Aging Out: An Exploration of Caregiving, Community, and How Americans Grow Old

by Lucy Schiller

A deeply personal investigation into the current state of eldercare and what it means to grow old in America

Unlike many other cultures, our collective stance toward older people in the United States has long been one of casual avoidance and neglect. This attitude became brutally clear during the height of the COVID pandemic, when too many people saw elderly deaths not as tragedies but as foregone conclusions.

Like many of us, Lucy Schiller experienced this callousness firsthand when her grandmother passed away during the pandemic. In the wake of this trauma, propelled by equal parts grief and curiosity about her own fear of aging, Schiller embarked on an investigative journey to understand why the prospect of aging is so frightening and how being “old” in America intersects with class, race, disability, and public policy.

From profit-driven networks of care facilities to systemic failures in economic support, the future of older Americans looks increasingly uncertain. In Aging Out, Schiller reports this crisis, sharing the human toll of inadequate housing, health care, and community, while simultaneously excavating her own complicated relationship with aging.

Combining the incisive reporting of Evicted with the beautifully rendered introspection of The Empathy Exams, Aging Out is an intimate and unflinching exploration of what it means to age in this country and why Americans—including Schiller herself—are so terrified of getting old.

Genres: Nonfiction, Health

272 pages, Hardcover

Published July 14, 2026

Reviews

[Adam‘’s book reviews · Rating 2 out of 5]

Aging Out: An Exploration of Caregiving, Community, and How Americans Grow Old by Lucy Schiller examines aging in the United States, focusing on caregiving systems, nursing homes versus assisted living, Medicare and Medicare Advantage, non-medical home care, and the role of lobbying and activism. The book combines personal narrative with broader discussion of how institutions and policies shape the experience of growing old, with most of the analysis centered on societal and structural issues rather than individual case studies.

I thought the strongest part of the book was the section on non-medical home care. That’s where the author actually includes interviews with older adults, and it felt more grounded and real. Outside of that, I didn’t enjoy the book. I felt like it stayed too broad and relied too much on the author’s perspective instead of showing how people actually experience these issues. The chapters were hard to follow, and the structure made it difficult to stay engaged.

I was also disappointed that the book spent so much time pointing out problems without offering solutions. I expected something more practical—like identifying issues and then showing what different communities, states, or organizations are doing to address them. Instead, it came across more like ongoing complaints without direction. By the end, I didn’t feel like I learned much beyond the basics, and it didn’t give me a clearer understanding of what could be done differently.

Overall, there is some useful information here, but the approach didn’t work for me. The lack of focus, limited real-world perspective, and absence of solutions made it frustrating to get through, and I had a hard time connecting with it.

Thanks to NetGalley and Flatiron Books for providing an advance copy.

[Stacey Sturgis · Rating 4 out of 5]

After speaking to my husband for about 20 minutes to sort my thoughts on this book, I feel finally ready to write a review.

Let it first be said that Lucy Schiller is a beautiful writer. She employs turns of phrase that make the pages simply sing in ways that are unusual for narrative nonfiction. I never thought I would find Pittsburgh a city that I wanted to visit until after I read her work. She paints vivid imagery for the reader and brings immediacy to the issues of aging, community and social justice for those affected by disability and infirmity at any age.

I think, at the end, that this could be have been fully successful as a memoir of her experience losing her grandmother and her subsequent recovery writing in Pittsburgh, with co-published essays or articles dealing with her aging research. It just didn’t gel together for me as a whole. The work is thorough, extremely well-grounded in scholarship. But it is undermined, in my estimation, by the disconnect from the emotional resonance of the rest of the work.

There is certainly much to be learned from what is written within this book, and I can recommend it to anyone working with older or disabled folks - social workers, community service providers, physicians, OT/PTs, nurses, and of course LTC and other facility staff.

Thank you to Flatiron Books and NetGalley for the early copy for review.

[Emily Amaral · Rating 3 out of 5]

I was besides myself to receive an ARC from Flatiron - Thank you! I'm an occupational therapist who works with geriatrics in a skilled nursing facility. As a result, the titular Aging Out has personal relevance and interest to me.

Lucy Schiller writes about "how younger people understand older people's material realities, the options available to them, and the choices they or their families made about housing." Accounts of elders residing in nursing homes, receiving home care programs, and even those incarcerated for life in prisons, were where the narrative really shone. Additional parts of the book I found interesting included explanations of some of the social programs for elders and how they came to be formed in the United States. AARP, Gray Panthers, for-profit, and privatized healthcare systems are discussed and Schiller attempts an objective examination of the role they may come to play in her own life.

Unfortunately I was less interested in the author's own anxieties about aging. Schiller writes- at length- about how "individualized the event of [her grandmother's] death seemed to have made her" and how she was "actively attempting to arrange [the facts] into a factual narrative that made some degree of sense." In this, she grapples. Schiller struggles to live in the moment; she excessively ruminates on the superficial quality of her relationships; she wonders why she's in Pittsburg. (Pittsburg is mentioned no fewer than 136 times.) I could not bring myself to care about her descriptions of various landmarks, street signs, and infrastructure she expounds upon while walking her dog. Schiller's account of her grandmother passing from COVID-19 was poignant and begs the question is a life longer lived worth less, when are are all humans being? Nevertheless, this was not marketed as a memoir, and as such, these passages went on for too long. I found myself tempted to skim them, hoping to read more about the elderly population she interviewed, volunteered for, and interacted with.

[Jamie Polivka · Rating 4 out of 5]

In the vein of Being Mortal, Lucy Schiller gives us a book that shines a light on all the injustices and hardships elderly folks live through.

It’s not a huge book, but does thoroughly examine questions such as: what is aging? When are people considered old? What is loneliness and how does it affect the elderly? She treats the elderly as a demographic and centers their humanity.

The book opens with her and her grandma moving into a house together with the author as her caretaker. Her grandma was previously in a retirement facility, but moved out because of Covid. If elderly are already halfway to death why did it matter if Covid shortened their lives? And thus goes the book.

Through the experience of assisting her grandma and through the experiences of other elderly people she came to know, she describes times when they slip through the cracks and the programs that hope to “catch” them. The differences of Medicare, AARP, buddy/“pal” programs, etc. I was introduced to the Gray Panthers and the discourse surrounding the aging incarcerated population. Things I had never considered, but now I’m concerned about.

Thank you to Schiller for writing a book on this important topic and to NetGalley and MacMillan Audio for the ARC.

[Ginger Hudock · Rating 5 out of 5]

The author is a writer and teacher specializing in non-fiction. This book looks at aging and how the aged live in nursing homes, senior living centers or on their own. One chapter looks at the founding of AARP and Medicare. This book is written from the perspective of a single, non-religious woman in her late thirties. Much of what is in the book looks at similarly single older people with no children, and considering aging and disability. This was a depressing book for me, but as a 65+ married Christian I know that this does not have to be the way. I am surrounded by family and friends and a church community that cares for all of its members. Read this book to learn about a segment of our society and how you might be called to be involved.
I received and advanced copy from the publisher via Net Galley.

[Dana · Rating 3 out of 5]

Wow, this book covers a lot! The author weaves the story of her grandmother dying from Covid and her grief over the death throughout practical details around long-term care, Medicare and much more.
I could really identify with the author’s beef around attributing Covid deaths in the elderly to “old age” - seems like a deception and I can understand her outrage. She does a great job of covering aging in general and the discrimination against older people. As an older woman, I frequently feel that invisibility that is often described. The book really goes into lots of detail about Medicare options. I think this information is useful for people just approaching retirement and Medicare age because there are so many factors to consider. It was a bit too much information for me as I am past this and not needing to make these decisions. So those parts of the book bogged me down some. But I still think that she presented good information for just the right audience.
I listened to the audio version of this book and the narrator was excellent.
Thanks to NetGalley and Macmillan Audio for the Advanced Reader Copy in exchange for an honest review. Opinions are my own.

[Lisa notes · Rating 3 out of 5]

Lucy Schiller blends her own experiences with a broader look at what it means to grow old in America. I appreciated the conversations she had with people who work in elder care, which offered interesting insights into the challenges of aging and caregiving.

The book was strongest when it focused on those bigger issues. Some of the personal stories about people and places in Schiller's life felt a little too long, and I thought the book sometimes drifted from its main topic. The organization also didn't quite work for me, though that may be just a matter of taste.

One clear takeaway is how much quality elder care often depends on having enough money—a sobering reality. Overall, I found the book informative, but I wished it had stayed more focused and gone deeper into the questions it raised.

[Haley · Rating 4 out of 5]

Aging Out is one of the rare non-fiction books that reads like fiction. I was entertained through out my time reading and felt I learned so much about how people are treated as they age in the United States. There was a lot of background from the author but it didn’t feel self indulgent or unnecessary; in fact all of the information we received helped to push the narrative along. I would recommend

[Lydia Wagner · Rating 4 out of 5]

Thanks to NetGalley and the publisher for the advanced copy of Aging Out. A clear-eyed overview of aging in America and how far we still have to go. The author blends personal stories with sharp reporting to paint a full landscape of the crisis.

[Lexi readingwhilehot · Rating 3 out of 5]

The writing and voice is literally exceptional, I just think the subject was too expansive for my preference. To explore aging was broad, and so ideas and stories mingled and swam together in a really beautiful way. It was like reading someone’s (perfectly executed) diary.

[Ray · Rating 3 out of 5]

ARC

This is important info and I think that it also needs a lot of editing.