Abstract
This inspirational book offers the insights of Martha Holstein, an accomplished gerontologist and ethicist, encompassing decades of reflection on how public policy, political ideology, gender, and aging all intersect. One of three books in the series Diversity and Aging edited by Toni Calasanti, Holstein’s subject is aging in an inhospitable society in which the prevailing culture presents us with an unrealistic dichotomy: either we are forever young and engaged, or we are frail and disengaged. She asks readers to consider how our attempts to position ourselves, and those for whom we care, on the non-old side of this dichotomy result in significant psychological, existential, moral, and practical distortions in our society and our lives. She invites readers to join her in becoming “fully age conscious” (p. 7) as she lays down a challenge to all, including and especially gerontologists, to acknowledge this limiting and unrealistic dichotomy and to disrupt it. Throughout this book, Holstein invites us to question and prods us to critically reflect on this dichotomy while insistently, yet compassionately, reminding us that this phenomenon is not only about older women, it is also about us.
Holstein draws on an eclectic mix of social and biological research, fiction, poetry, writings of older women, informal conversations with older women, and self-reflection as a 73 year-old woman and a gerontologist of 40 years. She, thus, brings to life the core feminist principle that the personal is the political, showing us that her own experiences and the lived experiences of others matter. Holstein also points to the influence of feminist standpoint theory on her worldview, explaining that our standpoint matters, because where we stand is what we see. Looking alternately through the lenses of political economy, public policy, and political ideology from the standpoint of non-elite women, she confronts our societal preferences for individualism, consumerism, and autonomy in the areas of health care, retirement planning and support, long-term care, and end-of-life care, and in so doing exposes the weaknesses in the social fabric that are created by our failure to acknowledge that caring for each other is relationally based. Holstein eyes the elephant in the room (the marginalization of older adults, particularly women), names it, and then tries to demonstrate how to lead this elephant from the room to create more space for all people to grow old more comfortably.
The book begins with an introduction that initiates the reader into Holstein’s worldview, explains the structure of the book, and sets out the three themes under which the content is organized: first, that old age is both a biological reality and an embedded experience—we are who we are now as well as all the ages we have ever been; second, that social injustices tend to emerge when economic and commercial elites set public agendas—depending on where we stand, we may see this more or less clearly; and third, the importance of reclaiming the state of being old as a time of life when we can be free of the expectations of others, including the expectation not to be old. In this chapter, Holstein also introduces her readers to five women who live in the affordable retirement community of Mayslake, a Chicago suburb. She informally conversed with these women over the 3 years she spent researching and writing this book. She weaves their observations and experiences into the text throughout the chapters, as well as gathering into the introduction what did not fit logically elsewhere.
The remainder of the book is organized into three parts. Part I, titled “The Body and Beyond,” focuses on the experience of inhabiting and adapting to changes in an aging female body as felt from within and from without in terms of encountering ageism. Chapter 1 focuses on the material, moral, political, and social meanings ascribed by society and ourselves to our aging bodies. Holstein reflects on how women often respond to societal norms that decry visible signs of aging, causing us to attempt to place ourselves and others on the “non-old” side of the societal dichotomy. Chapter 2 focuses on the many insidious fictions perpetrated by ageist attitudes and how these trap us into devaluing ourselves in our attempts to feel valued by an ageist society as we ourselves age. Holstein encourages readers to embrace the differences that come with aging, rather than denying them, and points out that our resistance to aging prevents us from telling the stories that have the power to change perceptions of aging over time. Chapter 3 unmasks a dark side to successful and productive aging that is highly thought-provoking. Holstein argues that by extending the norms of midlife to old age, we deny old age as a valuable state of being, and therefore make it less likely that it will receive the political and social support that is so vital to a good later life (especially for those who have suffered cumulative disadvantages throughout their lives). Chapter 4 addresses chronic illness, taking the view that we should not try to create categories or binaries that preclude us from successful aging simply because we are chronically ill.
Part II, titled “Aging Women in Contemporary Society,” presents Holstein’s view of a dystopian future with regard to long-term care, economic security in retirement, and end-of-life care based on the prevailing norms of autonomy, independence, and home-based care. Chapter 5 takes a look 30 years into the future and suggests ways we can avoid the marginalization of older women and men through the isolating forces created by an over-reliance on the ideology of independence, while not relying on outdated models of institutionalized care. Holstein urges us to recognize the relational nature of care and to seek imaginative, congregate models that do not institutionalize elders. Chapter 6 considers the potential for Social Security reforms and their role in helping older adults maintain basic living standards, despite political attempts to frame the issue as an unsolvable crisis. Holstein argues passionately that “hyperindividualism and meritocracy sliding into elitism” (p. 204) serve most older adults badly and that change is both possible and well overdue. Chapter 7 contains Holstein’s reflections on end of life care, including the poignant story of her friend Susan’s life while dying, and her own wishes for a good death. This chapter includes reflections on advanced care planning, hospice and palliative care, the culture of medicine, and how to spark cultural conversations about death and dying in a society that prefers to avert its gaze from this inevitable part of life. Part III, titled “I’m an Old Lady and Damn Proud of It,” is a call to action contained within a single chapter. Holstein rallies readers to “claim our own voices” (p. 238) so that we may articulate our experiences of growing and being old, and allow our voices and views to spill over into the arena of public policy making, so that they can become influential and informative in the way that currently is the province of scientific data and the political narratives of powerful elites.
Holstein’s book is very well referenced, providing an excellent resource for readers who are unfamiliar with gender perspectives on aging, and a solid reminder of the richness of the scholarly work amassed to date for those who are already acquainted with it. She provides a two-page literature review on women and aging, citing 24 works written between 1991 and 2013 that fill the interdisciplinary spaces between gerontology, political economy, women’s/gender studies, and ethics. Holstein acknowledges in her introduction that her focus is old women but that much of what she says is applicable to old men too. Her way of parenthetically highlighting this throughout the narrative results in a slightly awkward flow at times. In a similar vein, the mixing of perspectives at times results in a feeling of disjointedness in the narrative as the voices of the women of Mayslake are interwoven with Holstein’s own voice and voices from the scholarly literature. However, it is this dynamic interweaving of perspectives that provides such a rich reading experience and prevents a neat categorization of Holstein’s book, a result that is ultimately both refreshing and empowering.
For those who have questioned many of the tenets of modern aging as seen through the eyes of Western, neo-liberal society, Holstein’s book will be like a fierce and familiar longtime friend and advocate, raging against all that is wrong in the way we view aging while seeking our support to create a more just society. For those who have not adopted quite such a critical perspective on aging, this book will be eye-opening and mind-expanding, and perhaps the first step on a journey of discovery. Holstein’s work has the potential to create healthy discomfort, even for gerontologists, if we are more comfortable thinking of others—rather than ourselves—as old. She requires us to pry open some well-sealed doors, to look behind them, and to openly inspect our personal and societal norms about aging as a first step to re-shaping them. This is a book to read and reflect on, think deeply about, set aside, and come back to again and again. There is more in this compact volume than can be absorbed in one reading, and its reading should not be a solitary task. It cries out for debate and discussion, and it would, thus, make an excellent resource for instructors and students in social gerontology, ethics, women’s studies, and the psychology of aging. It should be considered required reading for all thinking gerontologists.