The book weaves the topics of growth, change, adaption, and resilience throughout chapters as key experiences of old age. Each connects to the other, as growth occurs through experiencing change, adapting to that change, and becoming resilient to change.

Pipher advocates for a “developmental perspective” in later life to stimulate growth. A developmental perspective is a psychological concept that emphasizes milestones throughout life stages, such as the development of specific skills in children and building relationships and purpose in adulthood. For Pipher, the developmental perspective in later life entails embracing opportunities for growth from the complex challenges that occur during this period.

One challenge older women face is dealing with changing bodies and ideas of attractiveness and sexuality as they age. Ava’s story illustrates how these changing bodies impact identity: Ava’s sexuality and beauty are key to her identity, and when that self-perception changed after being called a “senior citizen,” she struggled with the loss of this identity, which required her to adapt to a new self-concept.

For older women, loss often involves the loss of loved ones or abilities; however, death, health problems, and loss converge to provide growth opportunities. Pipher explains, “For us to survive loss, we must grow, and it is this growth that will propel us into a life of even greater meaning and gratitude” (83).