What a Major New Report Says About How America Can Age Better at Home

Here is a headline that deserves to be celebrated: even among Americans 85 and older, fewer than 10 percent live in a nursing home. The overwhelming majority of older adults — at every age — are living in their own homes and communities. That is one of the most quietly remarkable facts about aging in America today, and it is the starting point for one of the most important aging policy reports published in 2025.

The Milken Institute Future of Aging — a nonpartisan think tank whose advisory board includes leaders from AARP, Bank of America, the John A. Hartford Foundation, MIT AgeLab, and the TIAA Institute — released Longevity Ready: A Systems Approach to Aging Well at Home in November 2025. The report, the product of 40 expert interviews, a cross-sector roundtable, and comprehensive literature reviews, examines how America can better support the growing number of seniors who want to remain in their own homes — and lays out a clear, hopeful path forward.

Older Adulthood Is Now a 30-Year Stage of Life

One of the report’s most striking observations is how dramatically the landscape of aging has shifted. The average 65-year-old today can expect to live an additional 20 years. Older adulthood is now frequently a 30-year stage of life — longer than childhood, longer than most careers. The US population aged 65 and over is projected to grow from 61 million in 2024 to 82 million by 2050, and older adults already outnumber children in 11 states and nearly half of all US counties.

This is, as the report’s foreword describes it, one of society’s greatest achievements. But it also brings new responsibilities — and the central challenge the report addresses is what it calls the growing gap between lifespan and healthspan: the number of years lived in genuinely good health. Women currently spend an average of 14 years in poor health at the end of life; men, 11 years. The goal — and the opportunity — is to narrow that gap significantly.

What “Aging Well at Home” Actually Requires

The report identifies six interconnected dimensions that together determine whether a person can age well at home. It is not one thing — not just finances, not just health — but the interplay of all six:

The Preparation Gap — and Why It’s Solvable

The report is candid about how underprepared most Americans are for the realities of longer lives. Only 37 percent of older adults have looked for information about aging issues and available care options. Only 18 percent have modified their home to make it easier to live in as their needs change. And 58 percent mistakenly believe Medicare will cover long-term care costs — a misunderstanding that can have devastating financial consequences.

But the report’s primary message is not alarm — it is opportunity. The authors argue that this preparation gap exists largely because the systems, tools, and information that could help people plan are fragmented, hard to find, and rarely introduced at the right time. The fix is not asking individuals to do more on their own. It is building better pathways so that the right support reaches people when they are ready to act.

Five Opportunities That Could Change Everything

The Milken Institute identifies five specific areas where meaningful progress is possible right now:

The Good News Hidden in the Data

The report is notable not just for its rigor but for its tone. Despite the challenging statistics, it is fundamentally optimistic — and that optimism is grounded in evidence. Ninety-one percent of older adults agree that their healthspan matters more than their overall lifespan. Ninety-seven percent agree that being healthy means being able to do the things they want to do. These are not the attitudes of a population resigned to decline. They are the attitudes of people who want to live actively and well — and are ready to be supported in doing so.

The technology, the community models, the planning frameworks — they are all available. The Milken Institute’s argument is that what’s needed now is the collective will to connect them to the people who need them, before a crisis forces the issue. As MIT AgeLab Director Joseph Coughlin observed in the report, well-designed systems can ease the burden of choice and set smart paths in motion. The same insight drives the work at Journey Health & Lifestyle — connecting seniors to the right tools, at the right time, before they need them urgently.

Source: Milken Institute Future of Aging — Longevity Ready: A Systems Approach to Aging Well at Home (November 2025). Authors: Lauren Dunning and Jennifer Rossano. Research supported by Manulife. Advisory contributors include MIT AgeLab, AARP, TIAA Institute, John A. Hartford Foundation, Bank of America, and Johns Hopkins University.