Health Education Research, Vol. 17, No. 1, 138-139,
February 2002
© 2002 Oxford University Press
BOOK REVIEW |
Promoting the Health of Older People
Anthony Chiva and David Stears (eds) Open University Press, Buckingham, 2001 151 pp. ISBN 0 335 20438 4 (pb)
South Leeds Community Unit Day Hospital
There is perhaps something quite ironic about a book that continues a tradition of easy reading, in format, content and style, but has the reader (or the reviewer, in this case) reaching for a dictionary to check the second word of a title page. The contents, notes on contributors (impressive enough to whet the appetite), Series Editor's preface (Gearing), foreword (Tones) and acknowledgements all lead towards the Editors' opening gambit: `The proem to the next step in health generation'. Proem? A misprint of poem perhaps? Chambers dictionary revealed `...an introduction: a prelude: a preface...'.
One tiny esoteric slip, or a minor piece of pedantry (depending on one's perspective), should not cause this book to be underestimated or undervalued. Quite probably those charged with producing this continuing series of `Rethinking Ageing' textbooks could argue that by encouraging dictionary usage they are fulfilling an important part of their academic remit.
Chiva and Stears use this book to highlight the potential for holistic health promotion in the lives of older people. The first five chapters consider issues around the principles to practice. Wycherley's discussion of life-skills (from adaptation to transcendence) is relevant to those nursing and assessing older clients, while aiming to encourage accommodation, growth and management skills. The importance of producing a life review has never been more pertinent and the value of constructing a satisfactory life history needs no further recommendation.
Nash's chapter looks at issues of global integration and she is honest in her appraisal of the questions raised, where:
Frankl's search for meaning in life took place amidst the Nazi death camps, and it was within that most awful of contexts that he was able to transcend the daily grind, and even help others to find a reason for life. (p. 67)
Elsewhere, Nash effectively cites Berne, Festinger and Maslow.
The concluding six chapters are devoted to the practical issues of health promotion for older people. Again the majority of writers introduce historical perspectives, as when Walker points out that the concept of retirement is a 20th century achievement. The experiences that can be brought to volunteering and the importance of life-long learning projects are also itemized, along with other tangible benefits.
It falls to Davies to consider the issues of health promotion and sexuality. Her background, as a physiologist and lecturer, provides the breadth of knowledge to write factually about subjects often steeped in feelings of alienation—and which may be sidelined or relegated in importance. That she can write about issues such as incontinence, masturbation, isolation, lack of communication and embarrassment without embarrassment makes the chapter noteworthy.
In an atmosphere where liberal expectations have opened up topics of conversation, sexual behaviour of older people is, if not taboo, still potentially contentious. Nursing journal letters pages often return to the issue of how to advise clients about such matters. Concern still exists about how to discuss frustrations that could, in certain circumstances, possibly be perceived as encouraging prostitution, so it is important to note Davies' point that `boundaries are required to define misunderstandings which could arise' (p. 96).
The nature of nursing allows an interplay between the hypothetical and the practical, and few issues are more keenly debated than those arising from risk-taking policies. Allen moves the debate along nicely by citing the need to develop an innovative fall prevention strategy in a primary care setting. The research issues raised, along with the conclusions reached, are now being considered by our team and may well be introduced into our policy document in due course.
The importance of health promotion across the spectrum should never be undervalued or undermined by lack of knowledge or appropriate expertise. If an imbalance has existed previously in the care of older people this book goes some considerable way to rectify that failing. Any health professional working with older clients may question the perceived low profile of such a vital service within the NHS—this paperback raises topics and offers practical suggestions to go some way towards redressing the balance.
As indicated earlier, the format allows easy access to the subject of health promotion of older people. The identified target readership includes advanced undergraduate and postgraduate students of medical sociology, social work, nursing and health studies. The practicalities of health promotion are now more readily available for an increasingly professional workforce. Chiva and Stears' writers offer encouragement and motivation by their research and commitment. Self-empowerment is integral to the promotion of health and this book shows the way forward.
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