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The Forgotten Middle and Why They Matter
The Forgotten Middle and Why They Matter

Navigating the Forgotten Middle: Understanding the Future of Senior Care


The concept of the "Forgotten Middle" in senior care is gaining significant attention in gerontology and public policy. This term refers to middle-income seniors who are often overlooked in the discourse about elder care. They neither qualify for government aid due to their income nor can they afford high-end private care. As a leading expert in longevity and seniors, my research aims to shed light on this group's unique challenges. Here are three key aspects everyone should be aware of regarding the Forgotten Middle and the future of senior care.


1. The Expanding Demographic of the Forgotten Middle

The Forgotten Middle is growing rapidly. A study by NORC at the University of Chicago in 2019 estimated that by 2029, 54% of the 14.4 million middle-income older adults will not have sufficient financial resources to pay for yearly assisted living rent. This alarming statistic highlights the urgent need to address the care needs of this group.


2. The Housing and Healthcare Gap

Affordable housing and accessible healthcare are two critical issues for the Forgotten Middle. A Health Affairs study revealed that middle-income seniors are often caught in a bind: they earn too much to qualify for subsidized housing or Medicaid but can't afford high-cost care options. This gap creates a precarious situation for millions, risking inadequate care and housing insecurity in their senior years.


3. Policy and Market Solutions

There's a growing call for policy interventions and market innovations. As noted in a 2020 article in The Gerontologist, there is a significant opportunity for the private sector to develop more affordable senior housing and care options. Additionally, policy reforms are needed to make long-term care insurance and other senior services more accessible and affordable for this income group.


The Forgotten Middle represents a looming crisis in senior care. Without adequate attention and action, millions of middle-income seniors may face a future without appropriate care or housing. It's imperative for policymakers, healthcare providers, and private sector leaders to collaborate in creating sustainable solutions that address the unique needs of this growing demographic.

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