Saturday, August 5, 2006
My review of What Are Old People For?
William H. Thomas, M.D., author, describes himself as delighted with the practical, yet this is not a book in which to find practical application. It is a book of whys and wherefores. I found this frustrating at first. Once I realized, though, that he addresses the hows in other books I understood the importance of this one.
Dr. Thomas argues that industrialized society's fear and loathing of old age are both the cause and the result of our marginalization of old age. He proposes that we have become overrun by the "Cult of Adulthood", which:
Dr. Thomas also takes a middling stab at documenting and imagining prehistoric and historic elderhood and comes away with some provocative insights about why Nature favored the evolution of old age in humans. He recognizes that much of what we believe about traditional elderhood may be a construct of both nostalgia and myth but argues persuasively that both of these types of thinking must be founded in truth, a truth which argues that elderhood isn't simply to be indulged and/or appreciated for it's own sake but is a force for the development of a healthy childhood and a productive, sane adulthood, acting like weights balancing a scale. He believes that our marginalization of both childhood and elderhood have dire consequences for humanity's and our environment's survival and are at the root of our current frantic human malaise. Essentially, he says, by stripping childhood and elderhood of their natural power, the Cult of Adulthood has not only become all powerful, it has become dangerously powerful.
Dr. Thomas proposes that we must reinvent elderhood (and childhood, too, by the way), using what we know historically, what we imagine nostalgically and what we observe with newly opened eyes, of those characteristics of elderhood that we don't notice through our cultish eyes but which struggle to be recognized even as elders are discouraged, incarcerated and drugged out of expressing these natural characteristics.
Although there is much, much more theory than practicality in this book, I don't consider Dr. Thomas' vision overly romantic. I found his ideal descriptions of elderhood helpful and culled some workable practicalities from them on how to more involve my mother in our life together, including:
While I was still reading the book, one of my frequent site visitors expressed interest in what Dr. Thomas might have to say about dementia. Not much, I'm afraid. He does nod toward reinterpreting it as "the power of forgetting", an alternate understanding of and living with Time, etc. He encourages people to reexamine dementia as full of possibility rather than tragedy, but his encouragement lacks specificity or practical suggestion.
In his attempt to reframe our take on elderhood, his attitude is that it's silly to buck our society's and culture's inability to keep elders in our communities through family care. His primary focus is on the development of intentional, respectful elder care communities that include the residential elders in the initiation, evolution and maintenance of these communities in often surprising ways. His hope is that these communities (some of which are already in existence) can be nudged into the embrace of the larger, highly mobile, adult-led nuclear family community within which the elder communities exist. When he talks about this possibility, he is full of specifics and detailed in his criticism of current nursing home administration. This is the part of the book, in fact, that I found most inspirational in regard to changing a few things that I'm doing with my mother. I should note here that, although I'm confused about whether he is one of the originators of The Eden Alternative and The Green House Project, he has taken on both as primary causes and lends mighty support to their development.
He also has a fair amount to say about ideal vocational caregiving, based on his scathing appraisal of how institutional caregiving strangles the best intentions of motivated caregivers. He envisions a new type of caregiver, a "Midwife of Elderhood", whom he christens "shahbaz" within the context of a new story he tells about what caregiving is all about. New name or not, despite lack of practical detail of what this midwife does, his vision is not only enchanting but I found it mentally exhilarating. The only aspect of the shahbaz movement that bothers me is that he lists and congratulates, in his Acknowledgments, 37 "first shahbazim": 33 have obvious female names, 2 have obvious male names and 2 have names which are common to both males and females. I guess this is to be expected. After all, we aren't "there" yet.
This focus on the development of the above mentioned communities is so acute that there is little overt information which would be of use to people like me, who are living with Ancient Ones at home. I've been considering, over the last week or so while I've been reading this book, that what I'm doing is obsolete from the point of view of society (at least the culture within which it is assumed I live). He argues, here and there, that attempting to resurrect what I am doing on a society wide scale is akin to beating a dead horse. I understand what he's talking about. At times I agree with him. It's hard for me to accept, though, that the restructuring of societal thought implied in the development of his ideal elder communities couldn't also accommodate the possibility of bringing our elders into our homes and families felicitously, if that is an individual family's wish, without the adult members of this community having to risk everything, including livelihood, physical health and sanity.
Still, I'm glad I read the book. It explained some things in concepts that make sense to me. In roundabout ways, I got some ideas from it for improving the level of care to which I treat my mother. I feel a little more optimistic about the possibility of industrialized society one day fully embracing elderhood for what it is, rather than marginalizing it for what it isn't. I'm pleased that his visions for communities with an emphasis on bringing out the value of elderhood and respecting all of elderhood seem to be making inroads in our society, despite heavy opposition. This book reminds me of another inspirational, lightly factual book I read in the late 60's, Education and Ecstasy, by George Leonard. I remember, while reading that book, among others, including one Dr. Thomas cites in his notes, Summerhill by A.S. Neill, how sure I was that education would never be the same again and couldn't possibly get worse. I was wrong. We all were. I hope, forty years from now, someone isn't noting the same about Dr. Thomas' vision.
Oh, yeah. "What", exactly, "are old people for?" Before I read this book I'd considered this through a differently framed question: Why grow old and why nurture, to the best of our ability, those who grow old, regardless of what this may mean? My answer: Because we can. After reading this book, I think Dr. Thomas would agree with me.
Dr. Thomas argues that industrialized society's fear and loathing of old age are both the cause and the result of our marginalization of old age. He proposes that we have become overrun by the "Cult of Adulthood", which:
- Worships "the perfection of youth[ful adulthood]" above all;
- Elevates "DOING-being", the primary state of Adulthood, above "BEING-doing", the primary state of both childhood and what he refers to as "elderhood", thus plunging both children and elders into estranged circumstances and placing them at the ignorant mercy of Adulthood;
- Thus, the Cult of Adulthood considers childhood and elderhood states that must be either absorbed forward or back into Adulthood by any means possible, including encouraging children and elders to act, look and think like adults, or, failing this, incarcerated against the possibility of infecting the Perfect State of Adulthood.
Dr. Thomas also takes a middling stab at documenting and imagining prehistoric and historic elderhood and comes away with some provocative insights about why Nature favored the evolution of old age in humans. He recognizes that much of what we believe about traditional elderhood may be a construct of both nostalgia and myth but argues persuasively that both of these types of thinking must be founded in truth, a truth which argues that elderhood isn't simply to be indulged and/or appreciated for it's own sake but is a force for the development of a healthy childhood and a productive, sane adulthood, acting like weights balancing a scale. He believes that our marginalization of both childhood and elderhood have dire consequences for humanity's and our environment's survival and are at the root of our current frantic human malaise. Essentially, he says, by stripping childhood and elderhood of their natural power, the Cult of Adulthood has not only become all powerful, it has become dangerously powerful.
Dr. Thomas proposes that we must reinvent elderhood (and childhood, too, by the way), using what we know historically, what we imagine nostalgically and what we observe with newly opened eyes, of those characteristics of elderhood that we don't notice through our cultish eyes but which struggle to be recognized even as elders are discouraged, incarcerated and drugged out of expressing these natural characteristics.
Although there is much, much more theory than practicality in this book, I don't consider Dr. Thomas' vision overly romantic. I found his ideal descriptions of elderhood helpful and culled some workable practicalities from them on how to more involve my mother in our life together, including:
- involving her more in cooking preparation (I've already started this and it isn't nearly as painful as I thought it might be, considering that I am one of those cooks who doesn't want anyone else in the kitchen when I'm cooking);
- working to see to it that she has more exposure to children (and they to her; I'm going to seek permission for her to attend any children's story hours our library has established, not as a reader or "helper" but as a listener, so that she and the children are on the same level and can react to one another on equal footing in an only lightly controlled environment...I don't know if this will be allowed but it's on my list of things to check into next week);
- encouraging her more strongly than I have in getting out into our yard and enjoying the amazing natural habitat in which we live (I've managed to do this once this last week; instead of calling it a "walkering session" I reframed it as a survey of what we have and a brainstorming session on how we might want to encourage our property's advantages; it was a wildly successful trek and lasted about 45 minutes).
While I was still reading the book, one of my frequent site visitors expressed interest in what Dr. Thomas might have to say about dementia. Not much, I'm afraid. He does nod toward reinterpreting it as "the power of forgetting", an alternate understanding of and living with Time, etc. He encourages people to reexamine dementia as full of possibility rather than tragedy, but his encouragement lacks specificity or practical suggestion.
In his attempt to reframe our take on elderhood, his attitude is that it's silly to buck our society's and culture's inability to keep elders in our communities through family care. His primary focus is on the development of intentional, respectful elder care communities that include the residential elders in the initiation, evolution and maintenance of these communities in often surprising ways. His hope is that these communities (some of which are already in existence) can be nudged into the embrace of the larger, highly mobile, adult-led nuclear family community within which the elder communities exist. When he talks about this possibility, he is full of specifics and detailed in his criticism of current nursing home administration. This is the part of the book, in fact, that I found most inspirational in regard to changing a few things that I'm doing with my mother. I should note here that, although I'm confused about whether he is one of the originators of The Eden Alternative and The Green House Project, he has taken on both as primary causes and lends mighty support to their development.
He also has a fair amount to say about ideal vocational caregiving, based on his scathing appraisal of how institutional caregiving strangles the best intentions of motivated caregivers. He envisions a new type of caregiver, a "Midwife of Elderhood", whom he christens "shahbaz" within the context of a new story he tells about what caregiving is all about. New name or not, despite lack of practical detail of what this midwife does, his vision is not only enchanting but I found it mentally exhilarating. The only aspect of the shahbaz movement that bothers me is that he lists and congratulates, in his Acknowledgments, 37 "first shahbazim": 33 have obvious female names, 2 have obvious male names and 2 have names which are common to both males and females. I guess this is to be expected. After all, we aren't "there" yet.
This focus on the development of the above mentioned communities is so acute that there is little overt information which would be of use to people like me, who are living with Ancient Ones at home. I've been considering, over the last week or so while I've been reading this book, that what I'm doing is obsolete from the point of view of society (at least the culture within which it is assumed I live). He argues, here and there, that attempting to resurrect what I am doing on a society wide scale is akin to beating a dead horse. I understand what he's talking about. At times I agree with him. It's hard for me to accept, though, that the restructuring of societal thought implied in the development of his ideal elder communities couldn't also accommodate the possibility of bringing our elders into our homes and families felicitously, if that is an individual family's wish, without the adult members of this community having to risk everything, including livelihood, physical health and sanity.
Still, I'm glad I read the book. It explained some things in concepts that make sense to me. In roundabout ways, I got some ideas from it for improving the level of care to which I treat my mother. I feel a little more optimistic about the possibility of industrialized society one day fully embracing elderhood for what it is, rather than marginalizing it for what it isn't. I'm pleased that his visions for communities with an emphasis on bringing out the value of elderhood and respecting all of elderhood seem to be making inroads in our society, despite heavy opposition. This book reminds me of another inspirational, lightly factual book I read in the late 60's, Education and Ecstasy, by George Leonard. I remember, while reading that book, among others, including one Dr. Thomas cites in his notes, Summerhill by A.S. Neill, how sure I was that education would never be the same again and couldn't possibly get worse. I was wrong. We all were. I hope, forty years from now, someone isn't noting the same about Dr. Thomas' vision.
Oh, yeah. "What", exactly, "are old people for?" Before I read this book I'd considered this through a differently framed question: Why grow old and why nurture, to the best of our ability, those who grow old, regardless of what this may mean? My answer: Because we can. After reading this book, I think Dr. Thomas would agree with me.
