A new book seeks to dispel the notions that old age is all about agony, loneliness, non-productivity and dependency by guiding people how to embrace the inevitable advanced years with grace.

Dr Prasoon Chatterjee, a professor in the Geriatric medicine department at AIIMS, Delhi, offers navigational details from active adulthood to the final stage of life in "Health and Well Being in Late Life: Perspectives and Narratives from India". The book is replete with anecdotes which can be easily identified by any elderly or those having aged members in their family. One of the many interesting stories in the book is that of a beautiful relationship between an 80-year-old woman and her 45-year-old divorced daughter, who is helping her stay elegant and calm in her final stage of life. There are also inspiring stories about unsung heroes who despite physical and social challenges are making most of their lives and are actively participating in the society.

With 10 chapters, the book covers a plethora of facets of ageing ranging from forgetfulness, fall and frailty to constipation, cancer and stroke. Chatterjee also attempts to remove doubts that ageing is equivalent to the concept of 'sanyas' and tells tales where sexual health has direct relationship with wellbeing and quality of life. He narrates an episode involving a 76-year-old retired financial advisor to the government of India who during a visit to his OPD with lot of hesitation mustered the courage to declare that he was not satisfied with his sexual life. "During my childhood, I never saw my grandparents getting physically close to each other, and they were in their late 60s. I used to sleep with my grandfather, so I always deprived them of staying together."

"We take it for granted that the ageing is equivalent to the Vedic concept of sanyas, where the old man leaves the family and lives in the jungle and tries to unite with God, and even if they stay in the family, due to hormonal changes and social custom, they will not have any sexual relation with their partners," Chatterjee writes in his book. He stresses on the need for adopting a proactive approach to enquire and know more about sexual problems of older adults. Going a bit further, he talks about the transcendental nature of love and in a chapter titled 'Love Is Beyond Age', in which he narrates the story of an old-age home where widowed 64-year-old Meena and widower 60-year-old Prakash fall in love with each other and stay together overcoming social hindrances.

The book highlights the role of aspiration index personality, life lessons, spirituality, behavioural modification and lifelong learning as effective models of achieving active and graceful ageing. The author also advises doctors as well as caregivers when to treat and not to treat in late life. He has also dedicated an entire chapter to constipation, a problem most of the aged people face. In it, he tries to explain the link between ageing and constipation, stating bowel movement frequency decreases with aging because of reduced mobility, reduced fluid intake and dietary fiber, medical co-morbidities and related medications, all of which do impact colonic motility and transit".

Age-related decline in the external anal sphincter and pelvic muscle strength can contribute to difficulties in evacuation but were probably not the only cause, he writes and goes to explain that it is not necessary to clear the bowels every day and passing motion a day to three days in a week is normal. He also explains the relationship of 'emotion and motion' through real life examples and discourages the present day practice of 'try and see' concept with various laxative and bulk forming agents. In one of the chapters, Chatterjee elaborates on dementia, a clinically complex condition with low awareness and sensitisation in the society.

Ignorance often leads to indifference of caregivers and care providers because of the subjective complaints of forgetfulness by older adults, which are considered as a normal ageing phenomenon, he says, adding even if diagnosis is made, the situation remains grim.

In a patient's language, he writes, "Doctor, when I had prostate cancer, family members used to sympathise, but when they realised I had dementia, they began avoiding me and probably cursing me as I would be a fully dependent show piece of the family. The most unfortunate part being that even doctors choose to spend little time with me. He probably considered me useless and chose to invest his time in a more worthwhile undertaking. They still forget that I can appreciate their gesture, affection, ignorance and hatred."

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