If you aren’t currently among the more than 46 million Americans over the age of 65, with any luck, someday you will be. That’s why geriatric physician Louise Aronson’s Elderhood, a passionate, deeply informed critique of how our healthcare system fails in its treatment of the elderly, is such a vitally important book.
As Aronson explains, American medicine is reluctant to acknowledge old age as a distinct stage of life—one with unique medical challenges but hardly lacking in opportunities for deep fulfillment. Whether it’s the failure, until this year, of pharmaceutical trials to test drugs on elderly subjects, resulting in unanticipated side effects, or the tendency to view the final years of an elderly person’s life only through the lens of illness and disability, our perspective is both shortsighted and flawed.
Another more profound flaw, Aronson argues, is our medical establishment’s stubborn insistence on treating organs and diseases rather than whole human beings, often prizing science and technology over simple, compassionate care. These efforts typically trigger costly late-life interventions that may be successful in the narrowest sense, prolonging life for a time but often inflicting physical and psychological pain on their recipients that severely compromises their quality of life. Aronson advocates for a new care paradigm, focused on the “optimization of health and well-being,” even when an earlier death may be the consequence.
Elderhood shares some of its DNA with Atul Gawande’s Being Mortal. But unlike the well-known surgeon, Aronson brings to bear some three decades of geriatric practice, a branch of medicine that didn’t even emerge as a specialty in the U.S. until 1978. She draws extensively on case histories, including moving stories about her father’s final days and her mother’s resilience in facing the challenges of old age. Aronson, who holds a master’s degree in creative writing, is as comfortable drawing on resources outside the field of medicine, quoting poet Donald Hall or novelist Karl Ove Knausgaard, as she is parsing a scientific study. Though the subject of this provocative book is the elderly, its message touches the entire span of human life.