The BGS Book Club Discusses Elderhood, by Louise Aronsen

Katherine Chin is an Academic Foundation Doctor at University Hospitals of Leicester NHS Trust. She tweets @KatherineChin18

What a lovely way to spend an evening! On November 17th, the BGS Twitter Book Club met to discuss our thoughts on the Pulitzer-nominated book, ‘Elderhood’, by US geriatrician Louise Aronson. We welcomed conversation from a range of participants, with input from medical students, a spectrum of health care professionals, and members of different spheres such as English Literature and teaching. We were also delighted to welcome the author herself! This was the second book club hosted by Charlotte Squires, the BGS Digital Media Editor. SAs with the inaugural BGS book club in September, it aimed to provide a platform for readers to discuss reflections and ideas generated from reading the selected book.

Our chosen book is a non-fiction work. Entitled ‘Elderhood: redefining Aging, Transforming Medicine, Reimagining Life’, it holds a rich history of geriatrics as a specialty combined with personal reflections on the author’s career, and on how care of older adults is often far from perfect. It offers an insight into how society views its older people and how with this knowledge, we can be empowered to improve the lived experience of this age group.

The book club discussion is held on Twitter and the thoughts of our participants can be followed by searching #geribookclub. The first question of the evening asked:

“What did this book have to say about how older adults are treated by society? Did you learn anything new, or change your perspective?”

A theme that Aronson revisits throughout the book is her concerns about the perception of older people in the US. She writes “we have created a society where we do everything possible to stay alive, yet dread being old.” Many members agreed that the usually unseen biases held by society may have become more visible through the pandemic. As said by one of our book clubbers, “the current pandemic has really highlighted the ageism already prevalent in society that Aronson refers to throughout the book.”

The suggestion was made that perhaps the stigma may stem from an unease with ageing because of a fear of death. It was agreed that the book challenges society’s preconceived perceptions of older people and it would be valuable reading for all healthcare professionals and healthcare students. By becoming more aware of stigmas, we are better equipped to tackle them. Our book clubbers mentioned that reading the book uncovered biases that they weren’t even aware they held, despite many working within this field. From discussions, it seems Elderhood prompted many of us to reflect on our own thoughts of ageing.

The second of our questions asked “What insights into the US healthcare system did you find on reading? Did it change your outlook on our NHS system?”

Our readers suggested that in the US, healthcare is more greatly focused on disease management and the role of the doctor to diagnose, as opposed to a person-centred approach, although it was a common consensus that the UK is far from being immune to the same attitude. There was also interesting discussion about care needs in contrast to medical needs and how the book suggested there may be an emphasis on the latter in the US system. It seems that Elderhood prompted us to reflect on why the term “non-medical” and “medical” are used and also triggered thanks for the NHS system, whilst noting that it is frustrating that services such as audiology and dentistry are not entirely NHS-funded despite being highly important.

Our third question asked “What qualities do you think healthcare professionals need to care well for older adults?”

What a comprehensive list of qualities the book clubbers compiled! I think we may have created the perfect healthcare professional in our responses. Suggestions from the group included empathy, patience, curiosity, humility, openness. We also discussed the importance of having the ability and awareness (and sometimes bravery) to ask a patient “what matters to you?”, in addition to being skilled at collaborative working. Interestingly it was suggested that an important quality is to be able to see someone as a person, which then prompted the question “is it harder to be seen as an individual when you’ve become old and frail?” This reminded me of the recent BGS blog published during OT awareness week, about how this discipline turns ‘patients’ back into ‘people’.

Our fourth question was “What do people need in order to age well? Does it change with generations?”

This was an interesting question that prompted numerous responses. Many book clubbers felt that having a strong support network was vital. Dr Aronsen writes ‘when asked for the recipe for good old age, I often give a list; good genes, good luck, enough money, and one good kid, usually a daughter’, although we felt that the gendered judgment did not reflect the family support we usually see. We also discussed the importance of feeling needed and having purpose. Going back to our earlier question it was suggested that if we as a culture were more accepting of ageing, then perhaps we would better at embracing the additional needs that may accompany it. Echoing some of the points from the book, participants reflected the crucial importance of having accessible infrastructures within society that are designed with older adults in mind, using examples of access to toilet facilities to manage incontinence, and public transport designed to support users of mobility aids.

Our final question asked “Dr Aronson writes about the role of technology in older adult care, including the potential use of robot carers or companions. Does this excite, amuse, or scare you, and why?”

This question got a flurry of replies. It seems that on the whole people instinctively felt that human touch and company could not be replaced by technology and there were a lot of responses of being mostly uneasy about this concept There were however interesting examples of robot animals being used for therapeutic purposes and discussion about the potential role for virtual reality in the future (look up “Paro the seal robot” for a very cute example). We also wondered if different generations might react to these developments differently, depending on what they are used to.

That rounds up the summary of our book club discussing ‘Elderhood’ by Louise Aronson. Thank you to all who attended and thank you, Louise, for writing such compelling and thought-provoking book.

If you want to view the discussion in more depth, just look up #geribookclub on Twitter for the full conversation.

Join us again for our next book club on Tuesday 12th January at 8pm, where we will be discussing Richard Osman’s ‘Thursday Murder Club’. Everyone is welcome regardless of whether you have finished the book or not; all that is needed is access to twitter and nimble thumbs for the lively discussions! We look forward to meeting you.