OURSELVES, GROWING OLDER: Women Aging with Knowledge and Power By Paula Brown Doress, Diana Laskin Siegal And the Midlife and Older Women Book Project (in cooperation with the Boston Women's Health Book Collective) Touchstone/Simon and Schuster. 544 pp. $24.95; paperback, $15.95
IN 1971 the Boston Women's Health Book Collective published its first book, Our Bodies, Ourselves, and feminist health care was born. That book became a bible for the women's self-help clinics that sprouted around the country at the time, advocating self-examination, menstrual extraction and natural childbirth for reasons almost more political than medical. The result was a body of newly educated patients so "empowered" by their knowledge of the female anatomy, especially the reproductive anatomy, that some obstetricians and gynecologists actually changed their ways.
Now the Boston Women's Health Book Collective has discovered old age. "We can prolong our healthy, active years by paying attention to good nutrition, activity and movement, solitude and rest, good relationships, and our links to the communities in which we live and work," the group writes in Ourselves, Growing Older, which is about this last stage of life.
As with all the books produced by the collective -- Ourselves and Our Children; Our Jobs, Our Health; and The New Our Bodies, Ourselves -- Ourselves, Growing Older sees its subject in political terms. According to the 45 authors, aging is -- like birth control, like abortion, like parenting, like work -- a political event. Good politics leads to good aging, they write, and is in turn justification for staying healthy: "To keep involved and growing, we must recognize and fight ageism in all of its manifestations. We can deal with ageism more effectively if we have energy and strength."
A self-help book with a conscience, Ourselves, Growing Older carves a unique niche on the shelf now overflowing with advice on how to age gracefully. Grace isn't the point here; strength is, individuality is, feistiness is. The many voices of older women -- and some who, from my own 34-year-old perspective, seem not old at all -- give us a picture of how many different ways there are for women to be 50, or 60, or 70, or 80 years old.
This book includes not only the expected stuff -- a chapter on menopause, a chapter on sex, a chapter on osteoporosis (a condition associated with calcium loss that results in loss of bone mass) -- but also some nice surprises. There's a whole chapter on cosmetic surgery, for instance, whose basic point is that face lifts are a sign of oppression. "In the years before we learned to think of the signs of aging as 'unattractive,' " the authors write, "a wrinkled face was often the most loving and the most beloved face we knew." Yet when we start to look like our own adored grandmas, we struggle mightily to turn back the clock.
There's also a helpful chapter on alternative living arrangements, with advice on how to find help meeting housing costs -- through Section 8 subsidies, home equity conversions and the like -- and creating housing alternatives -- such as intergenerational group homes, congregate housing and adaptations in existing homes to meet an older person's changing needs.
One of the nicest surprises here is the chapter on urinary incontinence. Leave it to the collective to bring out into the open a subject long considered, by the millions of women who encounter it, too delicate and too embarrassing to discuss. As many as half of all women, they write, have a bladder control problem at some stage in their lives. And the older they are the more likely they are to face it, especially the form called urge incontinence, when the need to urinate comes on suddenly and powerfully. "We women will have to chart our own course to deal with this problem," the authors write, just as these same women have managed other "female troubles" unrecognized or untreated by the medical community. Then they go on to do exactly that, providing information about useful exercises (particularly Kegel exercises), dietary changes (particularly getting enough water and enough vitamin C) and, if all else fails, drugs or surgery.
EVEN IN THE expected chapters, like the one on osteoporosis, you can find bits of information rarely reported elsewhere. I never knew, for instance, that dried skim milk is very high in phosphorus, the compound that can deplete bones of needed calcium. "So if you add powdered milk to soups or casseroles for extra calcium," the authors write, "take care to cut out other unnecessary sources of phosphorus."
Sometimes the collective's politics can interfere with its good advice. For instance, in the section advocating weight training for women, the authors seem to get carried away with their own rhetoric. "Society has stereotyped women as soft, round, weak, and submissive," they write. "We can and must break that image. Our very health and survival depend on it." Building muscle is no doubt good for most women, especially as they age and risk losing bone mass, but it seems a bit extreme to imply that if we don't all start doing resistance exercises we will die.
In all, though, Ourselves, Growing Older is a wonderfully helpful book. It pleases me to think of all those women, the feminists of the '60s and '70s, graying and wrinkling and sagging and still wearing their Sisterhood is Powerful T-shirts. They will create for those of us who follow a new, powerful, committed model for the best way to grow old.
Robin Marantz Henig is a Washington medical writer whose books incluude "How a Woman Ages."