In the United States, social policy debate concerning the elderly has, for almost two decades, been permeated by the rhetoric of crisis and attacks on the entitlement programmes that provide the backbone of support for older persons. Based on demographics alone, with older women outliving and outnumbering older men, ageing is appropriately defined as a gender issue and, in important respects, a women’s issue. Corroborating this view, Dr Robert Butler, former director of the National Institute on Aging, recently described the U.S. health programmes for the elderly, Medicare and Medicaid, as ‘women’s programs’ for the very old (Butler, 1996).