Book Review
Dignity and Old Age
Robert Disch, Harry R Moody and Rose Dobrof (eds)
ISBN: 978-0-7890053-4-2 1998 xvi+178 pages Haworth Press, New York
Yvonne D Wells
Lincoln Gerontology Centre, Faculty of Health Sciences, La Trobe University, Bundoora VIC
Dignity and Old Age is one of a series of books which has been co-published simultaneously as the Journal of Gerontological Social Work (in this case, Volume 29, Number 2/3). It emerged from a conference on "Dignity and Aging", which brought together gerontologists and practitioners to examine the meaning of dignity and its implications for how we view old age and older people. The book contains 10 articles of varying length, complexity, and quality. There are two preliminary articles by Robert Coles and Harry Moody, followed by four articles on the meaning of dignity, and a further four on implications for practice and policy.
The book does not get off to a good start. The first chapter, by Robert Coles, is clearly an unedited transcript of a talk. The original talk was obviously amusing and touching. However, too many of the sentences are long, unfocused, and difficult to read. For example: "Some of the saddest moments I have, among a privileged group of students in this great university in Cambridge, Massachusetts, some of the saddest moments are when I sit with students and realise how little contact they've had with their own parents. That's one problem with grandparents: how little they know and therefore have been given." (pp.9- 10) Another criticism is that the chapter has little explicit connection with dignity. The word appears only twice in the text. Instead, the author tells a series of anecdotes about the importance of older people in developing moral and spiritual strengths in younger generations. The rest of the book is well-written. However, I found the chapters on the meaning of dignity difficult to process. This difficulty resulted partly from the way the word dignity is used in the book. Expressions like "It's all right to treat older people with dignity" (p.15) are troublesome. An older person may be treated with respect, or to preserve their dignity, but can one treat someone with dignity? I don't think so, and my dictionary didn't seem to think so either. Even more confusing, in Linda George's otherwise excellent discussion on the importance of not inflicting indignities on older people, is a sentence beginning "Ultimately, however, dignity is voluntary ..." (p.49). I enjoyed Robert Disch's discussion subtided "Aging Male Writers Confront the Medical System", but this chapter is about spiritual struggle. The word dignity barely appears, and when it does it describes an internal quality. Illness and the medical system confront the sense of dignity of the three men whose experience Disch reviews. In contrast, the chapters on practice and policy are engaging and challenging. Harry Moody's chapter is a discussion on the difficulty of balancing the ethics of truth-telling and courtesy, especially when a person has Alzheimer's disease. Truth-telling may pose an immediate threat to the dignity of a dementing person, but courtesy may undermine honesty in a relationship. Sid Arnasons's chapter is a discussion of the ways in which dignity may be threatened by the means-testing of entitlements. While the specifics of this chapter apply only to the United States, the general lessons are applicable anywhere in the Western world. Johnson's chapter on whether dignity is affordable contains a history of changes in public policy towards private provision and economic rationalism, and ends with a challenge to retirement policies.
A minor criticism of the book is that referencing styles varied between chapters. This book has a place in teaching applications of policies and ethics to older people. Selected chapters could be useful to gerontology educators, for example.
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