Thanks for the kind and detailed feedback, I really appreciate it!
The clicking definitely seems to be a feature that was not very well liked. In hindsight it seems pretty clear now :D
I hadn't thought about the end condition though. I didn't end up working it in, but the elderly do "ascend" once they are off the top of the screen, so you don't have to keep them up forever forever, but the screen does fill up pretty fast. There's certainly something to be played with in terms of balance and making the game have more of an 'arch' to the experience.