Joosten's tense novel Berlin Syndrome (2011) is distinctive for, amongst other things, its restrained but potent prose. A Long Time Coming stakes out different territory, and yet Joosten's distinctive writerly ability – somehow, she is subtle and subtle as a sledgehammer – is on frequent display. She invites readers to reconsider how we understand and fret about the ageing process – in ourselves and, especially, in others. Anchoring this discussion is the political and social reality of Australia's ageing demographic, which in turn sits in juxtaposition with what Joosten calls 'our youth-loving culture'. As Joosten convincingly puts it, 'Too often, older people are considered as a homogeneous mass – old, first and foremost, and therefore lacking distinctiveness.'

The eight essays, some of which have been previously published, cover a discursive but related set of topics, ranging from a visit to a nursing home in the Tiwi Islands, to feminism and ageing, to poverty experienced by older people, to dementia in fiction, and more. Frequently, Joosten employs a combination of interviews, learned commentary (she is a trained social worker and she works at the National Ageing Research Institute), and memoir, resulting in an intelligent but not stuffy writing voice that self-consciously focuses on the present and the future rather than taking convenient refuge in the past.

This mixed-medium approach to storytelling works best in the superb final essay, 'As Long as Life Endures'. Anchored around Joosten's visits to a woman called Betty, who lives in a nursing home, it meditates on loneliness, empathy, frustration, companionship, death, and a great deal more. Joosten is a participant in the action as well as an observer and interpreter. The story of the relationship she develops with Betty is frank, graceful and, at times, unnerving in its honesty. At one point, Joosten wonders if Betty is merely tolerating her visits. Another time, she asks Betty what she'll be having for dinner. Betty replies, 'Sandwiches, probably. Or a pasty. It's all so ... soft.'

None of the other essays matches this high point. Still, each of them contains insightful passages, whether it is Joosten's critical analysis of both positive-ageing campaigns and the anti-ageing industry, her discussion of family violence and sexual assaults directed at older people, her observations about the aged-care workforce, or her deeply thoughtful examination of the way society perceives dementia. The essay 'Invisible Women' includes an absorbing discussion of photographer Ella Dreyfus's exhibition Age and Consent (1999), which features images of elderly women's torsos (Joosten's original essay, in the autumn 2015 issue of literary magazine Meanjin, benefited from the inclusion of several of Dreyfus's images). Joosten considers the possible objectification of the subjects, while maintaining that the photographs 'are a quiet celebration of older women's bodies, refreshingly arresting depictions that both honour and discard the cliché of the female nude'.

Melanie JoostenAt times, the mix of interviews, memoir, and analysis doesn't quite gel. With such a delicate balance in play, Joosten sometimes misses opportunities to dwell in more depth on such things as government policies, funding models, reports about ageing, and the practices of accreditation bodies. Periodically, too, she questions her own limited knowledge or perceptions. At times, this seems apt, but at other times it sits awkwardly in the context of Joosten's knowledge, relentless inquisitiveness, political combativeness, and, not least, capacity to ask pertinent questions.

Self-questioning turns to self-judging in the essay 'Notes on Writing and Doing Good', in which Joosten reflects on being a writer as opposed to being a social worker. In isolation, this essay is a purposeful exegesis in which Joosten asks valid questions about the importance of action beyond thinking and creating. But the essay also sits awkwardly here, disrupting the book's cohesion. It resonates more powerfully in its first place of publication, the autumn 2012 issue of Meanjin.

Still, 'Notes on Writing and Doing Good' helps makes clear that it is Joosten's attention to the detail of language that animates A Long Time Coming. This sometimes manifests in her critical examination of phrases that slip into everyday use, such as 'active ageing', 'positive ageing', or 'person-centred care', the latter of which she calls 'a rude tautology that robs every individual of their selfhood'. It also manifests in the quality of Joosten's own phrase-making: 'Neville's conversation is a polite tugboat, ploughing resolutely through the choppy waters of my questions.' And not least, it manifests in the questions Joosten asks interviewees, and the responses she elicits. At one point, a seventy-nine-year-old woman called Anne tells Joosten, 'I mean, it's very irritating being invisible, but I'm very confident about making myself visible by using my voice, and I enjoy working with other people to make that happen.'

As a provocation, A Long Time Coming is reasoned and impassioned in roughly equal measure. Joosten calls for a fundamental recalibration of the way Australians think about growing old, and the way we expect and imagine the elderly will and should live.