Ageing is often framed through the lens of independence, with a strong emphasis on not burdening younger family members. Little attention, however, has been given to how this framing reflects and reinforces age inequality by devaluing older adults relative to younger ones. Drawing on semi-structured interviews with 43 Italians aged 65 and older, conducted in 2018/2019 and 2022, we identify an orientation we term ‘altruistic ageing’ – a perspective that centres younger people’s needs by expecting older adults to adopt a selfless concern for others’ wellbeing. This orientation emerged in participants’ definitions of burden, which centred on receiving long-term or intensive assistance or co-residing with younger family members. These definitions reflected a privileging of younger adults’ time, personal freedom, social relationships and commitment to paid work. Altruistic ageing had consequences: It encouraged healthy behaviours but also narrowed acceptable long-term care options and constrained definitions of a ‘good death’. By unpacking the framing of older adults as burdens, our study reveals how age inequality operates through a culturally sanctioned ideal that morally justifies prioritizing the young over the old.

Over the next 30 years, the number of people aged over 65 will exceed the number of children worldwide. Moreover, people at extreme old age will constitute a significant group of older adults. Undoubtedly, global ageing appears as a great challenge to the whole international community in relation to the protection of rights of older persons, including their right to health. The last one is recognised on international forums as one of the most current and complex issues. Therefore, in this paper, I discuss how the right of older adults to health is protected by international norms, and identify trends and perspectives for implementing this right effectively. Examining the degree of protection, I analyse existing international instruments and their interpretation provided by international bodies. I consider that the new international developments should fill in the existing loophole in international law and oblige States to focus on elimination of ageism, age discrimination in access to health care and various barriers to enjoying the right to health by older persons.