With 35 million people in America now age sixty-five and older, "the old old" - those over 85 - are now considered the fastest growing segment of the U.S. population. While medical advances have enabled an unprecedented number of Americans to live longer and healthier lives, this new longevity has also had unintended consequences. For millions of Americans, living longer also means serious chronic illness and a protracted physical decline that can require an immense amount of care, often for years and sometimes even decades. Yet just as the need for care is rising, the number of available caregivers is dwindling. With families more dispersed than ever and a healthcare system overburdened, many experts fear that we are on the threshold of a major crisis in care.

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