A midsize SUV with some good side steps (not those stylish step bars) would take care if ingress/egress issues. As for the Highlander/Pilot comparo. I own an MDX. I love it. It's large enough for all of the required duties it has to do, it's very comfortable and roomy. The MDX (Pilot) is wide, allowing 3 to sit in the back with ease. I have a car seat in the middle of the rear bench and one person can still sit comfortably on each side. The 3rd row is a joke, I can fit people there on occaision but it's not a comfortable place to be. Cargo room is very good (better in the Pilot because of the boxy rear) and the engine is very strong. The Highlander (and RX330) are also very good choices. I believe the Toyota sits lower to the ground so getting in and out may be easier. It's not as large as the Honda twins but it's still a very good size. I would have to say the Toyota engine/tranny is a bit smoother than the Honda and a little more nimble. It's the trade off you've got to take when you go with the larger Pilot/MDX. Both Honda and Toyota equip these things very well. If you have the budget and want the fancy doodads, the RX330 and MDX are the way to go. The Highlander and Pilot are good family haulers....the Lexus and Acura versions are that with a bit of gravy on the side.
Alternatives, Murano is a good idea, as is an FX35, a Volvo XC90, BMW X3, Cadillac SRX, and possibly look at a Land Rover LR3. I don't know what you are planning to spend but the sky is the limit really....if you are looking in the $40K range, the Toyota and Honda are hard to beat. Also another consideration is the station wagons.....Subaru Legacy, Mazda 6, BMW 3 and 5 series, Audi A4 and A6. Volkswagen Passat. Volvo V70. Saab Sportcombi. Lots to consider.