The real crisis facing Puerto Rico is the lack of systems to support elder care, not the fact that the island is aging, José Roberto Acarón, state director of AARP Puerto Rico, said in remarks filed Oct. 22.^[1] He pointed to a sharp shift in the island's population. Puerto Rico's old age index climbed 41% over a five year period.^[2] Acarón's framing moves the question away from the number itself and toward what gets built around it. By his account, the figure is less a problem on its own than a measure of how far behind the care systems have fallen.