The Elderly as Modern Pioneers, SiIverman P, Bloomington, IN, Indiana University Press, 1988, 464 pages, softcover, $19.50.
Two themes unify this comprehensive lection of articles written by noted American gerontologists, anthrotologists, and psychologists. The first describes the elderly as modern pioneers in a rapidly changing society, just as pioneer life is difficult for these elderly who blaze new trails in the dark social web of a post-industrial society, to it is challenging for those who research, study, and care for the elderly. In some arenas, considerable knowledge has been gained, or networks of social support have been developed, to provide substantial frameworks for understanding. In others, the authors argue, the infrastructure of traditional American pioneer values actually contribute significant barriers to the efforts of developing socially acceptable responses to enhance healthy aging.
The second theme unifying this text is that aging can best be understood within the framework of the life course perspective. Thus, aging is viewed as a life-long sequence of growing up and growing old. Consisting of three sets of processes (biological, psychological, and social), the life course of individuals is affected by social and environmental changes. Most importantly, new patterns of aging can affect social change.
These themes help to unify the chapters of this scholarly yet highly readable text. The book progresses from biological issues to psychological topics and social themes. Given the use of the life course framework and the multiple dimensions of the study of gerontology, however, individual contributors address topics eclectically.
Several chapters are of particular interest to nurses who work with the elderly. "Biologic Theories of Aging" provides an excellent summary of the current state of understanding theories of genetic level, cellular level, tissue and organ, and whole body. "Personality in Later Life" identifies the primary issue on this topic that often confounds families and care providers: What is the degree of continuity or discontinuity in personality that can be found as the person moves along the life course? Preliminary research indicates that individuals who experience increased stress are more likely to change on a personal level. "Sex in the Later Years" summarizes the multiple physiological, psychological, and social dimensions that have an impact on the sexual health of older adults.
The last four chapters will be of interest to those working with the frail elderly or those requiring long-term care. "The Living Dead" convincingly argues that community-based care must be evaluated by criteria other than avoidance of nursing home placement. "Mental Disorders Among the Elderly" relates the development and evaluation of the first support group for Hispanic families who care for members with dementia of the Alzheimer's type. "The Institutional Segregation of the Elderly" describes the cultural framework of institutional care, identifying the ingrained values of lack of tolerance for helplessness and dependency as contributing to the long-standing adversarial relationship between nursing homes and the American public. Finally, "Death and Dying" offers a cross-cultural view of aging, dying, death, and bereavement.