| HOME | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|---|
| ||||||||||||||
BOOK REVIEW |
136 Farwood Road Wynnewood, PA 19096
The Cambridge Handbook of Age and Ageing, edited by Malcolm L. Johnson in association with Vern L. Bengtson, Peter G. Coleman, and Thomas B. L. Kirkwood. Cambridge University Press, Cambridge, UK, 2005, 744 pp., $110.00 (cloth), $55.00 (paper.)
The past half century has seen an explosion of scientific interest in the phenomenon of human aging and old age. We continue to be intrigued by basic questions about the nature of aging, its manifestations, limits, implications for the relationships between and among individuals and social groups, and for roles throughout the lifespan. Our quests have spawned a substantial literature, a wide variety of educational enterprises, private and public bureaucratic structures at federal, state and local levels, financial and economic programs and structures that affect fundamental distribution and allocation decisions at all societal levels. This scientific interest and its consequent outputs reach into every level and stage of how we live our lives throughout the lifetime.
The interest in human old age and aging, of course, is hardly new, nor is it peculiarly American. However, it is the scale of application of systematic scientific inquiry that renders this last half century different from earlier times. In addition, the technology of knowledge dissemination and consequently scholarly debate and instruction is having an increasing impact on how scholars, students, and journalists access the information and data they are seeking.
The Cambridge Handbook of Age and Ageing is a provocative addition to the substantial library of reference volumes on gerontology variously titled "encyclopedias" or "handbooks."
Encyclopedias are compendia of relatively short discrete articles on a broad field or topic embracing a wide variety of professional competencies and concerns, usually presented alphabetically (with cross references to other entries on related topics within the publications). Reference lists tend to be short, an expected result given that the articles are on narrow topics. Encyclopedias by their very nature of comprehensive coverage tend to be physically large and may be multi-volume publications
Handbooks are intended to be handy references, readily available and by implication portable. In the world of gerontology, and I suspect elsewhere, they are single volumes devoted to an arena of interest selected from the many that fall within a broader general topic. These topics are more closely explicated than in encyclopedias by articles under a limited number of general headings. The articles are generally substantially referenced.
Both encyclopedias and handbooks are intended for use by students and established scholars alike. Often, they are intended and do become the first stop on the way to preparing something further. As such, their reference lists and cross references to other articles or entries in the same volume are especially useful. Examples of both types of reference works published between 2000 and the end of 2006 may be found in Appendix A.
The Cambridge Handbook partakes of the characteristics of both encyclopedia and handbook. It seeks to embrace "Age and Ageing," but is organized like its eponymous predecessors. Weighing in at about four and a half pounds and 744 pages it pushes (or, perhaps, bursts through) the envelope as a "handbook." It is a collection of generally fine readings that have been brought together in a single volume. In that regard, it might serve as a text for an overview course. However, the Handbook is not intended nor organized as a general "textbook". Its organization into substantive chapters without ready links to common themes of theory, practice, policy, and other considerations does not assist students who do not start from the scheme of organizing gerontology utilized by the Cambridge Handbook. Students and scholars pursuing a particular aspect of gerontology might be better advised to narrow the search at the outset, addressing the broader treatment of a topic as presented in one or another of the handbooks.
The articles are typically accompanied by substantial bibliographies of print materials, a useful feature throughout. However, references to web-based or web-accessed material are rare.
Even beyond the question of how the volume can be usefully employed, the book prompts a series of questions regarding the central purpose and audience for the Cambridge Handbook, the uses for which it is likely intended, and then, in turn, the resources and technology now current in knowledge dissemination.
Purpose and Central Themes
The preface by the editor-in-chief, Malcolm L. Johnson, reflects the tension between presenting a source book that reflects the current state of knowledge, and offering a presentation of " ... the latest and most important developments in research, in a way which provides the reader with a body of concepts and ideas to shape interpretations of the ever growing resources of data and commentary" (p. xxiii).
This handbook has emerged from at least thirty years of effort to expand the scope of gerontological inquiry to include the worlds of economics, law, the arts, biography and oral history, lifespan psychology, gender, and moral economy. Johnson's long interest in the importance of theoretical grounding in designing public policy is evident in every section of the volume.
Historically, Johnson points out, "the core area of gerontology has been health" (p. xxiii). There have been and apparently continue to be "improvements" in life expectation. Good health is an essential component of a good old age. The international continued improvement in health "... reflects income, wealth, and education. So it is not surprising that health and its promotion has been the central arena of gerontology for the whole of its relatively short collective life" (p. xxiii). Examination of conference programs, literature, etc. suggests that the growing importance of research on the social features of life in old age has produced studies that are "overwhelmed by the weight of inquiries about illnesses ... and the interventions that ameliorate their consequences" (p. xxiii), and that has not changed in the last three decades. Johnson then goes on to observe,
What has changed is the nature of the focus on health, illness and its remediation [with] research more [heavily weighted with objective quantifiable data translatable] into scales, typologies and protocols for assessment and evaluation ... (a strong professional data base).. But, there is no parallel development in our conceptualizing. Theoretical work remains a remarkably neglected area of gerontological work. So the oft-repeated observation that gerontology is "data rich and theory poor is demonstrably still the case." (p. xxiii)
This is a sweeping conclusion, particularly given the publication of the Handbook of Theories of Aging (Bengtson & Schaie, 1999) To be sure, there are yet to be found agreed upon theories of biological and/or social aspects of aging, much less a unified theory that is all embracing. However, the theories handbook does suggest that whatever the shortcomings, conflicts, and shifting acceptance or rejection of theories, lack of attention to development of theory is not a reasonable criticism today.
What is reasonable is the observation that there is a serious disconnect between the worlds of practice and research so far as understanding and utilizing theory in the development of programs, policies, and techniques of intervention or prophylaxis in addressing the palpable problems that aging presents in different societies and social strata.
This conclusion is personal. As a planner, policy maker, and practitioner, I always regarded having a defensible theory to underpin whatever position I espoused as the sine qua non of my advocacy. This posture served me well in roles over more than half a century at both broad (i.e. national and state) population levels and individual "clinical" levels. As an administrator, public interest lawyer, and private attorney, I dealt with issues as broad as system reform and constitutional interpretation, and as narrow as assisting individuals in fashioning binding instruments for health care or end-of-life decisions, and determining competency or incompetency. Understanding and embracing a theory at the outset of an endeavor is a good strategy which I believe has served me well. However, we have not yet discovered the bridges that span the gulf between the researchers and the planners, policy makers and practitioners, nor the incentives which will bring the latter to the appreciation of theory and the former to an understanding of how theory plays out for the practitioner in the everyday politics of programs and practice.
This disconnect is not remedied in the Cambridge Handbook. In that regard it is not different from other basic reference works. However, its purported breadth and its organization are at odds; it is neither an encyclopedia nor a handbook.
Johnson acknowledges the push of government and private funders to produce biological studies designed to yield beneficial interventions to halt or ameliorate physical decline, clinical medicine studies to produce pharmaceutical and other medical interventions to deal with age-related illness and disability, and research regarding roles of health professionals and others in long-term care and techniques to support independence in late life (pp. xxiii-xxiv). He avers that prevention is better and cheaper than treatment—hardly a new idea—and believes that improved health of the elderly will be realized but strain societal support for pensions. "Nonetheless, this body of evidence and analysis has remained comparatively neglected by politicians and policy makers until market collapse with its dramatic impact on pension funds thrust the issue onto the public agenda" (p. xxiv).
He goes on to suggest a number of issues and concerns that, while addressed in the Handbook, still "await their day in the sun"—" ... the consequences of aging in Asia, Sub-Saharan Africa, and South America; death and dying in very old age; spirituality in later life; the ethics of intergenerational tensions at the macro and micro levels; the consequences of declines in cognition, memory and self-esteem in an ever more complex world; the role of inheritance in the personal, familial and national economy" (p. xxiv).
But having said that, Johnson, perhaps with a note of resignation, goes on to acknowledge that despite greater interest and attention to the "complexities of human behaviour" (as reflected in aging and old age), our preoccupation with physical health will continue to dominate both the nature of gerontological research and the availability of funds to carry it out. Almost wistfully, he looks to health researchers to lead the shift to a "human investment model" which we have previously called "health promotion."
Johnson wrestled with the vision for the Cambridge Handbook. Recognizing that the time had passed when one could achieve a single comprehensive sourcebook for gerontology, nonetheless, he undertakes to present the full range of contemporary knowledge and debate, "the latest and most important developments in research, in a way which provides the reader with a body of concepts and ideas to shape interpretations of the ever growing resources of data and commentary"[emphasis added] (p. xxiii). In other words, the undertaking sought the creation of a volume which would begin to serve as a source book for those shaping public policy at the broadest levels—education through the lifetime, social safety nets and social support mechanisms, law, ethics, macro- and micro-economics, and society-wide allocation decision making—and for those involved in carrying out those tasks, whether as administrators, clinicians, overseers, or educators. By any measure, this is a formidable goal, particularly in light of the current volume of reference books in gerontology, new information technology, and the inference of a broad audience which may reflect more hope than reality.
A review of reference works published between 2000 and the end of 2006 includes three encyclopedias of aging plus an encyclopedia of gerontology, three encyclopedias of death and dying, and ten other significant references in gerontology and geriatrics (See Appendix A). This listing does not include textbooks on gerontology. Without detailing the potentials for overlap, this burgeoning publication of reference works raises question about the added value that yet another brings to the field.
Organization of the Handbook
The Handbook consists of 72 articles arrayed in seven sections: Introduction and Overview, The Ageing Body, The Ageing Mind, The Ageing Self, The Ageing of Relationships, The Ageing of Societies, and Policies and Provisions for Older People. It also has a 62 page index. This organizational arrangement is intended to provide "the reader with a comprehensive view of the subject area, in the form of ‘state of the art’ chapters from leading authorities [representing] the major domains of debate and empirical enquiry." The material in each section is "offered in a relatively unstructured way. No attempt has been made to sequence or link the contributions as this would create a false construction of the way research and ideas proceed" (p. xxii).
And therein lies the dilemma of this work. It is a collection of articles, roughly grouped and insufficiently connected and related to make manifest the need for new directions required to bring about the resolution and reconciliation of whatever the theoretical deficiencies the field suffers from, or the issues or ways in which the "domains of debate and empirical enquiry" can somehow come together in more coherent fashion.
That said, some specific observations are in order on both those articles that represent worthy reviews of the state of the art, and notable omissions from the volume.
The Introduction and Overview, sets the agenda. Notably, Vern Bengtson, Norella Putney, and Johnson, in "The Problem of Theory in Gerontology Today," provide an overview of theories in aging that should be required reading for practitioners, planners and policy makers of every stripe, whether at the clinical level, or at legislative and judicial levels. This entry, together with the remaining articles—Andrew Achenbaum's broad essay on historical perspectives; Alexandre Kalache, Sandhi Barreto, and Ingrid Keller's article, "Global Ageing: The Demographic Revolution in All Cultures and Societies"; "The Psychological Science of Human Ageing" by Paul Baltes, Alexandra Freund, and Shu-Chen Li; and Thomas Kirkwood's, "The Biological Science of Human Ageing"—provides an underpinning for the articles that follow in all ensuing sections.
However, it is left to the reader to tie the Baltes, Freund, and Li article to Jutta Heckhausen's chapter, "Psychological Approaches to Human Development." This is more than a matter of organization. Heckhausen explores several models and/or theories of lifespan development, an area included in the Baltes et al. sweeping review of all levels of analysis of theories of aging. However, if these two chapters were somehow coordinated and related to Simon Biggs Chapter, "Psychodynamic Approaches to the Lifecourse and Ageing," social, political, and economic planners concerned with the consequences of an aging society and changes in dependency ratios would be better informed and better armed in addressing possible massive changes in lifespan education and training.
Other examples can be cited. In the opening chapter of the last section of the Handbook, Johnson undertakes an abbreviated view of the history of the social construction of old age as a problem. The subject matter deserves more than the seven pages devoted to it. A review which reaches across history from Biblical times to the present and across cultures from Asia to Europe cannot escape generalizations which can't hold up, even when offered with mandatory phrases that intend to acknowledge exceptions. In the context of history, Johnson cites the following as candidates for the "likely drivers of the next generation of re-definitions": Ageism, Family Care, Life Extension, and Work, Retirement and Income, adding that all are treated in more detail elsewhere in the Handbook (although that is not entirely the case). However, almost as an afterthought he allows that the above list is, by no means, exhaustive, and adds, with references to appropriate chapters, "the special circumstances of women, ethical issues arising from care decisions; end of life/human rights, Third Age identities and citizenship, generational equity, healthcare and long term care, extension of life, and the treatment of disabling conditions which define old age". And then adds, "Of equal magnitude is the explosion of older population in the developing world."
It is the explosion of research, thoughtful analysis, and enhanced understanding of the complexities that have joined to overwhelm the attempt to embrace them all within the confines of the Handbook. Despite explicit recognition of life extension as a major driving force of interest, the volume reflects none of the vigorous debate generated over antiaging research (see, e.g., Juengst, Binstock, Mehlman, & Post, 2003). Nor will one find very much of the changes in clinical practice of medicine, psychiatry, nursing, and social work reflected in this handbook, even though there are articles devoted to those professional areas. For those, seeking reflection on lived lives of the elderly, Jaber Gubrium's fine article, "The Social Worlds of Old Age," stands virtually alone. This is not surprising given Gubrium's leadership in explicating what daily experience is like in the journal, Ageing and Society.
The last section of the Handbook, Policies and Provisions for Older People, is of special interest to planners, policy makers, and practitioners. Following the introductory chapter by Johnson, there are 13 articles, seven of which are concerned with various elements of "care."
Individually, the "care" articles treat ethics, age as a criterion in rationing health care, nursing care, "social/long term care," long-term care, care to people in their own homes, and managed care in Great Britain. However, there are precious few descriptions of what "care" really means in terms of interactions between caregivers and the care receivers. The articles are more about general concerns about the concept than about what takes place—who does what and to whom, restraint use, behaviors and control by drugs, the nature of conversation, techniques of care, and so on.
Two of the articles in this section concern economics (roughly speaking): "Restructuring the Lifecourse: Work and Retirement", and "Wealth, Health and Ageing: The Multiple Modern Complexities of Financial Gerontology."
Two others address public policy explicitly dealing with an overview of health policy internationally, and public policy in ethnically diverse societies respectively. Finally, there is one article on adapting to new technologies.
Read individually, they are, in general, narrow treatments of material dealt with more extensively elsewhere in books or journal articles. There is no effort at synthesis or connection to other articles in the Handbook, notwithstanding Johnson's incisive preface, his article, "The Social Construction of Old Age as a Problem", and the first introductory article, "The Problem of Theory in Gerontology Today" (by Bengtson, Putney, and Johnson).
For some articles in the last section it seems that constraints of space or concept produced articles unseemly in their limitation. "Ethical Care Dilemmas in Old Age Care" (by H. R. Moody) has little of the breadth of concept, the elegance of scope, or the understanding of process of dealing with ethical dilemmas evident in his excellent text, Aging: Concepts and Controversies (Moody, 2002). "Adaptation to New Technologies" (by Neil Charness and Sara Czaja) is limited to information technology and computers. Apart from a single paragraph there is no recognition of the developments in assistive technologies ranging from motorized wheelchairs and modified automobiles, to communication boards, voice-activated mechanisms, prostheses for physical and sensory disabilities, various home modifications, etc.—all startling in their breadth, proliferation, and liberating aspects. These new technologies present issues of distribution, consumer knowledge and demand, financing, understanding "disability" in the context of health benefit designations, and legal entitlements and human rights. Many of these concerns track the issues raised in Johnson's article, not to mention implications in health care/social care, economics of healthcare, long term care, etc. However, the article confines itself to the fairly narrow area of computer technology and the degree to which the elderly adapt to computer technology. Even here, the exploration of the potentials for enhancing or diminishing social capital of the elderly (University of Sydney, 2006) is not dealt with.
Impact of the Medium
The new age of information technology and the changes in student and scholarly processes in research and information acquisition have changed the uses of print publication, the meaning of "up-to-date" and "state-of-the-art." The whirlwind development of the Internet; digitization of data; the accessibility of data bases and formal public documents (e.g. government reports, laws, regulations, records of various sorts, etc.); networked systems in universities and other commercial and non-commercial settings; and the ease of production, recording, editing, and exchange of information among Internet users have raised economic, legal, and ethical issues (e.g., easier plagiarism). Such issues include intellectual property rights; the legal and cultural definition of "publishing"; financing and economics of publishing; library, university and personal (e.g. student, faculty, commercial entity) budgeting and expenditure for various print materials, and, of course, the impact on the publishing enterprise in general.
Computers are now available in two out of three U.S. homes. More impressive and to the point is the extent of computer usage among children and the implications for how they will access information and data as they enter the roles of student and scholar. In 2003, 76% of all children aged 3 to 17 lived in a household with a computer and 83 % of the 57 million enrolled children used a computer at school (U.S. Census Bureau, 2006). Card catalogs at libraries are disappearing, research librarians' recourse to authoritative files is via the computer, and students and researchers are programmed to a facile compatibility with the computer and its access to the World Wide Web. How that programming is manifested may be a function of birth cohort differences.
My exposure to formal education as a student extended from 1930 to 1975 with some substantial breaks during that period. My bibliographic inquiry throughout that period was limited to print publications. All indices, catalogs, and similar reference tools were in hard copy form. My starting point was my text book, or the Book of Knowledge or Encyclopedia Britannica, or the library card catalog. I think I'm "hard wired" to those processes, albeit I have adapted to computer technology. But that is different from the "hard wiring" of those who have grown up with the computer and its utilities.
In preparation for this review, I queried a small number of college faculty, research librarians, and professional society personnel about their use of basic gerontology reference volumes and in the case of faculty their impressions about their students' (undergraduate and graduate) use. By no stretch of the imagination could this inquiry be regarded as anything but heuristic—and that might be stretching it a bit.
Nonetheless, the range of responses was informative. With reference to student use, response was almost unanimous that the student's first stop was a computer search. Faculty occasionally suggested use of one or another of "basic" reference works. Few faculty members, if any, used the reference books themselves. The most enthusiastic response was from those engaged in providing information about "experts" in this or that aspect of gerontology, citing the reference books as the best available ready resource for identifying such experts. None viewed the general reference books (i.e. encyclopedias by whatever appellation) as having significant archival value. Handbooks, in general, were viewed differently. They were regarded as useful compilations of specific aspects of gerontology—theory, social science, biology, etc. and are referred to as such and used as such.
The point of all this is to direct the attention of print publishers and libraries, universities, colleges, and faculty to recognize that the new technology requires some threshold inquiries in considering reference book publication: Does a reference book meet current standards of "latest available findings and data"? Does digitizing text make possible in a reference book electronic links to related articles? Does a reference work in print stay "up to date" and "current" using present print technology and timetables for updating? At the risk of raising forbidden topics, the debate about and increasing use of Wikipedia by students, scholars, and faculty suggests that open access references require serious attention (Agarwal, 2006; McHenry, 2004).
Given the pricing of reference books, does the cost/benefit analysis (including usage by students and researchers) suggest proportionality? How do we weigh the respective costs and benefits of subscribing to digitized "libraries" and purchasing enough copies of highly-used print volumes?
Without belaboring the point excessively, the development of the Public Library of Science (PLoS, 2006), an open access publisher of seven on-line journals, may be the canary in the coal mine of trade publication, starting with scholarly journals (Barbour & Patterson, 2006). The relatively recent (February 9, 2005) publication of the Policy on Enhancing Public Access to Archived Publications Resulting from NIH Funded Research (2005) is certainly a harbinger of significant change in open access publication and traditional print publication. These changes are certain to influence publishers, prospective editors, and prospective authors in their decisions regarding print publication of reference volumes. Review articles may find their way into web-accessed journals. Handbooks may be published both in print and in digital form with annual or more frequent updates available on-line or on discs. Publication finances may increasingly rely on page charges rather than book sales—shifting the cost on to research funding sources. Internal fiscal shifts within colleges and universities will occur, not to mention library architectural design and equipment specifications.
In the context of this review, one wonders whether this and other reference volumes are in the future of library reference sections, and if so, will they be similar to or different from the book in hand? This is not a baseless speculation. Already, more than 53,000 libraries utilize the services of the Online Computer Library Center "to locate, acquire, catalog, lend and preserve library materials." Its NetLibrary Division contains and makes available through multiple formats complete texts and abstracts of over 100,000 titles from hundreds of global publishers in various media including eBooks and eAudiobooks (NetLibrary, 2006).
We are the victims of our substantial successes of the last half century. Whether measured by the improved state of the elderly in the developed world, the achievements of research and the promise of more in the future, the numbers of well-trained, well-motivated toilers in the several vineyards of gerontology, and the vigorous pursuit of knowledge in so many areas of gerontology, the changes for the better are stunning.
But therein lies our perplexity. We have so increased the field, we have trouble seeing it all, and even parsing the sectors and how they relate to each other. But we dare not stop. Proceeding effectively will undoubtedly require much more than adjusting to new techniques of searching for information.
Perhaps we should begin to think about a "Scholars' Guide for the Perplexed Gerontologist," a guide which might include the following:
Appendix A
Basic Reference Books on Aging and Gerontology,Published 2000–2006
Binstock, R. H., & George, L. K. (Eds.). (2006). Handbook of Aging and the Social Sciences, 6th edition). San Diego, CA: Academic Press.
Birren, J., (2006). (Ed.). Encyclopedia of Gerontology, 2nd edition (two volumes) San Diego, CA: Academic Press.
Birren, J. E., & Schaie, K. W. (Eds.). (2006). Handbook of the Psychology of Aging, 6th edition. San Diego, CA: Academic Press.
Cassell, D. K., Salinas, R. C., & Winn, P. S. (Eds.). (2005). Encyclopedia of Death and Dying. New York: Facts on File.
Craik, F., & Salthouse, T., L. (Eds.). (2000). Handbook of Aging and Cognition. Hillsdale, NJ: Erlbaum Associates.
Ekerdt, D. J. (Ed.). (2002). Encyclopedia of Aging (Four Volumes). New York: MacMillan Publishing Co.
Hazzard, W. R., Blass, J. P. & Halter, J. B. (Eds.). (2003). Principles of Geriatric Medicine and Gerontology, 5th edition. New York: McGraw-Hill Co.
He, W., Sengupta, M., Velkoff, V. A., & DeBarros, K. A. (Eds.) (2005). 65+ in the United States. U.S. Department of Health and Human Services, National Institute on Aging and U.S. Bureau of the Census, Current Population Reports, Special Studies, P23-209, U.S. Government Printing Office, Washington, DC.
Howarth, G., & Leaman, O. (Eds.). (2002). Encyclopedia of Death and Dying. New York: Routledge.
Kastenbaum, R. (Ed.). (2003). Macmillan Encyclopedia of Death and Dying New York: Macmillan Publishing Co.
Maddox, G. L. (Ed.). (2001). The Encyclopedia of Aging, 3rd edition (two volumes). New York: Springer Publishing Company.
Masoro, E. J., & Austad, S. N. (Eds.) (2006). Handbook of the Biology of Aging, 6th edition. San Diego, CA: Academic Press.
Palmore, E., Branch, L., & Harris, D. K., (Eds.). (2005.) Encyclopedia of Ageism. Binghamton, NY: Haworth Press.
Schulz, R., L. (Ed.). (2006). Encyclopedia of Aging: A Comprehensive Resource in Gerontology and Geriatrics. New York: Springer Publishing Company.
Sri Kantha, S. (2004.) Elsevier's Dictionary of Gerontology and Geriatrics: In English, with Definitions and Japanese (transliterated and in Japanese Characters). Oxfordshire, UK: Elsevier Science Ltd.
Tallis, R. C., & Fillit, H. M. (Eds.). (2003). Geriatric Medicine and Gerontology 6th edition, London: Churchill Livingstone.
Yoon, H., & Hendricks, J., (Eds.) (2006). Handbook of Asian Aging. Amityville, NY: Baywood, Publishing Company.
References
| ||||||||||||||
| HOME | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|---|
