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How We Age: A Doctor's Journey into the Heart of Growing Old

As anyone who has ever cared for an elderly person can attest, time takes its role in the aging process very seriously.  For caregivers, be they family members or medical professionals, finding a way to maintain their charge’s physical, mental, and emotional health in their waning years can be an immensely tough row to hoe.

In his newest book, How We Age: A Doctor’s Journey into the Heart of Growing Old, Marc E. Agronin, M.D., takes a different view than you are accustomed to reading about with regard to caring for the elderly.  His belief that “aging equals vitality, wisdom, creativity, spirit and, ultimately, hope” is a refreshing departure from those who concentrate primarily on what the elderly cannot do.

How We Age provides a look at various aspects of aging in five parts, beginning with how science understands it and how, psychologically, it is imagined and experienced.  After we meet Dr. Agronin’s most memorable patients on “a medical rounds of sorts,” we are then provided an in-depth look at the changing role of memory in old age.  The meaning and development of wisdom and how it is practiced by the elderly and caregivers are then discussed before moving into the final part of the book that explores “aging to the very frontiers of life.”

As the psychiatrist at one of the largest nursing homes in the country, located in Miami, Dr. Agronin tells the stories of his patients in a captivating way.  He looks past the ravages of old age and the results of traumatic experiences to discover the wisdom and meaning in their lives.

Twentieth-century theologian Abraham Heschel’s definition of wisdom is shared with readers as “more than an achievement of aging; it is as integral and essential to the aging process as walking is to the toddler, play is to the young child, and the pursuit of love and partnership is to the young adult.”  Dr. Agronin’s definition of meaning in the later stages of life “refers to both an intellectual and an emotional sense of rightness, harmony, and purpose.”  

These two tenets of his approach to caring for the elderly are evident in the patients we meet in How We Age, whose illnesses include dementia, Alzheimer’s, post-traumatic stress, alcoholism, and mental illness among others.  At the heart of the care plan is that they experience life with dignity rather than death with dignity during their remaining days, however long that may be.

Interestingly, what can sometimes be troublesome for a family is presented as an essential activity in old age.  Reminiscing by a loved one can be seen by the family as an inability to live in the present, choosing instead to dwell in the past.  However, Dr. Agronin believes the ultimate goal of reminiscence is “not to restore what has been lost but to experience gratitude that can come only with the realization that we never truly lose the gifts from the most important figures in our lives.”  While it is possible for this to also bring traumatic events to surface, that risk can be lessened when the listener shows genuine interest and caring for what the person is communicating.

I share Dr. Agronin’s belief that the doctor-patient relationship should be one of truth so that human dignity is preserved.  In the absence of presenting all the bad news at once, he describes “benevolent deception” as a series of partial truths leading toward the eventual disclosure of the whole truth.  This would seem to be a much kinder, gentler way to allow a patient the time necessary to digest what is currently happening to them and what is yet to come.  Even silence is put forth as a suitable expression of the truth in that what is not verbalized can hold deep meaning for a patient.

One in eight Americans, or 36.9 million people, were age 65 and over in the year 2009 according to the latest data available from the Department of Health and Human Services.  That number is expected to rise to almost 72.1 million by the year 2030, almost twice what it was in the year 2000. Dr. Agronin’s wonderfully written book, How We Age, can serve as a primer for families, friends, and healthcare providers.  Indeed, it should be required reading for anyone caring for those of advanced age to ensure an elderly person’s sense of purpose and integrity are not only maintained and encouraged, but also delighted in.

Although age may diminish or even take away completely our capacities for speech, mobility, and lucidity, it does not mean we also lose the life experiences and accomplishments that made us who we are.  Dr. Agronin is to be highly commended for authoring How We Age and bringing to light a new way of looking at the aging process and in caring for our elders with the same diligence and love with which they once cared for us.

How We Age:  A Doctor’s Journey into the Heart of Growing Old

Da Capo Press

320 pages


How We Age: A Doctor's Journey into the Heart of Growing Old

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Twila Klein

APA Reference
Klein, T. (2016). How We Age: A Doctor's Journey into the Heart of Growing Old. Psych Central. Retrieved on November 25, 2020, from
Scientifically Reviewed
Last updated: 17 May 2016
Last reviewed: By a member of our scientific advisory board on 17 May 2016
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