Health in Old Age Moyra Sidell; Buckingham: Open University Press; 1995; 178 pages
Much of this book was very practical and provoking. The first few chapters were somewhat slow reading, but the folowing chapters the primary focus in an interesting manner. The author, a Research Fello w /Lecturer at the Open University in the School of Health, Welfare, and Community Education, has a sensitive and knowledgeable perspective of health as related to older people.
The central framework of the book is Antonovsky's disease continuum. Every older person may be :ound somewhere along this continuum. An older person may have one or more physical problems, but still consider himself or herself healthy. In fact, studies report that older people often report their health to be good while objective data reveal multiple health problems.
Chapter 1 sets the stage by exploring many definitions of health from the literature. Chapter 2 explores older people's concepts of health and illness. Chapter 3 clearly describes and depicts in tabular form mortality and morbidity patterns in older people. Chapter 4, on the impact of chronic illness in older people, was short but served as preparation for the individual case studies in Chapters 5 (physical and functional) and 6 (mental). The life situations and chronic health problems of several individuals and couples were discussed in a very sensitive and clear manner with a summary of where they would be located on Antonovsky's health-easedisease continuum.
The final section (Chapters 7, 8 and 9) focused on formal health resources (physicians and hospitals), personal resources (hardiness), social support (family and friends), and future trends. Basic benefits and present and future problems of the National Health Service (NHS) of England were summarized. The NHS is nationalized and not socialized, as many perceive, because power remains with physicians and administrators. Satisfaction of older people with the system is high, although there are concerns about waiting time for appointments with physicians and levels of hospital staffing, not too different from the United States today.
A few general concerns should also be mentioned. The use of British terms (whilst) and spelling (behaviour) are obvious but not numerous. Also, all mortality and morbidity data, case studies, and health care delivery system issues (e.g., National Health Service) relate to the British Isles. However, comparisons with the United States are interesting and not too different in some areas. The bookbinding is not very secure and pages come out easily.
Overall, this short book provides a somewhat different and broader perspective of what health is in old age now and for the future.