Health Education Research, Vol. 17, No. 1, 139-140,
February 2002
© 2002 Oxford University Press
BOOK REVIEW |
Promoting Health in Old Age—Critical Issues in Self Health Care
Miriam Bernard Open University Press, Buckingham, 2000 196 pp. ISBN 0-335-19247-5 (pb)
South Leeds Community Unit Day Hospital
Bernard is Head of the School of Social Relations and Professor of Social Gerontology at Keele University. Those bald facts establish her suitability to produce this important volume in the Open Universities expanding Rethinking Ageing series. What makes this book particularly noteworthy is that she has produced it herself—quite a remarkable achievement.
In the Preface the point is made that this is `a synthesis of both practical experience and academic endeavour' and equally pertinent is the acknowledgement of her parents' roles in the development of the issues: some of her late father's photographs are used here.
While the production of Promoting Health in Old Age might have been a long process, the reader is not aware of any detrimental concerns—the feeling is closer to being led gently along, as the themes evolve and are duly considered. Against the backdrop of a steadily ageing population, it is worth remembering that the majority of older people live active and healthy lifestyles. It could be argued that people are less inhibited and more adventurous as they move beyond pensionable age, and often seek to fulfil long-planned projects.
Last century the nursing press reported that a septuagenarian `took to the air in a motor driven glider' and also participated in `abseiling and canoeing events' (In focus news, 1997/8), and those exploits, although noteworthy, are perhaps less exceptional nowadays.
Bernard's writing style is both adept and adroit, and her keen interest in the development of her studies is palpable. That this project has been 15 years in preparation is also a compliment to her dedication and stamina.
Against this backdrop singular comments stand out: as when `the recognition that there is scope for older people themselves to improve their health has been a long time in coming' (Introduction) and of the `keen interest exhibited by many older people in maintaining their own health' (p. 71).
Perhaps understandably, one of the most indexed terms is `empowerment' (with 12 references) and its importance to health care professionals is not underestimated here.
The question of why self-care issues have often been neglected when considering later life is addressed. The critical discussions are so freshly presented as to hint at extemporization—although that sense of spontaneity comes as a result of the passion for the subject, rather than through inspired improvisation at the keyboard.
The enormity of the undertaking is reflected in the overview, where literature from health education and promotion, self-help and self-care, and gerontology are synthesized to evaluate both research and developmental topics.
Chapter 4 is of particular importance to mental health nurses. By drawing on information from studies in Canada (the Century House project), issues about `mental fitness' are categorized. In general, the feedback received from various participants appeared to be highly favourable. That section also draws on details from undertakings in America, England and Israel.
By developing networks where participation, accessibility and informed choice are valued options for older people, Bernard is revitalizing an integral part of health promotion. Whether this book is a response to changing circumstances or the result of an evolving concern is fairly immaterial, for the issues have needed addressing for some considerable time.
The format of this paperback shares many similarities with other highly readable Rethinking Ageing textbooks. Putting aside the questionable ethics of recommending involvement in the national lottery, one could almost agree with an unnamed Nursing Times reviewer who, risking odds of 14 million-to-one, would consider buying a full set of these books in hardback (inside cover).
Fortunately, Bernard does not suggest such an idea to the client group under consideration. I suspect that most readers will find this paperback beneficial because of its lack of preciousness. Hardbacks may be bought to treasure, or even as an investment—retail prices would seem to encourage this trend—but textbooks need to be studied, discussed and argued over.
While readily accepting that Bernard has moved the debate forward considerably, the points made here should provoke much thought from the identified target audience.
I have remarkably few reservations about recommending this to all of the students or practitioners thus categorized by the Open University marketing department: those planning and delivering services alongside gerontology, nursing, medicine, social work, social sciences and women's studies students.
Technically, those diverse categories should emphasize the nature of this book—but its real value is that it may well become an inspiration for health care professionals. Those who aspire to higher profile professions sometimes underestimate health in Old Age. This is an important resource—not so much an introduction, more of a mission statement.
References
In focus news (1997/8) Elderly Care, 9(6), 5.
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