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Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life    by Louise Aronson order for
by Louise Aronson
Order:  USA  Can
Bloomsbury, 2019 (2019)
Hardcover, e-Book
* * *   Reviewed by Rheta Van Winkle

Louise Aronson is a geriatrician who loves working with old people. She has written Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life in an effort to share her experiences and concerns about the treatment of the elderly by doctors, hospitals, and medical schools, and the lack of training that's being offered in the particular problems faced by people over sixty-five. Her book's subtitle summarizes what she has hoped to accomplish in writing this book.

It makes no sense to Dr. Aronson that at this point in history, when society is experiencing increasing numbers of people over the age of sixty-five, that medicine seems to have less concern for them than for younger adults. Most scientific studies of health issues don't even include the elderly, which means that their reactions to various medicines and treatments aren't necessarily the same as those of younger adults. Aronson points out that someone who is young-old in their sixties or seventies will probably have more physical and health problems but still possibly be normal old-old in their eighties, and will most likely be more frail by the time they reach their nineties. She would like to see the designation elderhood added to childhood and adulthood so that all adults from the age of eighteen to somewhere in the hundreds aren't lumped together under the term normal. Excluding the elderly from studies is only one problem, however.

Care is all-important, whether it's the care that a doctor gives a patient or care needed by someone who can't do all those usual activities necessary to living, such as walking, driving, acquiring food and preparing it, or even bathing and dressing. In the author's experience, many doctors don't want to have to deal with the advancing disabilities of old age because they see only the negatives and the gradual advancement toward death. She points out that spending time talking to her patients is rewarding because of their interesting life experiences, 'like getting paid to listen to excerpts of a long, captivating novel.' Too often doctors spend their brief patient exams staring at computer screens, looking for codes to put in the chart that detail the complaints rather than looking at and really listening to their patient's concerns. This is not the kind of care that anyone should expect from a doctor and particularly not someone in the last third of life.

The other important care can be called caregiving and includes helpful younger relatives, neighbors, friends, or people hired to help out in the home or in a nursing home, rehabilitation center, hospital, or retirement home. Even if it's necessary for a person to be in a facility, having someone watching over the inhabitant frequently means that they will receive better care. Aronson says, 'When asked the recipe for a good old age, I often give a list: good genes, good luck, enough money, and one good kid, usually a daughter.' An alert neighbor who notices when mail or the newspaper hasn't been retrieved or a concerned spouse can also mean the difference between life and death to an older person.

There is so much good information in this book that it's difficult to condense the most important ideas. For instance, the author discusses the problems of moving into assisted living or to be closer to family. The person who moves loses 'their social networks, familiar haunts, and personal history.' Although many people are able to form new relationships and interests after moving, others will become lonely and depressed.

Finally, Dr. Aronson would like old people to receive more respect and be treated with dignity and the same interest in how they feel and what they expect from their doctors as younger people. One should never generalize someone because of his or her age. 'As geriatricians are fond of saying: 'When you’ve seen one eighty-year-old, you've seen one eighty-year-old.'' I loved this book and only wish that all of my own doctors would read it and learn from it. More imagination in the care of the elderly is certainly warranted, especially now.

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