by Edward H. Thompson Jr. and Lenard W. Kaye
Johns Hopkins University Press, 2013
Review by Christian Perring on Nov 12th 2013
At nearly 600 pages, this is a large book. It is divided into four sections, with a total of 23 chapters. The first section is on managing day to day life, and addresses what we often call wellness. It has chapters on staying active, eating well, healthy aging, stress, and relationships. The second section is about mind-body connections, and has chapters on sleep, appearance, spirituality, alcohol and drugs, and holistic medicine. The third section focuses on the body (sort of), with chapters on the heart, memory, diabetes, sexual health, bones, joints and muscles, teeth, eyes, and cancers. The final section is on relationships, with four chapters on sexual intimacy, retirement, caregiving, and end-of-life matters. Many of the chapters are co-written with experts on the relevant topics.
The question for potential users of the book is whether it is better than other sources. If you search for books on Amazon.com on healthy aging, you get a lot of results, and there are several books that this one competes with, although it seems to be the only one aimed only at men. It also seems that some of these books go out of print pretty quickly. There are plenty of websites devoted to healthy aging too, including the CDC, the Mayo Clinic, the NIH Medline Plus page, and WebMD. But the information in the book is far more detailed and useful than that on those websites. The fact that it is published by Johns Hopkins University Press in their "Health Book" series also may give the reader more reason to trust it. The authors are not themselves medical doctors; Thompson is a professor of sociology and Kaye is a professor of social work. Among the other contributors to the book is just one MD; others are academics and psychological therapists. So this is an unusual health book. It helps to understand that in the Acknowledgements, the authors explain that they take Our Bodies, Ourselves, and the companion volume Ourselves Growing Older. So this is a book that aims to put older men's health in a social and even political context, in a way that helps to empower men to take control of their own health. To some extent, it aims to speak directly to men's experience, and addressing men's needs in a way that books by health experts do not.
How does the books fare? The holistic approach is used all through, which is unusual for such guides. So for example, in the section on vision, the authors discuss normal changes related to aging, and then their first recommendation is for healthy eating to keep healthy eyes. They also recommend protecting eyes from the UV rays of the sun, and of course, smoking increases the risk of eye diseases. There are not the same sorts of considerations for all medical problems; the section on hearing problems does not point to any connection between diet and hearing. Oddly, this section does not mention tinnitus, even though the condition affects about 1 in 5 people. The section on vision and hearing losses does, however, mention the implications for mental health problems, since people with those losses are at increased risk for depression, anxiety, isolation and grief.
The chapter on body image is quite good. Men are obviously concerned with hair loss on their head, increasing amounts of gray and white hair, muscle loss, weight gain, and then "unexpected" hair, often most visible in the nose and ears. There are some solutions to hair loss, with treatments like Rogaine, although they have limited success. Men can dye their hair and trim off hair that they don't want. But as usual, the main solution to many of the problems of appearance is in eating well and getting exercise. The chapter gives a good perspective on appearance and discusses ideas in straightforward terms.
The chapter on holistic medicine is sensible. It takes a positive stance towards complementing traditional medicine with other approaches so long as they work, and it emphasizes using approaches that have evidence for their effectiveness. It discusses food, vitamins, supplements and herbs, and it points out the risks associated with some relatively untested treatments, as well as the benefits. Then there are rather descriptive sections on reflexology, massage therapy, chiropractic therapy, energy medicine, "non-contact therapeutic touch," Qigong, acupuncture, homeopathy, and Ayurveda. While it does not endorse any of these whole heartedly, it does say they have some potential benefits, and it does not dismiss them. That seems open minded and helpful, although it won't please all readers.
The chapter on sexual intimacy, though short, is one of the most interesting and provocative. Older men tend to get portrayed as inflexible and traditional. But as the chapter points out, as our bodies change, we have to learn to adapt. The authors are skeptical about the stereotypes of older males, and they explain that "Changing times and the lengthening of the individual life course would seem to be 'granting permission' to men to explore more fully emotional closeness and let go of the (sexual) performance anxieties that dominated our youth." (419) In a time when the sexuality of women and of gay, lesbian, bisexual, and transgender people gets a lot of attention, it is worth remembering that the sexuality of older men is also in transition. The authors explain that why there may be gender differences in emotional responsiveness, men still want connection in a relationship. While the sexual activity of older people does decline, they often remain sexually active. Sexual activity moves away from penetrative sex to kissing, hugging, touching and oral sex. Older people can explore their changing sexuality, and intimacy can become more intense in old age than it was in youth. It is possible for people to get better at managing conflict and achieve enduring closeness with age. So this chapter is far more optimistic and unconventional than most discussions which tend to focus on the use of drugs like Viagra for the treatment of erectile dysfunction.
In sum then, A Man's Guide to Healthy Aging provides a more unconventional approach than we might expect from a mainstream university press that tends to be associated with biomedical approaches. It provides not just information, which is probably available elsewhere, but also a distinctive way of thinking about the health of aging men. This book does not just reproduce the same information that is available in similar guides, and it should be useful to both men and their families in addressing their health problems.
© 2013 Christian Perring
Christian Perring, Professor of Philosophy, Dowling College, New York