterward died.

• Harvard healthcare policy professor David Grabowski warned that a shortage of caregivers creates “hazardous situations, increasing the likelihood of falls or dehydration” and could compromise the quality of life and care for millions of seniors​.

• Without available caregivers, people who need care “will suffer alone and struggle to maintain their quality of life; some will lose their homes and be driven onto the streets.” Americans 50+ are the fastest-growing group experiencing homelessness, and that number is expected to triple in the next five years.

Institutional Collapse

The workforce losses are pushing facilities toward closure:

• LeadingAge’s president warned that a decline in immigrant workers “could force nursing homes and assisted living facilities to close certain sections or even shut down entirely”​.

• The direct care industry already had 80% annual turnover in home care and nearly 100% turnover for nursing assistants between 2017 and 2018, even before the current enforcement surge.

• Elder law attorney Harry Margolis explained: “If you cut the availability of caregivers by 10 percent … it’s going to create huge problems”.

Compounding Harm: Medicaid Cuts

The One Big Beautiful Bill not only funds deportation—it also imposes nearly $930 billion in Medicaid cuts over 10 years. This is devastating because:

• 63% of nursing home residents rely on Medicaid to pay for their care.

• One in five older adults gets health insurance through Medicaid, including 5 million enrolled in Medicaid expansion under the ACA.

• Many paid caregivers themselves rely on Medicaid for their own health coverage—nearly half of direct care workers use some form of public assistance.

• The bill imposes new work requirements for Medicaid for ages 50–64, creating additional burdens on older Americans with chronic conditions or caregiving responsibilities.

The result is a double blow: the workers who provide care are being deported or driven out by fear, while the funding that pays for that care is being slashed.

Racial Dimensions: Why Caregivers of Color Bear the Heaviest Burden

Structural Racism in Direct Care Work

The concentration of Black, Latina, and immigrant women in direct care is not accidental—it is rooted in the history of domestic labor, slavery, and racialized care work. Research from Portland State University traces a direct line from the exploitation of enslaved Black women to the modern direct care workforce, where Black women are overrepresented in the lowest-paid, most physically demanding caregiving roles.

Key disparities include:

• Black and Hispanic direct care workers have 2.7 times higher household poverty rates than white workers in the same jobs.

• Black Caribbean immigrant workers face 3.5 times the risk of job strain compared to white American workers in nursing homes.

• Black workers report significantly lower job control and are more likely to be segregated into less enriching tasks.

• Direct care workers of color frequently face verbal abuse and racism from residents and families, including refusal of care based on the worker’s race.

• Black caregivers spend 31.2 hours per week providing care, compared to 21.2 for white caregivers.

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How ICE Enforcement Compounds Racial Harm

The deportation-industrial complex intensifies these existing racial inequities:

1. Racial profiling in enforcement: Reports document ICE detaining legal U.S. residents based on appearance. A U.S.-born nursing assistant of Latino descent described being told his skin color and surname make him a target regardless of citizenship.

2. Mixed-status household vulnerability: Many caregivers of color live in families where immigration statuses vary. A worker with a green card may have a spouse or parent who is undocumented. ICE enforcement terrorizes the entire household, making it impossible to work without fear.

3. Employer weaponization of ICE: Documented cases show employers calling ICE on workers who organize or report labor violations, using immigration enforcement as a tool of labor control. This disproportionately affects workers of color in low-wage care settings.

4. Psychological trauma: Workers who witness raids or hear of colleagues being detained report panic attacks, PTSD-like symptoms, difficulty concentrating, and persistent fear—all of which directly compromise their ability to provide safe care to elderly clients.

5. Loss of community care infrastructure: In communities of color where both elders and caregivers are disproportionately Black and Latino, the deportation machine destroys care networks built on trust, cultural familiarity, and shared language​.

The Self-Reinforcing Machine

The Brennan Center’s analysis emphasizes that the deportation-industrial complex is designed to be self-perpetuating​:

• For-profit prison corporations operate nearly 90% of ICE detention and have strong financial interests in maintaining mass detention​.

• Long-term contracts for detention facilities, surveillance systems, and staffing lock in expectations for continued funding that will be extremely difficult to reverse​.

• The bill provides a $10 billion unrestricted fund that DHS can use to incentivize state and local law enforcement to participate in immigration enforcement, further embedding the apparatus​.

• Oversight has been gutted: the administration has dismantled DHS oversight offices and is defying congressional oversight efforts​.

• The rush to hire 10,000 new officers under relaxed standards—officers who don’t need prior law enforcement experience—risks creating a permanent enforcement corps with a culture oriented toward deportation​.

Meanwhile, the bill provides no funding for immigration judges to process the 4 million case backlog, no support for legal orientation programs, and no resources for processing lawful immigration applications​. The system is designed to detain and deport, not to adjudicate fairly.

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The Demographic Collision

The timing makes this crisis especially acute:

• 10,000 Americans turn 65 every day, a pace that will continue for the next five years.

• By 2040, the population aged 80–85—the group most likely to need direct care—will reach 14 million, a 111% increase from 2022.

• The direct care industry needs to add 860,000 new jobs between 2022 and 2032, the largest growth of any sector in the country.

• Yet the workforce is simultaneously shrinking due to deportation, fear, TPS termination, and now Medicaid cuts that reduce the funding that pays workers’ wages.

As SEIU Executive Vice President Leslie Frane put it: “The people who rely on Medicaid for care are working people, poor people, seniors, people with disabilities. They are among the most vulnerable people in our society, and they are the people that Republicans consider expendable”.

What This Means in Practice

The deportation-industrial complex threatens elders and caregivers of color through at least five converging mechanisms:

1. Direct workforce loss: Deportation and TPS revocation remove caregivers from the labor pool entirely.

2. Fear-driven workforce contraction: Even documented and citizen workers of color reduce their visibility, skip shifts, or leave formal employment.

3. Institutional destabilization: Nursing homes and home care agencies lose staff, close wings, raise prices, or shut down.

4. Funding collapse: Medicaid cuts remove the financial foundation of elder care simultaneously.

5. Structural entrenchment: The for-profit detention infrastructure creates financial and political constituencies that will resist any future effort to dismantle the system.

The elderly who are harmed are not abstractions. They are the 94-year-old grandmother in West Virginia whose Medicaid-funded nursing home faces a 63% funding cut. They are the Holocaust survivors in Boca Raton offering to hide their Haitian caregivers. They are the woman who was found wrapped in her own feces after her caregiver was taken away. And they are the millions of Americans who will turn 80 in the coming decade with no one to help them bathe, eat, or stay alive in their own homes.

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The health center called to let me know June wanted to talk to me.

June had been one of my regular attendees at the worship service I conducted at the retirement community. She was ninety-eight. A devout Christian woman. Someone who did everything she could to be a good Christian her entire life. She was a good wife. A good mother. Charitable. Cheerful. Kind. Forgiving. Humble. Grateful. Consistent. Persistent.

But when I reached her, she was desperate.

“I’m in so much pain,” she said. “I want to die. Please. Isn’t there anything you can do to help me die?”

June had been in the health center for days. Constant, unrelenting pain. She’d been telling her doctor for months. But the doctor had labeled her a complainer, a hypochondriac, possibly senile. He wouldn’t return her calls. Wouldn’t order tests. Dismissed her reports of pain as exaggeration, attention-seeking, the inevitable complaints of a very old woman.

“I’m ninety-eight,” she told me, her voice breaking. “I know I’m old. But this is different. This isn’t just aging. Something is wrong. And no one will listen.”

I explained that unless her doctor certified she had six months or fewer to live, there was nothing I could do for her—except listen. But I promised I would advocate for her. I would push for tests. I would make calls.

It took over a week. The doctor finally, reluctantly, ordered imaging.

Five broken ribs. A liver tumor had begun growing.

Suddenly, the pain wasn’t imagined. Suddenly, June wasn’t a complainer. Suddenly, the doctor was apologetic, evasive, and defensive.

They admitted her to hospice. Four days later, June died.

Four days. After weeks of suffering. After begging for help. After being dismissed, patronized, and ignored.

What Killed June

June’s death certificate probably said “natural causes.” Old age. Her time had come. But that’s not what killed June. Structural ageism killed June. Not individual prejudice alone—though her doctor’s dismissal was real. Not just bad luck or one terrible physician. Something deeper. Something systemic. Something woven into the fabric of our healthcare system, our economy, our culture.

Structural ageism is the systematic, institutionalized devaluation of older people embedded in policies, practices, and cultural norms. It operates invisibly, normalized, unquestioned—until someone like June dies because of it.

The word ageism was coined by psychiatrist Robert Butler in 1969. He defined it as prejudice, discrimination, or stereotyping based on age. In the decades since, ageism has been recognized as one of the most socially acceptable forms of discrimination—the last prejudice we openly embrace, laugh about, and encode into law.

Birthday cards mock aging with tombstone imagery and jokes about memory loss. The anti-aging industry is projected to reach over eighty billion dollars globally by 2030, marketing aging itself as a disease to be cured. Mandatory retirement policies remove people from the workforce solely on the basis of age. Our language normalizes decline: “senior moment,” “over the hill,” “one foot in the grave.”

Why is ageism so acceptable when racism, sexism, and homophobia are increasingly challenged?

Because everyone ages. We all internalize ageism against our future selves. We distance ourselves from the reality of becoming old as long as possible. We delay confronting our own mortality. And so we participate in the very system that will eventually oppress us.

Gerontologist Tracey Gendron identified three reinforcing levels of ageism:

Institutional ageism: Policies and laws that systematically disadvantage elders. Medicare reimbursement rates discourage time-intensive elder care. Crisis standards during COVID that explicitly deprioritized older patients. Nursing home regulations that allow chronic understaffing.

Interpersonal ageism: Individuals treating elders with patronizing speech, dismissal, and invisibility. June’s doctor was refusing to return her calls. Physicians talking to adult children instead of directly to elderly patients. Healthcare workers calling ninety-year-olds “sweetie” or “hon.”

Internalized ageism: Elders viewing themselves through ageist lenses, apologizing for their age, their needs, their very existence. June says, “I know I’m old,” as if that made her suffering less real, less urgent, less worthy of attention.

June experienced all three.

The healthcare system that underfunded her care and undertreated her pain was institutional ageism. The doctor who dismissed her as a complainer and refused to return her calls was exhibiting interpersonal ageism. And when June apologized for her pain—as if being ninety-eight made it less legitimate—that was internalized ageism.

June’s doctor wasn’t uniquely cruel. He was operating within a healthcare system that trains physicians to view aging as decline rather than transformation. A system that rewards efficiency over attentiveness. A system that normalizes elder pain with the refrain “What do you expect at your age?”

The doctor’s dismissal of June wasn’t a personal failure. It was structural sin—sin embedded in systems that crush people systematically, predictably, lethally.

How Structural Ageism Kills

June’s story is not unique.

Research shows that older adults receive systematically different healthcare than younger patients with identical conditions.

Pain is systematically undertreated in elders. Physicians assume that pain is normal in old age, leading to inadequate pain management even when conditions are acute and treatable. June had five broken ribs and a growing tumor. For weeks, if not months. Dismissed as complaining. Pain that would have sent a forty-year-old to the emergency room was treated as expected background noise in a ninety-eight-year-old body.

Therapeutic nihilism is the medical belief that aggressive treatment “isn’t worth it” for elders. Physicians are statistically less likely to offer curative treatment to older patients and more likely to recommend comfort measures without fully consulting the patient about their goals and values. The doctor decides what’s “appropriate” based on the patient’s age rather than the patient’s informed preferences.

If June had been forty-eight instead of ninety-eight, would her doctor have responded differently? The question answers itself.

Diagnostic delays are common. Symptoms are dismissed as “normal aging” rather than investigated. Cancers go undiagnosed. Treatable conditions are overlooked. By the time June’s doctor finally ordered imaging, her suffering had lasted far longer than it should have.

Clinical trials routinely exclude older adults, meaning treatments aren’t tested on the population most likely to use them. We prescribe medications to ninety-year-olds based on studies conducted on fifty-year-olds, then wonder why side effects and interactions are worse than expected.

Gatekeeping to hospice care requires a doctor to certify that a patient has six months or fewer to live. This requirement excludes elders who need palliative pain management but aren’t yet actively dying. June couldn’t access hospice until she was literally dying—denying her months of relief.

COVID-19: When Ageism Became Explicit

The COVID-19 pandemic exposed what had long been implicit in policy and practice: that elder lives were considered expendable.

Multiple states enacted Crisis Standards of Care protocols that explicitly deprioritized elders and people with disabilities. Triage criteria like “likelihood of survival” and “years of life saved” systematically disadvantaged older patients. An eighty-year-old and a forty-year-old with identical health status would be scored differently—the elder deemed less worthy of life-saving intervention.

Approximately forty percent of U.S. COVID-19 deaths occurred in nursing homes and long-term care facilities. Yet resources were directed elsewhere. Testing was delayed. Personal protective equipment was scarce. Staff were untrained, overworked, or simply absent.

Some facilities were locked down completely. Elders died alone—without family, without clergy, without anyone holding their hand. For their protection.

Media and public health messaging framed COVID deaths as acceptable if victims had “underlying conditions” or were “already old.” As if preexisting illness or advanced age made death less tragic, less worth preventing, less deserving of resources.

June died during COVID. She died isolated, in pain, dismissed by her doctor, denied timely hospice care.

Her death certificate might say “natural causes.” But the cause was structural ageism.

Nursing Homes: Warehousing the Surplus Population

June lived in a Continuing Care Retirement Community—a relatively privileged setting. She had resources. She had a chaplain advocating for her. She had attended worship services and maintained community.

And still, the system failed her.

For elders in nursing homes—disproportionately poor, disproportionately people of color, disproportionately without family advocates—the situation is often worse.

Before COVID, approximately 1.3 million elders lived in U.S. nursing homes. Seventy percent of these facilities are for-profit, prioritizing shareholder returns over resident care. Chronic understaffing is the norm: the average nursing home has fewer than one registered nurse per one hundred residents during evening and night shifts.

Government inspections routinely document widespread abuse and neglect. Psychotropic drugs are overused as chemical restraints to manage behavior rather than addressing underlying needs. Residents may go days without meaningful human interaction. [Ed. Note: See the Articles in the corresponding series, “Toward Caregiver Liberation,” for more on this subject.]

COVID made visible what had always been true: nursing homes function as warehouses for elders society deems surplus, unproductive, burdensome.

This is structural sin—not only individual cruelty, though that exists, but systematic devaluation of human beings based on age and disability.

It’s Not Just Healthcare—It’s Economic

Joan—a working-class organizer who witnessed her friend June’s death—has something to say about this.

“People think ageism is about attitude,” Joan says. “Someone being rude to you at the grocery store because you’re slow. That’s ageism, sure. But the real ageism—the kind that actually destroys lives—is economic.”

She ticks off the numbers with the precision of someone who has calculated survival for decades:

“The average Social Security benefit for women is $1,666 per month. For Black women, it’s lower—$1,538. Average rent for a one-bedroom apartment in most U.S. cities exceeds $1,200. That leaves less than $500 monthly for food, utilities, medication, transportation, and everything else.”

“You do the math,” Joan says. “The system is designed to make us poor. And when we’re poor, we have no choices.”

The economic architecture of elder poverty operates through multiple mechanisms, each reinforcing the others.

Mandatory retirement ages and age discrimination in hiring push elders out of the workforce before they’re financially ready. Social Security—designed as supplemental income, not as sole support—fails to provide a livable income for those who worked in low-wage jobs or took time off to care for family members. Basic Medicare’s gaps—no dental, limited vision, inadequate long-term care coverage—force elders to choose between medical care and other basic needs.

These mechanisms don’t affect all elders equally. Economic ageism compounds with racism, sexism, and disability oppression. Black and Latina women who worked for decades in domestic labor or service industries with no retirement benefits now survive on Social Security alone. Indigenous elders on reservations face both economic deprivation and geographic isolation from services. Disabled elders who were excluded from stable employment throughout their lives reach old age with no financial cushion.

The connection to death and dying is direct. Economic precarity strips elders of autonomy in end-of-life choices. When you can’t afford palliative care, when you’re terrified that dying will bankrupt your spouse, when the choice is between eating and medication, autonomy becomes theoretical. You don’t choose how to die based on your values. You choose based on what you can afford.

That’s not autonomy. That’s economic coercion.

Imagine if June delayed seeking care because she knew the copays would devastate her budget. If she didn’t fill prescriptions because the cost meant she had to skip meals. Then, when she finally collapsed and was hospitalized, her “choice” to refuse aggressive treatment wasn’t autonomous—it was shaped by fear of medical debt.

Then the system failed her twice: first through economic abandonment, then through medical neglect that was recorded as respecting her wishes.

Liberation Theology Calls This Is Sin

Liberation theology was born in Latin America in the 1960s and ‘70s, centered on one question: What does the gospel demand when people are systematically oppressed?

Gustavo Gutiérrez, author of A Theology of Liberation, argues four foundational points:

First, God takes sides. God is not neutral. God is with the oppressed, against oppressors.

Second, sin is structural, not only personal. Systems can sin. Policies can crucify.

Third, salvation is this-worldly, not only otherworldly. Liberation theology demands justice now, not only heaven later.

Fourth, the poor are theologians. Their experience reveals God’s truth in ways academic theology cannot.

Applied to elders, this means:

· God sides with elders who suffer under ageist systems

· Ageism is structural sin—not just individual prejudice but systemic evil

· Liberation requires structural change, not simply being nicer to old people

· Elders’ experience is authoritative. June knew her pain. Her testimony is a theological truth.

James Cone, another liberation theologian, insists that God is explicitly revealed in the suffering of the oppressed. Jesus’s crucifixion isn’t abstract doctrine—it’s God’s solidarity with the lynched, the tortured, the murdered.

Cone’s question: Where is the crucifixion happening today? Where are bodies being destroyed by systemic violence?

One answer: Elders abandoned in nursing homes. Elders denied pain relief. Elders dismissed as complainers. Elders triaged to lower priority during pandemics.

June, dying in agony after months of medical neglect, is among “the crucified people.”

Cone would say: God is with June. Against the systems that failed her.

What June’s Death Taught Me

June died four days after finally being admitted to hospice. Four days of appropriate pain management. Four days of dignity. Four days of someone finally believing her, listening, caring.

Four days. After ninety-eight years of faithfulness.

As her chaplain, I stood at June’s bedside those last days, and I learned something I hadn’t fully understood in forty years of ministry:

Elder testimony is authoritative.

June knew something was wrong. Her body told her. But the system—the doctor, the protocols, the age-based assumptions—demanded proof before her pain could be taken seriously. Liberation theology says the oppressed know their own oppression. June knew. We didn’t listen.

What would it look like to start there? To believe elders when they report pain? To trust that when a ninety-eight-year-old woman says “something is wrong,” something IS wrong—and our job is to find it, not dismiss her?

Therapeutic nihilism is a choice, not a medical fact.

When a doctor says, “At your age, aggressive intervention might not be worth it,” who’s deciding what “worth it” means? The elder? Or the system?

June wasn’t given choices. She was given assumptions. What if we asked instead: What do YOU want? What does a good life look like for YOU? What trade-offs are YOU willing to make?

Liberation theology says autonomy requires informed consent, complete information, and respect for the elder’s values—not the doctor’s, not society’s, not what some protocol says is “appropriate for your age.”

The system protects itself.

June’s doctor won’t face consequences. Dismissing elder pain is normalized, expected, legally defensible as “clinical judgment.” The system protects him.

I’ve thought about filing a complaint. Documenting what happened. But what would that change? One doctor, one case, in a system designed to produce exactly this outcome?

Liberation theology asks a harder question: How do we change the system itself? What would accountability look like if it weren’t just individual discipline but structural transformation?

Economic injustice shapes every choice.

Many “Junes” may have delayed care because they couldn’t afford the copays. They didn’t fill prescriptions. Their “choices” about end-of-life care were shaped by fear of bankrupting their families.

As I noted earlier, nursing homes are understaffed because for-profit models prioritize shareholders over residents. Medicare underfunds geriatric care. The result: inadequate care, burnout, abuse.

Liberation theology says you can’t separate healthcare justice from economic justice. They’re the same struggle.

Alternatives exist, but we have to build them.

June lived in a CCRC. She had resources. She still died in preventable agony.

What if there were elder cooperatives? Intergenerational housing? Community-based care models that honored autonomy and dignity instead of warehousing and medicalization?

These models exist in pockets—small, underfunded, experimental. But they show what’s possible when elders lead, when profit isn’t the motive, when care means supporting life rather than managing death.

Joan Gathers the Stories

“When I first heard about June’s death, I was at one of our monthly gatherings—a circle of elders who’d begun meeting to talk about what we never talk about: the systems that diminish us, the theologies that harm us, the changes we need to see.

“June’s chaplain came to our circle and shared her story with permission from June’s family.

“As I listened—and recorded, because that’s become my role in this work, gathering and preserving our testimonies—I thought about my neighbor Mary. Mary, who died suddenly at ninety-one. Mary, whom I barely knew.

“I wondered: Did Mary die like June? In pain, dismissed, invisible?

“I wondered: When I’m in my nineties, will a doctor believe me? Or will I be a ‘complainer’ too?

“But mostly I wondered: What would it take to build a world where June’s death couldn’t happen?

“That question has become the center of our work together.

“I convene these circles—bringing elders together to share stories, to name what’s been done to us, to imagine what liberation could look like. I listen. I record. I help us see the patterns in our individual experiences.

“Sister Agnes, who you’ll meet in the next article, calls me ‘the keeper of our collective memory.’ I think of myself more as a friend who takes good notes.

“Because June’s death wasn’t unique. Every person in our circle that night had a story—a parent dismissed by doctors, a friend who died in unnecessary pain, their own experience of medical gaslighting because of their age.

“We’re not waiting for someone else to fix this. We’re organizing ourselves. Naming what’s happening. Building alternatives. Supporting each other. Demanding change.”

June’s death was caused by structural ageism. And if we do not name it, resist it, transform it—we’re complicit in every June who dies invisible, dismissed, in agony.

This article is the beginning of that work. Our work. The work we’re building together.

The stories continue in the articles ahead. And I’ll be here, listening, recording, helping us remember—and resist.

Next: Article 3—Aging as Transformation: Beyond Decline

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Estelí, Nicaragua – March 1984

Half a block off the plaza, in a narrow alley where revolutionary slogans couldn’t quite reach, I saw her.

I was thirty-one, recently ordained, with a documentary camera and grand aspirations. The Sandinista revolution was tearing Nicaragua apart. I’d come with a three-person crew to document “the truth”—whatever that meant. We’d interviewed Contra commanders in Honduras, seen their well-funded military bases, and heard their certainties. Now we were in Estelí, filming bullet holes in the town square, recording B-roll in the rain.

She stood in the drizzle, middle-aged, clothes worn thin, shoulders slightly hunched. The alley smelled of dust, wood smoke, and standing water. This was where the revolution’s grand promises couldn’t quite reach.

I approached with my microphone raised—the stance of every documentarian who believes recording suffering shows solidarity.

I asked, in halting Spanish, what she thought about the revolution. Whom did she support?

She looked at me for a long moment, then past me, then down the alley. Her expression was neither angry nor resigned. Just tired. Present. Real.

“I don’t know,” she said at last. “Nothing that is going on will make a difference in my life. That all happens above me. I will never see improvement regardless of who’s in power. I will have to survive as best I can, no matter who is in power.”

Then she turned and walked away. Not hurried, not angry. Just done with me.

I stood there with my microphone hanging loose, still recording. The tape kept running. I could hear my own breathing on it.

At the time, I thought the interview was a failure. I thought I had nothing usable.

That moment, that single encounter, forever changed my ministry.

Her answer still haunts me forty-two years later.

She gave me everything I needed to understand liberation theology.

What She Taught Me

That woman—whose name I never learned and whose face I can still see—taught me three things I would spend the next four decades learning to understand.

First: Liberation theology that doesn’t start with the voices of the oppressed isn’t liberation—it’s ventriloquism.

I came to Nicaragua with a microphone, assuming I had the right to ask and she had the obligation to answer. I was documenting “the revolution” as if she were a supporting actor in a drama I was narrating. She refused the frame. “That all happens above me.”

Revolutionary movements, counter-revolutionary movements, North American documentarians—none of it touched her survival. What I’d called “giving voice to the voiceless” was often just my own shadow speaking in a more flattering register.

Second: Invisibility is structural, not accidental.

She wasn’t half a block off the plaza by chance. That’s where poor people survive—in the alleys, the margins, the spaces “above” which power operates and below which suffering accumulates.

The revolution happened in the plaza. She lived in the alley.

Until liberation reaches the alleys and addresses the granular reality of survival, it is not liberation. It is only a change of who sits in the offices.

Third: Survival itself is resistance when systems are designed to crush you.

“I will simply have to survive as best I can.” Not thrive. Not flourish. *Survive.*

She said it with such clarity, such dignity. She wasn’t waiting for Sandinistas, Contras, or North American clergy to save her. She was surviving despite all of us. That is its own kind of revolution.

From Nicaragua to the Bedside

I came home and, within a year, found myself serving as a chaplain in a retirement community in San Francisco. I did not immediately connect the woman in the alley with the elders in walkers, who slept in recliners because lying flat was too uncomfortable.

But over four decades, as I sat by bedsides and listened to life stories, I heard them say, in their own ways, the same thing she had said:

“Nothing I say matters. They decide what happens to me, not with me. I’ll survive as best I can.”

Robert, seventy-nine, when I asked if he wanted aggressive treatment for his cancer: “What I want? Nobody’s asked me. The doctors talk to my daughter, then my daughter tells me the doctors know best. It doesn’t matter what I want. It all happens above me.”

Diane, ninety-two, when adult protective services investigated her choice to live alone despite fall risks: “They say they’re helping me. But ‘help’ that takes away my choices isn’t help. I’ll survive as best I can, like I always have.”

James, eighty-four, finds himself in intensive care when doctors ignored his advance directive requesting no resuscitation should his surgery go wrong: “I told them. I wrote it down. I had it notarized. Doesn’t matter. They didn’t want my death recorded as a surgical accident! They’ll do what they’re going to do. I’m just the body in the bed.”

We are half a block off the plaza now.

At seventy-two, having spent decades walking with elders through dying, institutional confinement, medical paternalism, spiritual abuse, and the systematic erasure that our society calls “aging,” I finally understand:

Elders occupy the same structural invisibility as the poor woman in that Nicaraguan alley.

Power happens “above” us. We survive below.

And survival itself—insisting on dignity, autonomy, and voice when systems are designed to silence us—is resistance.

Why This Series Exists

This is a series about elder liberation theology—what it means to reclaim our dignity, autonomy, and voices in a society that treats aging as decline, elders as burdens, and our deaths as cost savings.

It draws on forty years of chaplaincy work with elders in retirement homes and long-term care facilities, grounded in liberation theology and enriched by Buddhist, Islamic, Christian, and Indigenous wisdom. It tells stories of real elders (with names and details changed) navigating structural ageism, medical paternalism, spiritual abuse, and the fight for autonomy at life’s end.

And it offers tools: theological reconstruction, contemplative practices, organizing strategies, ritual frameworks, and a manifesto for policy change.

This series is for:

Elders ourselves—reclaiming our voices and refusing the narrative that we are declining

Families and caregivers—navigating impossible choices in broken systems

Healthcare and spiritual care professionals—learning to walk with elders rather than managing them

Activists and organizers—building movements for elder justice

Anyone who will age—which is everyone who stays alive

What Makes This Series Different

1. Elders are the subject, not the object.

This is not a series ABOUT elders written by younger people. This is a series BY an elder, FOR elders, centering elder voices and agency.

2. Liberation theology applied to aging.

We treat ageism as structural sin—parallel to racism, sexism, and classism—and apply liberation theology’s tools to dismantle it.

3. Interfaith and multi-tradition.

The series integrates Christian liberation theology, Buddhist contemplative practice, Islamic wisdom on honoring elders, and Indigenous frameworks for elderhood as a sacred life stage.

4. Both personal and systemic.

We address inner work—shadow integration, mental attitudes, spiritual preparation for dying—AND systemic organizing for policy change, institutional accountability, and collective resistance.

5. We don’t shy away from the hardest questions.

When do elders have the right to refuse treatment? To choose the timing of death? How do we distinguish autonomous choice from despair? What about dementia—does personhood remain? We don’t avoid complexity.

6. Narrative-driven theology.

Real elders, real stories, real dilemmas. Theology emerges from bedside encounters in retirement homes, not abstract arguments.

7. We build community, not just individual spirituality.

This series is designed for circles—study groups, Base Ecclesial Communities, interfaith gatherings. Liberation happens collectively.

What’s Coming in This Series

Over the coming weeks, this series will unfold in seventeen articles:

Foundation (Articles 1-3): How structural ageism kills. Aging as transformation, not decline.

Theological Work (Articles 4-6): Deconstructing the “sacred lies” about aging. Rebuilding liberating theology. Testing it in the hardest pastoral moments.

Inner Transformation (Articles 7-8): Shadow work in late life. Mental attitudes that shape how we age and die.

Autonomy & Dying (Articles 9-11): Medical aid in dying, advance directives, and why autonomy requires justice, not just choice.

Community & Resistance (Articles 12-13): How to form elder liberation circles. Digital legacies and technology justice.

Intersectionality & Action (Articles 14-17): How ageism compounds with racism, sexism, disability. Guidance for professionals. The Elder Liberation Manifesto. Community voices respond.

Each article integrates story, theology, and practice—giving you not just analysis but tools for your own liberation journey.

An Invitation

I am seventy-two. I have spent forty years as a chaplain in retirement homes and long-term care facilities, walking with hundreds of elders through dying, through institutional violence, through the reclaiming of dignity in systems designed to erase them.

I have also walked my own journey—from that alley in Nicaragua to retirement home chaplaincy, from complicity in ageist systems to prophetic resistance, from isolation to the deep solidarity of elders committed to collective liberation.

This series is my offering to you:

Not a roadmap with all the answers.

Not a theology that resolves every tension.

But a companion for the journey—yours and mine—toward elder liberation.

The woman in the alley taught me to listen to voices from below, not proclamations from above.

So this series begins with a question, not a declaration:

**What does liberation look like for you?**

Subscribe, and let’s discover it together.

The series begins next week with Article 2: Structural Ageism in Healthcare and Society—how systems of power kill elders like June, and why “better care” is not enough.

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