Having found O'Nan's "Snow Angels" a bit grim, but well-written, and" Last Night at the Lobster" equally well-written, and not nearly as sad as I'd feared, I spent a credit on this book ... which is very well-written, and not at all grim. Like "Lobster", it's character-driven; however, in a full-length novel (the other was a novella) that's tougher to pull off. Listening to the audio may have contributed as the short chapters (more or less) ran together, whereas a print book would've seemed less daunting (for lack of a better term).
Having lived a roughly parallel life to Emily's kids, I can vouch that O'Nan completely nailed the character aspect, although the isolation of Emily (and her sister-in-law) seemed a bit overdone to me. It may seem incongruous, but it is accurate that someone who buys a new car in cash would make a point of remembering to bring a restaurant coupon for a couple of bucks off.
There's almost no tension in the novel, except for a bit between Emily and her daughter, and daughter-in-law; the latter almost entirely "off screen" filtered from Emily's point-of-view, leading to me wonder whether that had been covered already in the previous book "Wish You Were Here". Instead, those chapters consist of Emily's reactions to various situations: new neighbors taking the place of the last other "old guard" resident (my folks were about the last to go in their neighborhood after 35 years), Election Day (she votes for McCain, unenthusiastically), etc. One vignette has her attending the funeral of an old friend, who's survived by a same sex partner - Emily is pleased to note that the woman's (biological) family accords her "widow" status. Later, she expresses disappointment that she hasn't gotten to meet her granddaughter's partner (they live in Boston). Demographically, seniors may be the strongest group opposed to gays, but O'Nan has made it clear that educated WASP's are an exception. One episode I didn't care for was Emily's refusal to try a product recommended by her cleaning lady for dealing with car scratches, with its class-conscious dismissal; instead she moans about paying $500 to the dealership. She also sneers at the woman's "Butler" accent.
The lack of action is at least partially compensated for by the author's sense of place. I've never been to Pittsburgh, but came away seeing the area clearly - and I'm not that "visual" a reader. Granted, he does get carried away at times: it wasn't really necessary to go through all the choices on the salad bar at the (coupon) restaurant in an early episode.
So - would I recommend the book? Yes, if one bears in mind that each chapter is a small part of a larger whole, that doesn't really contain a traditional story arc. If you're new to O'Nan, however, I'd go with Lobster first.
Audio narration itself was overall good, although at times it seemed even Ms. Gallo was overcome by the task of maintaining interest in quite mundane matters.